Anything that is endorsed by Trump is controversial already! The media is going to take it and run with it and turn it into a circus. Halted trials, retracted fake studies, WHO reinstating Hydroxychloroquine (HCQ) in its Global Solidarity trials and then removing it, and still continued usage of HCQ in several countries, point to the fact that HCQ is the most polarizing drug of our times. 

So much was said about Hydroxychloroquine in these past few months that we had to come up with an abbreviated version of its name: HCQ. According to studies in France China and India, a common and cheaply available drug used for treating Malaria, could work to prevent and treat COVID-19- one of the most dangerous viruses in recent times. Wasn’t that something!! Unfortunately, the controversy around HCQ refuses to die.

HCQ around the world

Firstly, anything that is endorsed by Trump is controversial already. The media is going to take it and run with it and turn it into a circus. But was President Trump the first one to endorse it? Not really. Researchers in China and France have shown the efficacy of HCQ as a prophylactic very early on in 2020. The Indian Council for Medical Research (ICMR) issued a statement on March 23, 2020 (about 10 days after National Emergency was declared in the USA) recommending use of the antimalarial drug hydroxy-chloroquine as preventive medicine (a prophylactic) for those who face a high risk of coronavirus infection. And a 2003 study published in “The Lancet” declared a coming of a ‘second youth’ for Chloroquine, also sharing a “speculative hypothesis that chloroquine/ hydroxychloroquine, due to its antiviral and anti-inflammatory properties, may have some effect on SARS”. 

After such a resounding endorsement for a known drug as HCQ, why is the narrative so ambiguous and not unanimous? At a time when the pressure to find a treatment regimen for a rapidly growing pandemic is immense, why is the medical community so focused on its serious side effects even when “The Lancet” has stated “low incidence of adverse events during chronic administration”

All drugs have side effects and almost all pharmaceuticals can cause death at high dosage. But HCQ has become notorious for being probably the very first drug whose side effects were taken seriously and splashed all over media. One is forced to ask: Is it to cause embarrassment to President Trump? ‘The Atlantic’ questions whether Trump took the drug for prevention, ever!

Primetime TV in the US is dominated by drug commercials for big pharma with butterflies, green meadows, and happy people with baritone voiceovers. Each of these fun-filled ads, invariably ends with a breathtaking minute of side effects that need a stomach of Braveheart. And yet these commercials are fine, the drugs are minting money and the side effects are dismissed at the doctor’s office with a nonchalant, “I never really heard any of my patients complaining” But for HCQ we heard ad nauseum about how dangerous it is.

Did they ever mention it was also a cheap drug and how it could impact the pockets of some vested interests? Lopinavir-ritonavir and Remdesivir have not clearly demonstrated efficacy; they are associated with many adverse events, and yet continue to be on the market as COVID treatment options despite unknown risks for such a new and hurriedly approved drug. Are there drugs or vaccines waiting in the pipeline, waiting to find the proverbial pot of gold at the end of this COVID-19 rainbow?

Gin and Tonic:

The Quinine Cocktail

HCQ by the way is also on the World Health Organization’s Model List of Essential Medicines, the safest and most effective and essential drugs needed in a health system. HCQ is a derivative of quinine, the naturally occurring ally of all adventurers and travelers, and of the colonialists since 1820. While colonizing Peru, the Conquistadors learned how the Natives had their herbal treatment for viral and malarial infections and it came from the Cinchona bark. Thus, Quinine became the herb of the imperialist saving many lives in Imperial India, Africa, and the Americas. Gin and Tonic became the only known bitter cocktail, one that actually was a life-saver tonic against tropical diseases. Since 1950s the laboratory synthesized derivative, HCQ has been used for malaria and other diseases.

Hence for a model drug with such ancestry, it is strange to see it come under such supreme scrutiny, especially with regards to adverse effects. In a global world of research, where mutual cooperation and multi-nation agreements drive drug studies and approvals, the FDA is seen toeing a different line and disapproving and discontinuing further studies on COVID-19 and use of HCQ, even when other countries like Australia and India continue to use it.

Today, the doctors and their staff in India are taking HCQ as part of prevention protocol including asymptomatic healthcare workers working in non-Covid hospitals, frontline staff on surveillance duty in containment zones, and paramilitary/ police personnel involved in coronavirus infection-related activities. Additionally, many other countries agreed that HCQ is a known safe bet in severe situations like the COVID 19 pandemic. But to muddle things, we had the fog of manipulation envelope critical clinical trials and HCQ usage, due to a now well documented fake research.

What do a fiction writer, a porn star and a doctor have in common?

The answer is Surgisphere. A Harvard educated Cardiologist, a data analytics company and a University of Utah Doctor got together to conduct a study on the pandemic and concluded in 5 weeks, that HCQ was not benefiting anybody and in fact was causing heart problems and deaths. Obviously everyone stopped using the drug for treatments. Hundreds of studies were stopped in their tracks and WHO halted its HCQ arm of the global Solidarity trials. Avid interest in tackling the pandemic obviously raised eyebrows at such contrasting views on HCQ. Researchers from around the world questioned the study and demanded raw data. This is when it was clear that the emperor had no clothes.

The two major studies from two major medical journals, The Lancet and The New England Journal of Medicine (NEJM), were retracted from their website. Both the studies were flagged for data discrepancy. There was concocted data, lack of primary data, bias in the research methodology and as Shekhar Gupta said in his online magazine ThePrint.in the research was fake! A report in The Guardian also found that the key employees of Surgisphere included a science fiction writer and an adult movie star.

DJT and HCQ

To quote Gupta: “If you see the Lancet editorials lately, those have become very politicized, very ideological, and very polarized,” and “HCQ got polarized simply because Donald Trump… was plugging it to the world.”

For a pandemic of the century, when 100s of studies were started and stalled and restarted, the final cork that sealed the fate of HCQ were three large studies, two in people exposed to the virus and at risk of infection and the other in severely ill patients. All these studies show no benefits. With these three studies, one in the US, UK, and Spain, the route to further exploration has been halted and approval for HCQ for COVID has been retracted by some countries.

The media is having a field day tying the drug to Donald J Trump. A Chicago Tribune storyline focused on how a drug (HCQ) promoted as a “game changer” by Trump is in fact being revoked by FDA.

And why is CNN rubbing its hands with glee at the prospect of huge stockpiles of now unusable HCQ? Is it only because it was touted by DJT on national pressers? But Donald J Trump did not come up with this fancy idea from his back pocket! As quoted earlier, there were significant studies proving this theory.

THE CNN FLIP FLOP
THE CNN FLIP FLOP

Conclusion

Halted trials, retracted fake studies by “The Lancet”, WHO reinstating HCQ in its Solidarity trials and then removing it, and continued usage of HCQ in several countries point to the fact that HCQ is the most polarizing drug of our times. 

One cannot but question whether HCQ was withdrawn as a COVID treatment option far too soon and for political expediency. Was there a real need to stop all further exploration or was someone afraid of a different opinion? For example, why is HCQ still used in COVID treatment in many countries then? If all further exploration is scanty, how do we determine what’s for the larger good of the people during a historical pandemic?

We need to compare HCQ, a drug with decades of patient exposure and known adverse effects with the newer anti-virals which were approved for emergency use based on interim data analysis with limited patient exposure, unknown risks, and inadequate long term safety data. And then ask was HCQ pushed out of the COVID -19 race too early? Was it written off and are patients being denied a possible treatment during this pandemic? These questions hang in the air and the answers seem to have been silenced for good.

Bias in the media and academia in social sciences is forever under scrutiny, due to its subjective nature. But the unearthing of bias in this critical medical emergent issue also points to the fact that science, the final frontier of objectivity has been invaded.

References:

Articles:

DISCLAIMER: The author is solely responsible for the views expressed in this article. The author carries the responsibility for citing and/or licensing of images utilized within the text.