The scientific process is slow and methodical, not ideal amid a frenzied pandemic. Health care professionals take an oath to do no harm; they need to be careful and precise, and their interventions must be evidence-based.
When President Trump impatiently promoted hydroxychloroquine, HCQ, for treatment of COVID-19 before it had been thoroughly tested, many scientists cringed about what could happen. Sadly, their fears came true.
The drug was distributed with no directives or safety monitoring; consequently, many patients too sick to benefit got the drug and suffered complications. On April 30, the Food and Drug Administration warned HCQ should not be used outside of a randomized trial or inpatient hospitalization with strict safety monitoring. Many doctors continued to give the drug.
Did they not know about the well-publicized warning? Did they decide to listen to Trump over medical experts? Or did they continue out of desperation to help patients with few other options? Unfortunately, some patients died. Whether HCQ killed them or they would have died anyway because of COVID-19 is unknown outside of a randomized trial. It appears in the court of public opinion, HCQ was the killer.
A multi-centered group of scientists are now conducting two randomized trials of HCQ with careful safety monitoring. Few people are enrolling in the study responding that HCQ doesn’t work or is too dangerous. How can anyone know with no published randomized trials? There are over six decades of safety information on this drug used for other illnesses such as lupus, rheumatoid arthritis and malaria and there has been little safety monitoring with the mass distribution of the drug for COVID-19.
Most scientists agree it should not be given to very sick hospitalized patients or those with pre-existing heart conditions. But there has been compelling evidence in animal models that it can prevent infection and slow replication in early disease and most COVID-19 transmission happens among people who have few or no symptoms. The only way to know if it works in humans is to conduct randomized trials, the gold standard for drug testing.
Negativity against HCQ may have been shaped by the media’s biased reporting against the drug. Was that reporting fueled by disdain of the president and a desire to prove him wrong? His handling of the press and the epidemic has been controversial.
Sadly, the scientific process has now been infiltrated with politics and disinformation. We may never know if the HCQ works unless the public decides it won’t be manipulated by political agendas. We need the answer to this question quickly so we have some ways to prevent and treat COVID-19 and get back to normal as soon as possible.
PATTY KISSINGER, Ph.D
Three medical doctors also signed this letter.