Hydroxychloroquine & the Judgment of History

How a safe, well-understood malaria drug was demonized as a COVID-19 treatment. Because a politician said good things about it.

In the aftermath of this pandemic, books will be written about how medical professionals responded. What treatments they tried, what worked, what didn’t – and how regulators and politicians assisted or hindered them.

In the meantime, a lengthy essay by Norman Doidge persuasively argues that history will judge many people and organizations harshly. Including most of the media.

Early in Hydroxychloroquine: A Morality Tale, Doidge says “politicization has started to penetrate the peer review process” of scientific journals. In fact, that process has been gathering steam for decades (see here, here, here, and here).

But this is a mere hiccup. Keep reading. Doidge methodically describes how boatloads of smart people suddenly started calling one of the world’s oldest, safest, and cheapest drugs dangerous.

Originally developed to prevent and treat malaria, Hydroxychloroquine (HCQ) was later found to be helpful for lupus and rheumatoid arthritis. It has long been deemed an Essential Medicine by the World Health Organization, which describes the drugs appearing on that list as “safe and cost-effective.”

The US Food & Drug Administration gave HCQ the safety thumbs-up back in 1955 – 65 bleeping years ago.

A factsheet on the website of the US Centers for Disease Control continues to declare that HCQ can be “safely taken by pregnant women and nursing mothers,” and prescribed to “children of all ages.”

So what changed? Only this: US President Donald Trump began talking about HCQ as a promising treatment for COVID-19.

In the midst of a worldwide pandemic in which millions of people are infected, hundreds of thousands are dying, and doctors are perishing as they try to save others, some people are so addled by their dislike of a politician they’ve stopped thinking straight. These include journalists, public health officials, and many practicing physicians.

After compelling research showed HCQ halved the death rate of patients in six Detroit hospitals, CNN invited a panel of commentators to tear apart this research on air. If it treated all research this way (especially weak nutritional studies), that would be responsible journalism. Instead, this was a politically motivated hit job.

Exposing widespread double standards and “rotten cherry picking,” Doidge observes that HCQ has become a “kind of Rorschach inkblot test.” He points out that the same people who’ve grown absurdly cautious about HCQ nevertheless advocate competing treatments for which we have scant data – and appear keen to promote COVID-19 vaccines that won’t have undergone years-long observation prior to being widely distributed:

hydroxychloroquine is given to relatively few people with COVID-19, all sick, many with nothing to lose. It enters the body, and leaves fairly quickly, and has been known to us for decades. COVID vaccines, which advocates will want to be mandatory and given to all people – healthy and not, young and old – are being rushed past their normal safety precautions and regulations, and the typical five-to-10-year observation period is being waived…with the endorsement of public health officials – the same ones, in many cases who are saying HCQ is suddenly extremely dangerous.

…it is a fantastic spectacle to behold…the magnitude and the chutzpah of which must inspire awe: a public health establishment, showing extraordinary risk aversion to medications and treatments that are extremely well known…suddenly throwing caution to the wind and endorsing the rollout of treatments that are entirely novel – and about which we literally can’t possibly know anything, as regards to their long-term effects.

…From unheard of extremes of caution…to unheard of extremes of risk-taking…

Read the entire fantastic essay here.

 

 

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LINKS:

  • The College of Physicians of Philadelphia teaches doctors that vaccine development is normally “a long, complex process, often lasting 10-15 years.” I’m all for cutting red tape and speeding things up, but if we normally observe the effects of a vaccine in small groups of people for five years prior to distributing it widely, skipping that stage will expose millions to unknown risks.
  • Like all drugs, HCQ is harmful in some circumstances. Doidge says it “can be dangerous in overdose, and for some people causes fatal heart arrhythmias, and it can cause retinal problems and blindness with long-term use (after 10 years of daily use, in 1% of patients), hearing loss, and even psychosis. Luckily, having been around so long, physicians had come to understand it very well, knew its dangers, how to screen for the approximately 1% of people who were vulnerable to these side effects, and also what drugs it interacted with that might trigger problems (such as antidepressants).
  • Doidge says a turning point in the HCQ saga was the publication of a (soon-retracted) study in The Lancet that concluded patients given HCQ died more frequently. I wrote about that matter here
  • Doidge cites an opinion piece by Yale epidemiology professor Harvey Risch, The Key to Defeating COVID-19 Already Exists. We Need to Start Using It
  • The WHO’s latest list of “the most efficacious, safe and cost–effective medicines” may be downloaded here; see earlier versions here
  • My attempts to backup Doidge’s article on Archive.org failed. A snapshot therefore appears here.

 

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August 24, 2020 at 07:03AM

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