WASHINGTON (CN) — Just a day after the American death toll due to Covid-19 climbed to 250,000, senators spent more than two hours Thursday debating the wisdom in deploying an anti-malarial drug in the virus war.
Four physicians gave conflicting testimony before the Senate’s Homeland Security Committee about the effectiveness of hydroxychloroquine — a drug President Donald Trump touted for months as a possible treatment to coronavirus. Trump claimed back in the spring to be taking a hydroxychloroquine as part of a cocktail to prevent infection, but the medication was not among those used to treat the president when he ultimately contracted Covid-19 this fall.
The president also was found to have a small stake in the drug’s French manufacturer Sanofi.
This past May, one of the largest studies on the drug’s mitigation of Covid-19 symptoms found that it was likely to increase the risk of death or hospitalization in patients, while providing no benefit treating the virus itself. France’s government banned the use of the treatment that same month after it was shown to increase risk of irregular heart beat and mortality in patients.
Dr. Harvey Risch, a professor of epidemiology at Yale University, testified Thursday that when investigating the early use of hydroxychloroquine in outpatients infected with Covid-19, he found the drug was “exceedingly safe.” That evidence came from “common sense,” he said, based on the hundreds of millions of doses prescribed for the drugs more than 60-year history.
Others witnesses, like Dr. Peter McCullough — the vice chief of internal medicine at Baylor University Medical Center — stressed the importance of hydroxychloroquine’s use during early ambulatory treatment. The drug’s use was responsible for dulling the spike in Covid-19 cases during the pandemic’s onset, McCullough claimed.
“Hydroxychloroquine was widely used early on, that’s what kept the March-April-May curve down, OK?” McCullough said.
But Dr. Ashish Jha, dean of Brown University’s School of Public Health, said every single high-quality study of hydroxychloroquine’s efficacy found no benefit of the drug’s use in Covid-19 patients. There was clear consensus between medical and scientific communities that hydroxychloroquine was ineffective, Jha said.
“A large randomized control trial published in the New England Journal of Medicine found no benefit of hydroxychloroquine given to outpatients who had been exposed to SARS-CoV-2,” Jha said. “The recovery trial found higher rates of death among hospitalized patients on hydroxychloroquine. But this included people whose symptoms had begun within the past seven days; that early phase of the disease that Dr. Risch talked about.”
The Food and Drug Administration even issued emergency use authorization for hydroxychloroquine but withdrew it as it became clear the drug was ineffective, he noted. Jha said the agency should have never issued the initial authorization for the drug, based on the amount of data available, the potential benefits and ability to collect more data.
“For hydroxychloroquine there was not sufficient evidence and the evidence that was there certainly did not suggest the benefits would outweigh the risks,” Jha said.
Risch refuted Jha’s claim the drug was ineffective, saying there had been an exhaustive amount of studies showing hydroxychloroquine’s efficacy or harm — the reason for those conflicting results being irrelevant, because of their focus on hospitalized patients. Doctors were chiefly concerned about using the anti-malaria drug within the first few days of infection, Risch said.
There have only been seven studies conducted on introducing the drug during this period, known as observational studies, Risch said. Although Jha claims these studies are inconclusive and not high-quality, Risch said, they were tantamount and randomized — although patients consulted with their physicians before undergoing hydroxychloroquine treatment.
“Now you may say, ‘well, couldn’t that lead to biases?’ The answer to that is yes, but the bias is that when patients are sick, they’re more likely to take the medication they’re offered,” Risch said.
Senator Ron Johnson talked briefly about his legislation the Right to Try Act, which would allow for patients to try drugs that haven’t passed the FDA’s final efficacy test but cleared previous safety hurdles. The bill was not the best example to apply to Covid-19 treatments, he said, but could be used for other Covid-19 treatments.
“A patient and a doctor still have a right to try that if there are no other available treatments, isn’t that the position we’re in, in early treatment of Covid?” said Johnson, a Florida Republican. “There’s no other treatments.”
The fourth witness at Thursday’s hearing was Dr. George Fareed, medical director and family medicine specialist at the Pioneers Medical Center.