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COVID-19: Where’s the Evidence on COVID-19 Treatment?

April 29, 2020

The American Medical Association and many other professional organizations demand “peer-reviewed science” before they will recommend or even accept the re-purposing of a long-established anti-malaria drug to treat or prevent COVID-19.

The American Medical Association and many other professional organizations demand “peer-reviewed science” before they will recommend or even accept the re-purposing of a long-established anti-malaria drug to treat or prevent COVID-19. In Arizona, use of hydroxychloroquine (HCQ) for prophylaxis in medical workers is “strictly forbidden” by Executive Order of Gov. Doug Ducey unless peer-reviewed evidence becomes available. In all but four states, prescribing or dispensing HCQ for COVID-19 is restricted.

We have known about COVID-19 for about four months; it can take years to plan, complete, and publish a randomized, double-blind controlled study. However, in 2005, the CDC Special Pathogens Branch described three mechanisms by which chloroquine might work and have both a prophylactic and therapeutic role in coronavirus infections. More than 20 relevant studies have been published in journals indexed in PubMed between Jan 28 and April 20, 2020.

AAPS concludes that: “the safety of Hydroxychloroquine is well documented. When the safe use of this drug is projected against its apparent effect of decreasing the progression of early cases to ventilator use, it is difficult to understand the reluctance of the authorities in charge of U.S. pandemic management to recommend its use in early COVID-19 cases.”

Additionally, AAPS is compiling observational results reported from China, France, South Korea, Algeria, and the U.S. Of 2,333 patients treated with HCQ, 2,137 or 91.6 percent improved clinically. There were 63 deaths, all but 11 in a single retrospective report from the Veterans Administration where the patients were severely ill.

Apr 27 data show that U.S. COVID-19 death rates are at least eight times higher than in countries with early and prophylactic use of HCQ.

Country

# of cases

      # of deaths

      Deaths/million

      Use of HCQ

India

27,890

881

0.6

      Early and prophylactic

Costa Rica

695

6

1.0

      Early and prophylactic

Australia

6,716

83

3.0

      Early and prophylactic

South Korea

10,728

242

5.0

      Early and prophylactic

Brazil

62,859

4,271

20.0

      Early and prophylactic

Israel

15,443

201

23.0

Early, some prophylactic use

U.S.

987,160

55,413

167.0

Late, in hospitalized patients

Opinion leaders should be demanding to know why this treatment option is not widely discussed or might even be forbidden.

For further information, see the May issue of AAPS News and our compendium of Corona Virus Articles.

Contact jane@aapsonline.org or (520) 323-3110. I would be happy to discuss these issues with you.

Article Tags
Health Care
Author
Jane M. Orient, M.D. is executive director of the Association of American Physicians and Surgeons and president of Doctors for Disaster Preparedness.
janeorientmd@gmail.com @jorient