Hydroxychloroquine

When Donald Trump mentioned that the drug hydroxychloroquine coupled with azithromycin might be a major mode of treatment for COVID-19—available right now, the Trump Derangement Syndrome crowd went into overdrive to criticize him for even mentioning the treatment. Giving god-like credence to Dr. Anthony Fauci's qualifying comments, they suggested that the drug wouldn't work and that suggesting that it would was irresponsible. They even alleged that it could kill people. As usual, they were wrong—very, very wrong.

Jeff Colyer and Daniel Hinthorn report:

A flash of potential good news from the front lines of the coronavirus pandemic: A treatment is showing promise. Doctors in France, South Korea and the U.S. are using an antimalarial drug known as hydroxychloroquine with success. We are physicians treating patients with Covid-19, and the therapy appears to be making a difference. It isn’t a silver bullet, but if deployed quickly and strategically the drug could potentially help bend the pandemic’s “hockey stick” curve.

Hydroxychloroquine is a common generic drug used to treat lupus, arthritis and malaria. The medication, whose brand name is Plaquenil, is relatively safe, with the main side effect being stomach irritation, though it can cause echocardiogram and vision changes. In 2005, a Centers for Disease Control and Prevention study showed that chloroquine, an analogue, could block a virus from penetrating a cell if administered before exposure. If tissue had already been infected, the drug inhibited the virus.

On March 9 a team of researchers in China published results showing hydroxychloroquine was effective against the 2019 coronavirus in a test tube. The authors suggested a five-day, 12-pill treatment for Covid-19: two 200-milligram tablets twice a day on the first day followed by one tablet twice a day for four more days.

A more recent French study used the drug in combination with azithromycin. Most Americans know azithromycin as the brand name Zithromax Z-Pak, prescribed for upper respiratory infections. The Z-Pak alone doesn’t appear to help fight Covid-19, and the findings of combination treatment are preliminary.


But researchers in France treated a small number of patients with both hydroxychloroquine and a Z-Pak, and 100% of them were cured by day six of treatment. Compare that with 57.1% of patients treated with hydroxychloroquine alone, and 12.5% of patients who received neither.

What’s more, most patients cleared the virus in three to six days rather than the 20 days observed in China. That reduces the time a patient can spread the virus to others. One lesson that should inform the U.S. approach: Use this treatment cocktail early, and don’t wait until a patient is on a ventilator in the intensive-care unit.

A couple of careful studies of hydroxychloroquine are in progress, but the results may take weeks or longer. Infectious-disease experts are already using hydroxychloroquine clinically with some success. With our colleague Dr. Joe Brewer in Kansas City, Mo., we are using hydroxychloroquine in two ways: to treat patients and as prophylaxis to protect health-care workers from infection.

One of the most disgusting aspects of this era is the manner in which Trump's opponents are reacting to his effort to manage this health crisis. Donald Trump is far from perfect and his administration's approach is as well, but demanding seamless planning and perfect timing in a time of crisis is intellectually dishonest and generally despicable. Even worse, stoking panic among the population (main stream media, are you listening?) in a far-less-that-subtle attempt to injure Trump politically is reprehensible.

In the management of the COVID-19 epidemic, Trump, despite his usual bluster and over-statements, has been far more organized, far more measured, and far more correct than any of his many media and political opponents. The growing evidence of the efficacy of hydroxychloroquine is but one example.