Hydroxychloroquine: great for malaria, not covid

stops covid virus in vitro (in a glass) but not in vivo (in the body)

wasn't given to Trump when he got very sick from covid, he got real medicines instead

The 2011 movie "Contagion" is a relatively accurate depiction of a potential pandemic. Unlike most Hollywood productions, the filmmakers had virologists and other medical experts help shape the narrative to keep the script as realistic as possible. (One of those experts, Dr. Larry Brilliant, is quoted below.) In the story, there is an unscrupulous blogger who markets forsythia extract, a fake cure for the disease, to make millions for himself. For the real pandemic, an analogy for forsythia is hydroxychloroquine (with or without zinc and azithromycin).

Hydroxychloroquine is a drug that has been used for decades. It is helpful for a few conditions but not something one would want to take otherwise due to side effects. There were a few scientists at the start of the coronavirus pandemic who thought HCQ had potential for treating covid-19 disease -- at a time when the medical community was unsure what, if anything, would work and were trying many approaches. In theory, in vitro, HCQ (with or without zinc and other things) seemed to make sense, but in the real world, in vivo, it is a dead end. Here are a few summaries that describe its ineffectiveness.

Note that discrediting this drug is sometimes portrayed as political disagreement with Donald Trump, instead of a scientific examination of a claim that is without merit. Whether this or any other treatment is effective or not has nothing to do with what comes out of Trump's mouth. But it is not a coincidence that the biggest political stunt for hydroxychloroquine in the summer of 2020 came from a press conference organized by Breitbart, a far right wing auxiliary to the Trump administration. That event made news notably for its inclusion of Dr. Stella Emnanuel, who claimed to have cured 350 people with HCQ but also believes that DNA from extraterrestrials are used in medical procedures and is concerned about intercourse with demons. Such lunacy by itself does not mean that HCQ is worthless for covid disease, but it suggests extreme caution is needed, to be polite.

It is worth remembering that Trump was not given Hydroxychloroquine or Ivermectin when got sick enough with Covid (October 2020) that he was rushed to Walter Reed hospital. Instead he got monoclonal antibodies, which were then so experimental that only about 200 others had been given it, it did not even have Emergency Use Authorization from the FDA. Trump also got remdesivir (now considered an evil drug in anti-vax world) and the steroid dexamethasone. Naysayers have questioned this observation, saying it's hard to believe anything about what Trump did or did not get. However, Trump didn't even claim to have gotten it after boasting for a half year about how wonderful it is.

Some HCQ supporters make an economic claim for it, not a medical argument. They say that since HCQ is relatively cheap big pharmaceutical corporations downplay it so their expensive treatments can be prescribed instead. This is tempting to believe for those of us who do not like profiteering, but if the rhetoric is ignored one can see this means nothing about its efficacy or lack thereof.

The first drug approved in the US to treat covid patients was remdesivir, an anti-viral originally developed to treat Ebola. Remdesivir was not effective against that, but when SARS-CoV-2 started spreading its manufacture looked at its potential for this. The first US patient treated for covid-19 was a 35 year old man in Washington State who had been in China and brought the virus back with him. He went to the hospital and his lungs started to fail. He was given Remdesivir on a compassionate use basis and his health started to improve immediately, and was discharged from the hospital not long afterwards. One patient is not proof, but it did make waves as a potential solution. Subsequent studies suggest it has some mild improvements for severely sick patients already in the hospital (it is administered intravenously, it's not a pill). It's far from a cure, unfortunately, mostly shortening the duration of hospitalization.

A more recent study of HCQ at the Ford hospital system in Michigan claimed success for its use. When Dr. Fauci was asked about this by Senator Rand Paul (R-Kentucky), he replied that the study did not prove that since patients were also given steroids - which seem to have more success than HCQ.

Dr. Larry Brilliant

Dr. Larry Brilliant was a participant in the decade long successful eradication of smallpox in the 1970s. This was one of the greatest achievements of the 20th century. The campaign cost about a quarter billion dollars, roughly the cost of a single B-1 bomber. Health care not warfare!

https://grabien.com/story.php?id=285583

Dr. Larry Brilliant: 'Malaria I Had Was Less Troublesome than the Hydroxychloroquine,' It's a 'Brutal Medicine'
'It doesn't work with Covid-19'

BRILLIANT: "I have personal experience. I lived in India and had malaria four times. I was treated with hydroxychloroquine. It's a brutal disease. That's a brutal medicine. The malaria I had was less troublesome than the hydroxychloroquine. I have to say it saves a lot of lives. With malaria. It doesn't work with covid-19. The idea of promoting it over and over again has caused the drugstores to dry up. They don't have hydroxychloroquine in store. People with lupus and other diseases when really need it and for which it is the proper prescription, can't get it now. Once again I think that we have to be careful what we say."

https://twitter.com/twhitfill/status/1288825416975708161

Travis Whitfill MPH
@twhitfill

A quick visual aid of major studies & levels of evidence against #hydroxychloroquine for the use in COVID-19 patients.

No robust studies have found any type of benefit for HCQ regarding covid.

[note: the "Henry Ford" study that claimed to show a positive benefit of taking HCQ gave both groups (drug and placebo) the steroid dexamethasone, which does have documented effectiveness against covid disease. Dr. Fauci made this point when testifying in front of Senator Rand Paul, who was touting the drug, because of course he does that sort of thing.]

https://twitter.com/Tsarorius/status/1252605614993412096

This Week in Virology podcast

This Week in Virology has the best mention why  hydroxychloroquine is not relevant to Covid-19 disease

www.microbe.tv/twiv/twiv-658/
TWiV 658: Everyone needs a H.E.A.R.T.

skip ahead to 2:08 (two hours, 8 min.)

H.E.A.R.T. stands for home everyday antigen rapid test.  Their  discussion of that is more interesting than the dead horse of hydroxychloroquine.

Dr. David Gorski, Respectful Insolence

https://respectfulinsolence.com/2020/07/29/hydroxychloroquine-the-black-knight-of-treatments-for-covid-19/

Hydroxychloroquine: The Black Knight of treatments for COVID-19