Hydroxychloroquine: The Drug Of Choice Of Right Wing Populists?

Given that it is touted by Presidents Donald Trump, Jail Bolsonaro amongst others, is the anti-malarial drug hydroxychloroquine the drug of choice of right wing populists in the treatment of COVID 19?

By: Ringo Bones

Brazilian strongman President Jair Bolsonaro recently used it after recently registering positive for COVID 19 and US President Donald Trump and his far right inner circle – like former NY City Mayor Rudi Giuliani – had been promoting it as an effective cure for the coronavirus. Originally for malaria and lupus, hydroxychloroquine was originally shortlisted by the Solidarity Trial – an international clinical trial launched by the WHO and other partners to help find an effective treatment for COVID 19. It was hoped that one or more treatments under trial, including hydroxychloroquine, will result in improving clinical outcomes in COVID 19 patients and save lives. But hydroxychloroquine trials were eventually stopped as of June 17, 2020 as evidence showed it did not result in the reduction of mortality of hospitalized COVID 19 patients when compared with standard care. Given that it has been proven to do nothing against COVID 19, why is it that some people – especially those in the far right populist wing – still insist that hydroxychloroquine is the only effective cure against COVID 19?

Conspiracy theories tend to be grounded in unusual coincidences or misunderstood science and they use highly emotional language to appeal to others. In a time when public mistrust is at an all-time low, it is important to counter false information with clear, high-quality evidence. Although not a conspiracy theory, the hype around hydroychloroquine started in March 14, 2020 when a Google Word document was circulated on Twitter touting the potential use of repurposing the old anti-malaria drug hydroxychloroquine as a possible COVID 19 cure. The document claimed to be written in consultation with prestigious medical schools and scientific institutions and by March 16 it had gone viral on Twitter. Unfortunately, it was only realized much later that the author of the document was actually a blockchain investor, who had inaccurately claimed to write it in consultation with medical schools and scientists.

The global hype around hydroxychloroquine had already been set in motion before the first clinical study testing it on COVID 19 patients was even published on March 17, 2020 with the study only finding a 50-percent improvement in the extremely small sample size of 14 patients with COVID 19 taking hydroxychloroquine alone. These authors have now been criticized for not randomly assigning patients to treatment groups, their small sample size and lack of a control group to compare with the treatment group with, meaning that the positive results could easily have occurred by chance.

However, by March 19, 2020 – US President Donald Trump, in conjunction with former NYC Mayor Rudi Giuliani, were promoting the potential of the drug at press conferences, incorrectly stating it had already been approved by the US Food and Drug Administration (FDA) to treat the COVID 19 virus. The FDA then had to release a statement cautioning people against using the drug off label. Later, when President Trump stated that he was taking a two week course of hydroxychloroquine, despite any evidence showing it could prevent COVID 19, there was widespread concern from healthcare professionals about the dangerous example this could set. A recent study confirmed a huge surge in hydroxychloroquine and chloroquine prescription fills – likely due to off label prescriptions for COVID 19.

Since then, hospitals now have to deal with the additional burden of treating people poisoning themselves after taking the drug, with one man fatally poisoning himself with a fish tank cleaning additive made with the same active ingredient as chloroquine. The bias towards this drug is even derailing clinical trials of other closely related COVID 19 treatment regimens. While studies done within cell dishes in labs show that both hydroxychloroquine and chloroquine can inhibit the virus, as with any medicine while studies in humans tend to be much more inconsistent. The largest study of the drug was published in The Lancet on May 22, 2020 stating that the drug increased the risk of death in hospitalized COVID 19 patients. This paper has now been famously retracted because of serious concerns about the verification of the data sources, study design and analysis used. While the verdict on hydroxychloroquine is far from clear, now is not the time for anyone to be taking this drug off label.