Untested treatments for COVID-19 like antimalarials might do more harm than good
Some are stockpiling them, causing widespread shortages across the country. Others are overdosing on them, leading to hospitalizations around the world and death.
Central to the crisis are antimalarial drugs -- chloroquine and hydroxychloroquine. The drugs were brought into the spotlight, thanks to US President Donald Trump's endorsement. He called them "game-changers", despite having no evidence to back his statement up.
It also does not help that the new coronavirus is unstoppable. In the absence of proven treatments, people are resorting to untested drugs to keep themselves safe from the disease, which has sickened 472,109 people around the world and killed more than 21,000 people.
But taking untested drugs for COVID-19 does more harm than good, say experts. "People do not realize these drug combinations can cause several side effects and even death in severe circumstances," Dr. Krutika Kuppalli, Leader in Biosecurity Fellow at Johns Hopkins Center for Health Security, told MEA WorldWide (MEAWW).
Buzz around antimalarials
So far, there is limited evidence to support that antimalarials can treat COVID-19. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said the evidence was thin and anecdotal.
He is right. Chinese researchers have evaluated the drug on cells grown in the lab. They saw that the drug stopped the virus from entering the cells. Doctors in China and South Korea have used these drugs on patients -- all of which are anecdotal evidence.
Researchers in France conducted a small study in patients and claimed that the drug combination -- hydroxychloroquine and the antibiotic named azithromycin -- was effective in reducing the amounts of virus in a patient's body.
They tested a small number of people: 36 patients, of which 26 received hydroxychloroquine in the study. Though promising, the study suffers from a few limitations, explains Dr. Kuppalli. The study was not powered for efficacy; it tested a small number of patients; the experts did not follow-up on the condition of the patients, she tweeted.
What is more, these drugs are known to cause severe side-effects. The study does not talk about the side effects either, Kuppalli said.
Other experts agree. "Please don't take hydroxychloroquine (Plaquenil) plus Azithromycin for #COVID19 UNLESS your doctor prescribes it," Dr. Edsel Salvana, director of the Institute of Molecular Biology and Biotechnology at the National Institutes of Health at the University of the Philippines, tweeted. Both drugs can lead to arrhythmias and sudden death, especially if you are taking other meds or have a heart condition, he explained.
Consequences
Following Trump's statements on the antimalarial drug, the demand for the drug shot up across the world. In Nigeria, two people reported chloroquine poisoning after overdosing on it. In the US, one man died and a woman ended up in critical care after self-medicating with a form of chloroquine phosphate.
"Given the uncertainty around Covid-19, we understand that people are trying to find new ways to prevent or treat this virus," Dr. Daniel Brooks, medical director of the Banner Poison and Drug Information Center, said in the statement. "But self-medicating is not the way to do so."
What is more, there are reports of doctors excessively prescribing the medicines for family and friends, leading to a nationwide shortage. This indirectly affects those in dire needs of these medications, especially patients suffering from lupus or rheumatoid arthritis.
"Please EVERYONE STOP prescribing and buying up the #Chloroquine and #Hydroxychloroquine there is already a shortage and we need it for patients who take it normally. There are side effects to monitor and we don’t know it works against #Covid_19," Dr. Kuppalli tweeted.
More clinical trials in the pipeline
Experts have been calling for larger trials before making recommendations. In the US, the New York State Department of Health will be testing the drug combination -- hydroxychloroquine and the antibiotic named azithromycin -- on people with moderate or severe coronavirus. Another study will evaluate whether the drug can protect people from contracting the infection, according to CNN.
The World Health Organization (WHO) will roll out extensive trials, evaluating several potential drugs, including hydroxychloroquine.
"The @WHO #Solidarity trial will test chloroquine or HCQ, lopinavir/ritonavir with and without interferon beta, remdesivir versus Standard of care in many countries around the world, to generate robust evidence on mortality and hospitalization of #COVIDー19 patients," Dr. Sowmya Swaminathan, Chief Scientist, World Health Organization, tweeted.