Health officials across the world are issuing warnings over the use of antimalarial drugs after President Trump’s comments about treating the coronavirus with them sparked panic-buying and overdoses.
In recent days, thousands of consumers across Africa and South Asia rushed to stockpile chloroquine and hydroxychloroquine, drugs that are usually used to combat malaria, vacuuming up supplies in cities in the developing world, sending prices skyrocketing and prompting panicked warnings from local authorities.
I don’t know what to say about this. It’s just appalling.
Here’s the latest on the various trials of these drugs for possible treatment:
Three months into the novel coronavirus pandemic, it’s still unclear which drugs could combat the viral disease and which won’t — despite public figures like President Donald Trump extolling the unproven promise of some medications. With public health on the line, the scientific community is searching for answers faster than ever.
When the novel coronavirus tore through China in January and February, researchers and doctors quickly launched dozens of clinical trials to test existing medications against COVID-19, the disease caused by the novel coronavirus. But the research done so far in China hasn’t generated enough data for conclusive answers.
“We commend the researchers around the world who have come together to systemically evaluate experimental therapeutics,” said Tedros Adhanom, director-general of the World Health Organization (WHO), in a press briefing. “Multiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives.”
In their fight for “clear, strong evidence,” the WHO is launching a multicountry clinical trial to test four drug regimens as COIVD-19 therapies: an experimental antiviral drug called remdesivir, the antimalarial drug chloroquine (or the related hydroxychloroquine), a combination of two HIV drugs, and those same two HIV drugs along with the anti-inflammatory interferon beta.
The trial will be flexible and could add or drop additional treatment approaches or locations over time. In that way, it appears to be similar to the adaptive trial that the National Institute of Allergy and Infectious Diseases started in the US in February, which initially set out to test remdesivir but could expand to other drugs. The US is not currently involved in the WHO trial.
Hundreds of other clinical trials are underway, and other groups also continue to test the medications that the WHO selected — here’s a breakdown of some of the drugs that researchers are zeroing in on.
Studies found that hydroxychloroquine and the related chloroquine can stop the novel coronavirus from infecting in cells in the lab, and anecdotal evidence suggests that it may help patients with COVID-19. Because the drug has been around for decades as an antimalarial treatment, scientists have experience with it.
“It’s a known medicine,” says Caleb Skipper, an infectious disease postdoctoral fellow at the University of Minnesota who’s working on a smaller trial of the drug. “Little blips of lab data over the last several years show this drug has activity against viruses.”
Skipper’strial is looking to see if hydroxychloroquine can prevent people who are exposed to the virus from developing severe disease. They’re hoping to recruit health care workers, who are at a high risk of exposure to the virus, to participate in the trial.
The goal, Skipper says, is to get the drug in people’s systems early. “Particularly with viruses, the earlier you inhibit their ability to replicate the better off you’re going to be. If a drug is going to work, it is more likely to work early on in disease,” he says. “If you catch someone really early and provide treatment early virus will have replicated a lot less.”
The existing evidence on hydroxychloroquine points in the right direction, Skipper says, but all of the research on the drug is still in very early stages. “It’s a long ways from being proven effective,” he says.
Despite the limited evidence available, public figures, including Elon Musk and Trump, are pushing the message that hydroxychloroquine and chloroquine are the solutions to the outbreaks. “I feel good about it. That’s all it is, just a feeling, you know, smart guy. I feel good about it,” Trump said in a press conference on Friday.
As a result of the hype, demand for the drug has spiked, and manufacturers are increasing production. In Nigeria, two people overdosed on the medication after Trump said it could cure COVID-19. People who take it for other conditions, like lupus, are struggling to access their usual supply.
To be very clear, there is still no conclusive evidence that chloroquine will treat COVID-19. And treatments that appear promising based on anecdotal reports or “feelings” often don’t end up working, which scientists know well: the majority of clinical trials fail, and they’re seeing that reinforced in coronavirus treatment efforts.
They have got to shut him up about this. He’s been a disaster at containing and mitigating the virus, but now he’s actively making people who don’t have the virus sick by talking up unproven therapies for COVID-10 that people with other diseases need.