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It's unknown if anti-malarial drugs can actually cure coronavirus patients, but because of Donald Trump's insistence, and a boost from New York Gov. Andrew Cuomo, the drugs — hydroxychloroquine and chloroquine — are being tested on thousands in New York hospitals.
There's no doubt New York hospitals are desperate for a cure for coronavirus COVID-19, and there just isn't one yet. However, with New York state experiencing close to half the country's coronavirus cases, and with the U.S. now having more than any other country, the Food and Drug Administration moved quickly to authorize this treatment plan, though it would normally take up to nine months to approve such a thing.
Health experts are concerned about safety risks. Known side effects include fatal heart arrhythmia and vision loss. Yet for some patients, that tradeoff could be worth it when they're dealing with COVID-19 and its quick, fatal results. Experts also worry about raising false hopes with the public.
The attention to the anti-malarial drugs in the past week has led to hoarding and runs on the supply. New York and other states have tried to block that with executive orders and by restricting prescriptions. One man even died this week when he ingested a form of chloroquine that is used as a parasite treatment for fish.
New York is using hydroxychloroquine and chloroquine in combination with the antibiotic azithromycin. The first patients to be treated will get the hydroxychloroquine and azithromycin.
A New York state health official said lauching this type of plan "is something that normally would have been done in six to nine months, and we're doing it in three or five days."
The experiment's results will be gathered and will contribute to an "observational" trial the government is coordinating. Along with mortality and overall recovery, the study will measure the overall viral load, length of time on a ventilator, and number of days the patient remained in the hospital.
"I have never seen anything like this. It is amazing how the country and everybody can pull together and come up with quick, innovative ways to try to attack it," said Onisis Stefas, the chief pharmacy officer for Northwell Health. With 22 hospitals in New York, Northwell has already been using the anti-malarial drugs to treat patients on a "compassionate-use" basis.
"Everybody's questioning it, and that's why these studies need to be done to confirm it," he added. "There aren't a lot of other options out there."
Nevada isn't making the same choices as New York. The state banned prescriptions for the coronavirus, via executive order, until results of clinical trials are known.
"We must deal with facts, not fiction," said Ishan Azzam, chief state medical officer for Nevada. The state is also trying to stop runs and hoarding, as it's led to a depleted supply, and the treatment is needed for other uses, such as lupus.
Despite Trump's mention of the drugs last week, there is litle that has been published about their effect on coronavirus patients. Rigorous trials are taking place across the United States. Dr. Anthony Fauci, who often appears in Trump's press briefings with him, has repeatedly warned that indications that the anti-malarial drugs will benefit coronavirus patients are so far anecdotal.
"Correctly identifying which patients are most susceptible to this unwanted, tragic side effect and knowing how to safely use these medications is important in neutralizing this threat," said Mayo Clinic genetic cardiologist Michael J. Ackerman. The drugs can cause permanent eye damage and even vision loss and blindness.
As Fauci and others have urged caution, Trump's incoming chief of staff, Rep. Mark Meadows (R-NC), contacted an Upstate New York family doctor, Vladimir "Zev" Zelenko, who claims to have used the anti-malaria drugs on hundreds of suspected COVID-19 cases.
Zelenko admitted in an interview that Meadows contacted him after he posted a video message to Facebook urging Trump, "Please advise the country that they should be taking this medication."
The doctor said in an interview that he and Meadows chatted over one call and several text messages, with the doctor saying the congressman was "very kind and receptive," and told him the teatment plan was being evaluated at high levels.
Fox News host Sean Hannity read Zelenko's open letter during a phone conversation with Vice President Mike Pence on his show on Monday evening. Trump's personal attorney, Rudy Giuliani, championed the treatment as well the next morning on Twitter.
Zelenko has shared material on Facebook that he says suggests the coronavirus may have been developed deliberately by China as a population control device and that the threat of it is being exaggerated by Democrats.
However, after Trump touted the drugs last week, Cuomo announced on Sunday that 70,000 doses of hydroxychloroquine and up to 750,000 doeses of chloroquine are on the way to New York. "There's a good basis to beleive they could work," he said.
Drug manufacturer Gilead Sciences is working with the FDA to develop a broader treatment for compassionate use for the drug remdesivir, an antivral drug used to treat Ebola virus and other viruses. If they are successful with it, they will work with the FDA to get it to coronavirus patients.
"It is very dangerous to take your medical advice from someone who does not actually practice medicine," said Alison Bateman-House, a professor of populations health at New York University, of Trump. The specialist in compassionate-use programs said there is some reason to believe there could be some benefit with this treatment, so she feels large-scale compassionate-use trials would be appropriate.
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