by Steve Golden —
As the COVID-19 vaccination campaign gets underway in the US (more on the vaccine in a future post!), some people have raised questions about why there wasn’t a focus on early treatment of the virus. Patients who tested positive are told to go home and isolate unless their symptoms become severe enough to seek treatment. For a virus that’s so deadly the world shut down entire societies, it’s odd that there has not been a more concerted effort to offer early, outpatient treatments to positive patients.
Dr. Mark Steffen, an MD and Kansas senator-elect from Reno County, said recently,
“Never before have we said ‘stay home until you’re about to die and then we’ll take care of you’, . . . We don’t say with breast cancer, you’re at stage one, come back and we’ll help you fight it when you get to stage four.”
My goal with this series is to provide readers with information about the COVID-19 pandemic that’s not being widely reported. But don’t take my word for it—follow the links and do your own research—and then share this with others who want a different perspective. (Check out Part 1 and Part 2 of the series.)
Early Treatment of COVID-19—What About Hydroxychloroquine?
- The Sentinel reported on December 8, 2020, that Kansas doctors are concerned that public health officials have ignored early treatment of COVID-19, particularly hydroxychloroquine (HCQ) and nebulized steroids.
- Dr. Harvey Risch, an MD and professor of epidemiology at Yale, raised the same concern at a U.S. senate committee meeting in November, stating “Our government research institutions have spent billions of dollars on expensive patent medications and vaccine development and almost nothing in outpatient treatments, the first line of defense.”
- In the same Sentinel piece, Dr. Mark Steffen, shared alarming news about one potential treatment: “And (Kansas officials) shut down the use of a nebulized steroid on this nonsensical theory that to use a nebulizer would just spread the virus. . . . They’re screaming that the sky is falling and they’re shutting down treatments based on theory.”
- Expensive treatments like remdesivir (over $3000 per dose), which have low effectiveness, are preferred and drive up hospital capacity numbers: “According to Steffen, the only approved COVID treatments require doctors to send sick patients home to wait to get better or get worse. To prescribe FDA-approved treatments for COVID, like Remdesivir and monoclonal antibody treatments like Regeneron, patients must be hospitalized.”
- Hydroxychloroquine was promoted by President Trump and given an emergency use authorization for COVID treatment early in the pandemic. Once it became a political football (like most things related to COVID), it fell out of favor with health officials and the emergency use authorization was revoked in June.
- In an unprecedented move, states across the nation began to regulate why and when physicians could prescribe HCQ. Non-medical professionals like state governors and non-providers like pharmacists were inserted into the doctor-patient relationship.
- The Kansas Board of Pharmacy published a new recommendation that pharmacists start contacting physicians to verify why HCQ is being prescribed, and many pharmacies now deny patients the medication if the diagnosis is COVID-19.
- It’s well established in studies that HCQ does not help patients in the later stages of COVID-19. However, as Dr. Risch has noted, studies of hospitalized patients should not be used to dictate outpatient treatment options. It’s sloppy science. Yet that’s what is happening.
- The Federalist wrote in August 2020 that there were 53 studies at that time showing positive outcomes in patients treated with HCQ, but the media had not reported on them.
- What the media did report on were flawed studies, such as a study on VA patients that used HCQ late in the disease course, or a Brazilian study using chloroquine (a drug related to HCQ) where 11 patients died—but the media failed to mention that the doctors were giving their patients lethal doses of chloroquine.
- The Federalist points out that other nations were using HCQ with success, but stopped briefly when the WHO withdrew its support for the drug over a now-debunked study in The Lancet. In Switzerland, the COVID-19 fatality rate increased four-fold during the period when HCQ was banned. Once HCQ was reinstated, the fatality rate dropped to its original level.
- Is HCQ safe? The short answer is yes. Every drug has possible side effects, but HCQ has been available and prescribed for nearly 70 years. It’s cheap and major side effects are rare.
- Dr. Simone Gold, the founder of America’s Frontline Doctors and a promoter of HCQ treatment, has written a white paper detailing the drug’s safety and effectiveness.
- The CDC has published an information sheet on HCQ for malaria treatment. Under the safety section, the CDC states the following:
- “Hydroxychloroquine is a relatively well tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. These side effects can often be lessened by taking hydroxychloroquine with food. Hydroxychloroquine may also cause itching in some people. All medicines may have some side effects. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug.”
- One of the largest studies on HCQ and potential cardiac side effects determined that “Short-term hydroxychloroquine treatment is safe.” The study only found concerns when HCQ was combined with azithromycin—a common combination treatment for COVID-19 when a doctor is willing to prescribe it.
- However, the American Heart Association reported in April 2020 that a new study showed “no instances” of a potentially deadly heart rhythm known as Torsades de pointes in patients taking HCQ alone or HCQ + azithromycin. They concluded, “Although use of these medications resulted in QT prolongation, clinicians seldomly needed to discontinue therapy.”
- Is HCQ effective? Yes, it is, for early, outpatient treatment of COVID-19 (i.e., your family doctor would prescribe it for early symptoms, the same way Tamiflu is prescribed).
- A 2005 study in Virology Journal found that chloroquine (a drug related to HCQ) was “effective in preventing the spread of SARS CoV in cell culture.” SARS-CoV-1 is the name for the SARS virus; SARS-CoV-2 is the name for COVID-19. This study was limited to animal testing, but since the viruses are directly related, some physicians believe HCQ will be effective for COVID-19 prevention/treatment.
- Again, Dr. Simone Gold, the founder of America’s Frontline Doctors and a promoter of HCQ treatment, has written a white paper detailing the drug’s effectiveness. She discusses a multitude of worldwide evidence.
- Dr. Risch discusses the evidence for HCQ use in outpatient settings in the American Journal of Epidemology.
- Dr. Risch offers a similar discussion that’s easier to read in Newsweek, where he concludes, “the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.”
- Whether or not direct evidence exists that HCQ is effective in treating early COVID-19 (versus the anecdotal evidence of physicians who are trying it), physicians have always had the ability to prescribe a drug for off-label uses. The fact that they are being prevented from doing that now demonstrates that politicians and public health officials are less concerned about saving lives than they are about winning political wars.
Are You Interested in Getting an HCQ Prescription?
- America’s Frontline Doctors has three different prescribing protocols available that you can show your doctor if he or she is willing to prescribe HCQ.
- If your doctor isn’t willing to prescribe HCQ, you can visit America’s Frontline Doctors’ Speak with an MD site to have a telemedicine visit with a doctor who will prescribe HCQ.
- They also offer a handy map of the US that will show you how easy or hard it is to get HCQ in your state or neighboring states.
The short version: Most of the studies of HCQ use in COVID-19 patients have been on severely ill, hospitalized patients, and HCQ is ineffective in those settings. Physicians have seen good results in outpatient treatment of early COVID-19 with HCQ, but state governments are now trying to regulate the practice of medicine by preventing doctors from prescribing the drug.