President Trump again touted the promise of the antimalarial drug hydroxychloroquine on Monday for use treating COVID-19, retweeting a story that appeared in the New York Post.
The piece in the Post detailed the case of Rio Giardinieri, a 52-year-old Florida man stricken by COVID-19 who was admitted to the intensive care unit at Joe DiMaggio Children’s Hospital in Hollywood, Fla. On oxygen in the intensive care unit and with doctors telling him there was nothing more they could do, Giardinieri asked to be put on hydroxychloroquine, a drug used to treat malaria and lupus that Trump has called a possible “game changer” in the fight against the coronavirus.
A preliminary study in France indicated that when patients took it in combination with the antibiotic azithromycin, they were clear of the virus in less time than a control group. Larger-scale trials, which could prove or disprove its benefits, are soon to get underway.
Shortly after receiving the medication via an IV, Giardinieri experienced dramatic heart palpitations and more breathing problems, but then he awoke hours later feeling “like nothing ever happened,” the Post reported.
By the following day, the paper said, his fever, pain and shortness of breath were gone. He expects to be discharged from the hospital by midweek, though the article did not include a statement from the hospital or the doctors who treated Giardinieri.
For a world desperate to find a cure for a virus that, as of Monday morning, had sickened more than 41,000 people and killed more than 500 in the U.S. alone, chloroquine has become a beacon of hope, especially for the president.
But Giardinieri’s recovery by itself falls far short of what scientists consider proof.
“Many of the things that you hear out there are what I call anecdotal reports,” Dr. Anthony Fauci, the leading expert on the president’s coronavirus task force, said during Saturday’s White House press briefing.
Asked whether Trump’s promotion of the drug was appropriate, Fauci sought to place the president’s views in context.
“The president is talking about hope for people, and it’s not an unreasonable thing to hope for people,” Fauci said. “So when you have approved drugs that physicians have the option, and a decision between the physician and the patient, are you going to use a drug that someone says from an anecdotal standpoint, not completely proven, but might have some effect, there are those who lean to the point of giving hope and saying, Give that person the option of having access to that drug. And then you have the other group, which is my job as a scientist, to say my job is to ultimately prove, without a doubt, that a drug is not only safe, but that it actually works.”
On Monday, an Arizona man died after ingesting chloroquine phosphate, “an additive commonly used at aquariums to clean fish tanks” that is not the same as the antimalarial medication, Banner Health reported. His wife, who also ate what the couple in their 60s assumed to be protective of COVID-19, remains in critical care.
“Given the uncertainty around COVID-19, we understand that people are trying to find new ways to prevent or treat this virus, but self-medicating is not the way to do so,” Dr. Daniel Brooks, Banner Poison and Drug Information Center medical director, said in a statement. “The last thing that we want right now is to inundate our emergency departments with patients who believe they found a vague and risky solution that could potentially jeopardize their health.”
Over the weekend, the Nigerian government said three people were hospitalized after overdosing on chloroquine in an attempt to protect themselves from COVID-19. That prompted the Nigeria Centre for Disease Control to issue a warning.
#FactsNotFear@WHO has NOT approved the use of chloroquine for #COVID19 management. Scientists are working hard to confirm the safety of several drugs for this disease.— NCDC (@NCDCgov) March 20, 2020
Please DO NOT engage in self-medication. This will cause harm and can lead to death.#COVID19Nigeria pic.twitter.com/K6kljq0VtW
Trump’s tweeting about the study in France, which was rushed into print by a medical journal without peer review, has resulted in a rush to obtain the drug, depleting the U.S. supply in a matter of days and endangering patients suffering from lupus and rheumatoid arthritis who rely on it.
Chloroquine also poses a risk of side effects, according to the Quinism Foundation, which supports research on encephalopathy caused by antimalarial drugs.
“In susceptible individuals, these drugs act as idiosyncratic neurotoxicants, potentially causing irreversible brain and brainstem dysfunction, even when used at relatively low doses,” Dr. Remington Nevin, a Johns Hopkins-trained psychiatric epidemiologist and the executive director of the Quinism Foundation, said in a statement. “This drug-induced dysfunction causes a disease of the brain and brainstem called quinoline encephalopathy, or quinism, which can be marked acutely by psychosis, confusion, and risk of suicide, and by lasting psychiatric and neurological symptoms.”
Doctors have also warned that indiscriminate use of the other drug Trump called a “game changer,” azithromycin, a first-line treatment for bacterial pneumonia, runs the risk of promoting antibiotic resistance.
For a president who has openly fretted about a “cure being worse than the problem itself” — referring to the economic consequences of a prolonged period of social distancing — that possibility doesn’t seem to apply to chloroquine.
WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!— Donald J. Trump (@realDonaldTrump) March 23, 2020
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