April 10, 2020.
Recollections & Reflections
IT has remained a largely unnoticed issue in Malaysia in the fight against Covid-19, with the exception of maybe a small number of Malaysians in the medical and scientific community but especially in the United States, even the suggestion that the anti-malarial drug chloroquine and its “sister” hydroxycloroquine be used to treat this unseen enemy of mankind is scoffed at by most doctors.
In the US, or specifically the White House, the man who has been very much in favour of the drugs is President Donald Trump himself, despite the best advice of the country’s foremost infectious disease expert Dr. Anthony Fauci.
Earlier on, the country’s Food and Drugs Administration did not approve the drug for this treatment but later changed tack to provide emergency use authorisation for the drugs to be used in clinical trials or for hospitalised patients when a doctor deems it appropriate.
“We have not taken a stance, nor are we, on whether doctors should prescribe it,” FDA Commissioner Dr. Stephen Hahn told Fox News recently. “We’re providing facts and information about the risks and benefits, but that really is and should be a doctor-patient decision.”
One article warned that it’s important to note upfront that regardless of what you may have heard, from Trump or any other sources, no drugs or treatments have been proven as effective for either the prevention of contracting Covid-19 or for its treatment.
That said, a number of different clinical studies are currently in progress all over the world, and in the U.S., the National Institutes of Health is looking to fill a 400-volunteer study that will provide clinical results related to use of remdesivir, an antiviral drug, but it’s still only in clinical trials even for treatment of that disease.
It is Trump who is urging America to use these unproven drugs to treat Covid-19 patients
But on the urgings of Trump, some states in the US are already taking this highly risky move to use the two drugs.
Other countries that are reported to have begun using these medically unproven drugs are France, against the better judgment of its medical watchdog and India but with a doctor’s prescriptions and some countries in the Middle-East.
Not much though has been heard or discussed about this in Britain or Australia and most countries in Asia but Malaysia did take this risk – and if knew the possible side-effects you would probably have said what a risk it was — during the first wave of the outbreak here, and that would be around late January and through to at least mid-February.
The public didn’t know about this, although most would not have been able to tell the difference. But some in the medical fraternity familiar with this contentious issue would have spoken up had this been made known to them.
The revelation came on March 29 from Health director-general Dr. Noor Hisham Abdullah at his daily press briefing.
Malaysia decided to use chloroquine during the first wave of the outbreak
Excerpts from a Bernama report used by Malay Mail Online: Chloroquine, a drug used for malaria, has been used to treat Covid-19 patients since the first wave of the outbreak in Malaysia and shown its efficacy, says Noor Hisham.
He said the anti-inflammatory properties of the drug were effective in treating Covid-19 which caused inflammation in the lower respiratory tract.
It must be noted that there has been no similar reports on the efficacy of chloroquine or any other drug for treatment of Covid-19, although there have been many clinical tests in several countries, probably due to the limited samplings and thus limited data to prove a case for it.
And this from a report in Reuters on April 7: The decades-old drug that President Donald Trump has persistently promoted as a potential weapon against Covid-19 has within a matter of weeks become a standard of care in areas of the United States hit hard by the pandemic — though doctors prescribing it have no idea whether it works.
Doctors and pharmacists from more than half a dozen large healthcare systems in New York, Louisiana, Massachusetts, Ohio, Washington and California told Reuters they are routinely using hydroxychloroquine on patients hospitalized with Covid-19. At the same time, several said they have seen no evidence that the drug, used for years to treat malaria and autoimmune disorders, has any effect on the virus.
But as part of the search for a treatment, the World Health Organisation has launched a multi-country clinical trial to test four drug regimens as Covid-19 therapies: remdesivir, chloroquine (or the related hydroxychloroquine), a combination of two HIV drugs, and those same two HIV drugs along with the anti-inflammatory interferon beta.
The trial will be flexible and could add or drop additional treatment approaches or locations over time. Malaysia is one of the more than 90 countries chosen and has agreed to participate but the US is not involved.
The explanation by WHO director-general Dr. Tedros Adhanom Ghebrevesus recently: “Because multiple small trials of the coronavirus vaccine with different methodologies may not provide the evidence needed, WHO and partners are organising the Solidarity trial to compare untested treatments throughout several countries.”
The downside to this development is that some countries have started to hoard their stockpile of the drugs mentioned. India, a manufacturer, decided to impose a ban on their exports but made a U-turn on being threatened by no other than Trump.