Hydroxychloroquine as a cure for COVID-19 as been causing serious debate in the health sector, where lies the truth?
HSENations recalls that Dr Stella Immanuel on Monday brought Hydroxychloroquine into public arena, claiming she had used it, along with Zinc and Azithromycyin, to great effect, to treat 350 COVID-19 patients despite the World Health Organisation withdrew the recommendation following some scientific studies that discredited the drug and also pointed out some fatal side effects.
Reacting to Dr Stella Immanuel’s claims, Anthony Fauci, a member of the White House coronavirus task force and the nation’s top infectious disease expert, again stated, in light of the Immanuel video, that the drug is not effective in treating COVID-19.
Fauci disclosed on Wednesday that scientific evidence has shown “consistently that hydroxychloroquine is not effective in the treatment of coronavirus disease, or COVID-19.”
But days before Immanuel’s impassioned speech in Washington, Harvey A. Risch, Professor of Epidemiology, Yale School of Public Health in a now viral Newsweek article, published 23 July, canvassed for the use of the drug to treat COVID-19.
“The key to defeating COVID-19 already exists. We need to start using it”, said the title of the article.
But he warns that the drug is effective when used early on afflicted patients.
Yale University has not denounced his position. On Wednesday, Sten H. Vermund, Dean and Anna M.R. Lauder Professor of Public Health; Professor of Pediatrics, Yale School of Medicine said Risch position falls within the realm of academic freedom.
Vermund in the press release said: As Dean of the Yale School of Public Health where Dr. Risch is employed, I have championed maintaining open academic discourse, including what some may view as unpopular voices.
“The tradition of academia is that faculty may do research, interpret their work, and disseminate their findings. If persons disagree with Dr. Risch’s review of the literature, it would be advisable to disseminate the alternative scientific interpretations, perhaps through letters or other publications with alternative viewpoints to the American Journal of Epidemiology, Newsweek, or other outlets.
“My role as Dean is not to suppress the work of the faculty, but rather, to support the academic freedom of our faculty, whether it is in the mainstream of thinking or is contrarian”.
Vermund further attested to Risch’s scholarly pedigree and the fact that the controversial drug was applied in the early days of COVID-19 in America.
“Dr. Harvey Risch is a distinguished cancer epidemiologist who has opined on the topic of hydroxychloroquine (HCQ) and COVID-19 out-patient therapy.
“He has written a review article in the American Journal of Epidemiology that cites evidence that he believes supports HCQ use for out-patient infection with SARS-CoV-2.
“Studies that indicate no effect or harmful effects, Dr. Risch believes, enrolled patients too sick to benefit from HCQ.
“Yale-affiliated physicians used HCQ early in the response to COVID-19, but it is only used rarely at present due to evidence that it is ineffective and potentially risky,” Vermund said.
Also, a medical expert based in Nigeria identified as Austine Ezeka emphasized that “Dr Stella Immanuel didn’t lie. It’s just a perspective”.
“Hydroxychloroquine is a great drug and it’s working. It’s just that the big pharma want to sell their vaccine and any cheaper alternatives is dangerous to their profit and they can use any means including government agencies to rubbish it.”
Why has hydroxychloroquine been disregarded?
First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.
Second, 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.
In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.
Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.
But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.
In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points. For the sake of high-risk patients, for the sake of our parents and grandparents, for the sake of the unemployed, for our economy and for our polity, especially those disproportionally affected, we must start treating immediately.
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