The Truth About Hydroxychloroquine

here's what happened today. Transmission of the coronavirus by people who aren't showing symptoms is quote very rare. The World Health Organization said Monday that contradicts earlier speculation by public health officials and researchers that disease was being spread by people who weren't shown signs of illness. New York City on Monday opened up non essential retail stores for the

first time in months. Governor Andrew Cuomo says a little more than one percent of New Yorkers tested Sunday were infected with the new coronavirus, the lowest rate since the pandemic began. The UK death toll rose by fewer than one hundred for the second straight day, and London reported no new fatalities for the first time since its lockdown began. But worldwide infections from the coronavirus surpassed seven million. That's up by one million cases in just a little more

than a week. The surge is driven by hotspots including Brazil and India. That worrisome trend adds weight to the value of social distancing. A report showed that lockdowns and other public health measures may have prevented about half a billion infections in six countries, including China and the US, And now our main story. Hydroxychloroquine is back in the news.

In the early days of the pandemic, the antimalarial drug was touted by President Trump and some doctors as an effective treatment for COVID nineteen, but the drug has largely been discredited for use against the virus. Now the studies dismissing the drug have also been thrown into doubt. So what's the truth about this controversial drug? I spoke to Bloomberg Health and Science reporters Michelle Cortes and Robert Langrath for some answers. Thank you both for joining us UM

you know in the news. We have heard a lot about this drug, hydroxy chloroquin in terms of whether or not it can treat COVID nineteen, but we've also heard that it's an actually antimalarial drug. Can you maybe walk us through the narrative here about how this drug began being touted as a potential treatment for COVID nineteen. When coronavirus first started circulating around the world, we had nothing

for it at all. It was a brand new virus and the entire world was a vulnerable So drug companies and academic researchers started combing through all the evidence that they had, looking at every type of drug. They looked at antibiotics, they looked at other anti virals, they looked at anti fungals, they looked at at immune system drugs, they looked at everything. And in laboratory tests, it looks like this drug actually makes it more difficult for the

virus to penetrate a healthy cell. And that's where it all started. When we saw something that effectiveness, it was approved. They believed that there was an acceptable amount of side effect risk. They moved forward with it, and as hydroxy chloroquine has been this new potential in terms of a

treatment for COVID nineteen. Obviously, we've seen many new reports being issued, a lot of discussion about its efficacy, and I was wondering if you might be able to explain a little bit about some of these reports and some of the conflicting evidence that we seem to be getting

from the reports about whether it is indeed defective. Very early on, some researchers in France tested them the medicine and patients, and they found that it dramatically lowered the amount of virus in patients who are affected with coronavirus, and so they believed that that would translate to a benefit. If you have less virus in your body, you're likely to have fewer symptoms and less likely to get deadly ill. Then there were other smaller studies that were coming out.

There were anecdotal reports. A doctor said that they gave the medicine to patients and within hours and days they were getting miraculously better. The thing is, in these cases they didn't have comparison patients, and most patients with coronavirus do get better, so it wasn't clear whether or not they were getting better because of this medicine or just because of time and their bodies taking care of the virus.

And then what happened there was there's this giant study he suddenly published a couple of weeks ago in the LANDSTUH, a well known medical journal, and it was led lead author was a you know, big name Harvard professor UH. And it purported to do kind of the mother of

all data gatherings from around the world and UH. And they purported to gather data from nine patients from around the world on all continents, hundreds and hundreds of hospitals, from all sorts of different electrotronic medical records UH providers UH and combine them to one joint report of how patients who got I draw c clorkin did. And it said that not only was it not working, UH, it was causing all sorts of harms, including increasing the risk

of heart disease and death. So what beyond that it didn't work and said it was dangerous? And what was the upshot of this study? This caused a great concern and caused the Double World Health Organization to pause a trial clinical trial hydroxychloricin UH that was going on. So

there's a very very big impact to this study. But A problem with this study is that as data researchers and kind of online sluice doctors and places around the world and the internet started, Internet started looking more carefully at the data behind this study. They found a large number of inconsistenccies and red flags and things that just

didn't add up. And one of the most basic ones was, how could uh this Uh, this small group of researchers gather all this data on from so many hospitals and around the world, with so many different privacy research privacy laws and rules, and put it all together in such a short period of time. Uh. And then it turned out that the data all came from one tiny company that nobody had ever heard of, called service Fare, that was led by a vascular surgeon in Illinois with a

very few employees and very little up presence. Uh. It just seemed highly implausible to outside researchers that this tiny little company could have gathered all this that nobody had ever heard of, could have just gathered all this data in the midst of the pandemic and done such a giant study so fast. But what else do we know about this small company that otherwise we would never have heard about? Yeah, we know very little about it. It's

very mysterious. It's very few employees are the main person associated, which appears to be this vascular surgeon, Zapandasi, who Illinois based vascular surgeon. Uh, but you know, we know very

little about the company. It's very mysterious. And so as people started asking questions about this data, uh, the Harvard researchers on the top researchers on the paper that his collaborators went back and said, we need an independent audit to verify that this data is real and where it came from, there's not problems with it and what and

uh he uh. Dr Desi said at first that he would cooperate with the audit, but then apparently he wouldn't provide the raw data, names of the hospitals, and that's when the paper was retracted. How did then this get published? Um? I mean, what were the circumstances that the Lancet was willing to accept clearly something that was very problematic in terms of its data sources. Well, yeah, I mean that

is exactly the question. It is, you know, pretty unbelievable in retrospect that these studies got got published and there's not just one study by this group. There's a second study that had to end up being retracted in the New England Journal Medicine. So this group got multiple studies

into multiple major journals. And one of the things that it may be happening is that in this rush to come out with new data and you know, healthful information COVID nineteen because it's new virus, and because we know so little and have so few treatments, you know, the journal also appearing the major medical journals also appeared to be pushing out you know, stuff quicker than ever before, and that appears to be leading to some mistakes, including

some major mistakes here such as this. This leads me to kind of too related questions in terms of what is the fallout from this um Both from the sense of, you know, this report had seems to have had significant impact in halting other clinical trial programs, other um studies involving hydroxy chloroquine. What is going to be the impact of this one report being retracted and also, i mean one of the longer, perhaps more broader impacts in terms

of well, certainly the reputation of the lancet. But again, this this rush to research and rush to publication as far as what we can find out about how to treat COVID nineteen. When it comes to hydroxy chloroquine, we can see that this imperfect and very fast science has really had an impact across the board. In the early days when we were grasping for anything and President Trump got on board with this, we saw use of hydrox

chloroquine go through the roof. Then we started seeing some pulling back, and after the lance At trial, we actually saw the w h O and others halt their trials because, of course, the idea that patients were actually being harmed by this medicine is terrifying. You don't want to make people who are already critically ill even worse. The questions that are surrounding all of these drugs, though, are leaving us just with unanswered issues of what do we do

going forward. The University of Minnesota did do a trial. It was double blind, randomized. It was a trial to see if people who had been exposed to the virus could get protection from coming down with it from actually be coming infected if they take hydroxychloroquin and it did not find that. It found that it didn't help those patients avoid getting infected, but it also didn't cause significant side effects. So where that leaves us now is just in the same unknown space that we were in the

very beginning. There are some people who really believe this is going to work, and there are other people who really believe that it doesn't work. If it does anything, it's not significant, it's not worth the time and effort, and patients should be moving on to other treatments that

might give them more benefit. Yeah, so I think this is a major warning sign for some of the medical journals, including the lance of the England Journal of Medicine, which also had a retraction on a different uh subject matter but from the same tiny company. Um this is a warning sign that they need to perhaps move a little bit slower to make as to make sure that the data coming out about this virus is really true and

correct data. It has really just been kind of a perfect storm when it comes to this early suggestions of possible benefit, this environment where we didn't have anything except for some fear data set that appeared at least initially to be good doctors who wanted to be helpful and get out information right away. But Bob's point is exactly exactly right. We actually need to make sure that our data is accurate and safe and that doctors are making

decisions based on things that are scientifically true. And the other thing to keep in mind is this virus is not going away. This is going to be with us for months, perhaps years, and we need to know the right answers, not just the fast ones. That was Michelle Cortez and Robert Langrath, and that's our show today. For coverage of the outbreak from around the world, visit Bloomberg dot com slash coronavirus and if you like the show, please leave us a review and a rating on Apple

podcast Us or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Topher Foreheads, Jordan Gaspoure, Magnus Hendrikson, and me Laura Carlson. Today's main story was reported by Michelle Cortes and Robert Langrith. Original music by Leo Sedrin. Our editors are Francesco Levi and Rick Shine. Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening.