Given that it has been touted by right wing populist
politicians, was there a conspiracy supporting the far right's "undying trust" of the
anti-malarial drug hydroxychloroquine in treating COVID 19?
By: Ringo Bones
Brazilian strongman President Jair Bolsonaro recently used
it after recently registering positive for COVID 19 and US President Donald
Trump and his far right inner circle – like former NY City Mayor Rudi Giuliani
– had been promoting it as an effective cure for the coronavirus. Originally
for malaria and lupus, hydroxychloroquine was originally shortlisted by the
Solidarity Trial – an international clinical trial launched by the WHO and
other partners to help find an effective treatment for COVID 19. It was hoped
that one or more treatments under trial, including hydroxychloroquine, will
result in improving clinical outcomes in COVID 19 patients and save lives. But
hydroxychloroquine trials were eventually stopped as of June 17, 2020 as
evidence showed it did not result in the reduction of mortality of hospitalized
COVID 19 patients when compared with standard care. Given that it has been
proven to do nothing against COVID 19, why is it that some people – especially those
in the far right populist wing – still insist that hydroxychloroquine is the
only effective cure against COVID 19?
Conspiracy theories tend to be grounded in unusual
coincidences or misunderstood science and they use highly emotional language to
appeal to others. In a time when public mistrust is at an all-time low, it is
important to counter false information with clear, high-quality evidence. Although
not a conspiracy theory, the hype around hydroychloroquine started in March 14,
2020 when a Google Word document was circulated on Twitter touting the
potential use of repurposing the old anti-malaria drug hydroxychloroquine as a
possible COVID 19 cure. The document claimed to be written in consultation with
prestigious medical schools and scientific institutions and by March 16 it had
gone viral on Twitter. Unfortunately, it was only realized much later that the
author of the document was actually a blockchain investor, who had inaccurately
claimed to write it in consultation with medical schools and scientists.
The global hype around hydroxychloroquine had already been
set in motion before the first clinical study testing it on COVID 19 patients
was even published on March 17, 2020 with the study only finding a 50-percent
improvement in the extremely small sample size of 14 patients with COVID 19
taking hydroxychloroquine alone. These authors have now been criticized for not
randomly assigning patients to treatment groups, their small sample size and
lack of a control group to compare with the treatment group with, meaning that
the positive results could easily have occurred by chance.
However, by March 19, 2020 – US President Donald Trump, in
conjunction with former NYC Mayor Rudi Giuliani, were promoting the potential
of the drug at press conferences, incorrectly stating it had already been approved
by the US Food and Drug Administration (FDA) to treat the COVID 19 virus. The
FDA then had to release a statement cautioning people against using the drug
off label. Later, when President Trump stated that he was taking a two week
course of hydroxychloroquine, despite any evidence showing it could prevent
COVID 19, there was widespread concern from healthcare professionals about the
dangerous example this could set. A recent study confirmed a huge surge in
hydroxychloroquine and chloroquine prescription fills – likely due to off label
prescriptions for COVID 19.
Since then, hospitals now have to deal with the additional
burden of treating people poisoning themselves after taking the drug, with one
man fatally poisoning himself with a fish tank cleaning additive made with the
same active ingredient as chloroquine. The bias towards this drug is even
derailing clinical trials of other closely related COVID 19 treatment regimens.
While studies done within cell dishes in labs show that both hydroxychloroquine
and chloroquine can inhibit the virus, as with any medicine while studies in
humans tend to be much more inconsistent. The largest study of the drug was
published in The Lancet on May 22, 2020 stating that the drug increased the
risk of death in hospitalized COVID 19 patients. This paper has now been
famously retracted because of serious concerns about the verification of the
data sources, study design and analysis used. While the verdict on
hydroxychloroquine is far from clear, now is not the time for anyone to be
taking this drug off label.
