(CN) — After Tesla CEO Elon Musk and President Donald Trump hyped a potentially dangerous anti-malaria drug for coronavirus, Google searches for chloroquine and hydroxychloroquine predictably spiked.
Distressingly for medical researchers monitoring this trend, many of those web searches included the terms “buy,” “order,” “Amazon,” “eBay” or “Walmart.”
Analyzing a public archive of Google Trends, a study published Wednesday in JAMA Internal Medicine found that searches for buying chloroquine jumped 442% and searches for purchasing hydroxychloroquine shot up 1,389% following Trump and Musk’s endorsements.
“What we really want the public and kind of the greater scientific community to take away from this is that ultimately these statements are not evidence-based and they’re dangerous, and I think that Covid-19 has caused enough human suffering already,” Michael Liu, a graduate student at Oxford who was lead author of the study, said in a phone interview. “I think we as a society need to think about how we can combat misinformation because we don’t want this to further exacerbate the current public health crisis.”
JAMA Internal Medicine is a monthly peer-reviewed medical journal published by the American Medical Association, and Liu’s study came in the form of a research letter with four fellow researchers from Harvard, Johns Hopkins and the University of California, San Diego.
Data showing how many of the Google searchers went ahead and bought the drug has not yet become available, but one can presume from the online traffic that significant spikes in sales took place.
“These changes represent about 93,000 and 96,000 more searches than expected for chloroquine and hydroxychloroquine, respectively, with 216,000 total searches for both drugs over just 14 days,” the 2-page letter states.
As illustrated in an eye-popping chart, the first giant spike in searches came on March 16, the day that Musk tweeted out a French study, now repudiated, claiming hydroxychloroquine combined with the antibiotic azithromycin held promise as a treatment for Covid-19.
Traffic surged again after Trump enthusiastically endorsed the drug at a March 19 briefing.
“Demand for chloroquine and hydroxychloroquine increased substantially following endorsements by high-profile figures and remained high even after a death attributable to chloroquine-containing products was reported,” the study states.
Here, the study cites a New York Times report on an Arizona man, Gary Lenius, who died after ingesting fish tank cleaner, which has the same active ingredient as chloroquine phosphate.
“Following news reports of the first fatal poisoning, searches to buy chloroquine or hydroxychloroquine remained substantially above expected levels at 212% and 1,167% higher, respectively,” the study found.
Following that tragic and well-publicized case in Arizona, the man’s widow Wanda Lenius told NBC that Trump’s endorsement goaded them to take the drug, but questions continue to swirl about that case. The Mesa City Police Department’s homicide division confirmed an investigation to the conservative Free Beacon, in response to the publication’s reporting on the couple’s troubled marriage and the dosage information shared with the wife in an interview.
That thorny case aside, the JAMA study highlights drug shortages as another danger of these online purchases.
“The danger really in that here is that there are a lot of indications for chloroquine and hydroxychloroquine like Lupus and rheumatoid arthritis that are approved, and a lot of patients now are actually seeing shortages for these conditions to which these drugs are actually approved for use and are shown to be effective,” Liu said in an interview.
Despite approving the drug to treat Lupus, arthritis and malaria, the Food and Drug Administration has given only a limited emergency authorization for hydroxychloroquine’s use against Covid-19. The agency later walked back that green light with a warning that the drug should only be used against coronavirus in controlled conditions like a hospital or clinical study, given the risks that it could cause fatal heart arrythmias.
Such warnings debunked Trump’s claims in White House briefings that the anti-malarial drug poses no health risks.
“It’s not going to hurt people,” Trump insisted, falsely, on April 5. “It can help them, but it’s not going to hurt them.”
Even before the coronavirus pandemic, that statement was never true of the anti-malarial drug. As of reported to the FDA by the end of last year, hydroxychloroquine has been associated with 9,987 adverse events, including 8,919 serious cases and 552 deaths.
The study’s four other authors — Theodore Caputi, Mark Dredze, Aaron Kesselheim and John Ayers — echoed that warning in the study.
“In times of public health crises, therapies not supported by adequate evidence — such as would lead to U.S. Food and Drug Administration approval — should not be touted by public figures,” they wrote. “Endorsements can lead to unsupervised use of the products with dangerous consequences to the people who take them, and hoarding of these medications can result in shortages for those who require them for legitimate health reasons. These negative consequences are magnified in this circumstance because chloroquine containing products are commercially available to the public through such sites as Amazon.”
The Lupus Foundation of America reported hydroxychloroquine shortages after Trump’s endorsement for its use against Covid-19, a treatment that is the subject of dozens of incomplete clinical studies.
“Until such time as these or other drugs are found to be effective for Covid-19 treatment, regulatory agencies and public-facing companies should be actively mitigating the negative consequences of this misinformation,” the study states. “The US Food and Drug Administration should warn the public against procuring unapproved therapies unless prescribed.”
Just as eBay stopped chloroquine sales, other Silicon Valley companies could also take action.
“Google responded to Covid-19 by integrating an educational website into search results related to the outbreak, and this could be expanded to include searches for unapproved Covid-19 therapies,” the study recommends.
Google did not immediately respond to emails requesting comment.
An FDA spokesman referred to its existing warning on hydroxychloroquine: “Do not buy these medicines from online pharmacies without a prescription from your health care professional.”