President Trump has expressed hope, perhaps too much, that a combination of hydroxychloroquine (HCQ) and azithromycin, an antibiotic also known as Zithromax and commonly sold in six-tablet packages known as Z-Paks, might help in the fight against COVID-19. Regarding HCQ, the president is relying on anecdotal information from China and South Korea, and a very small – and seriously flawed – preliminary French study of HCQ and the HCQ-Zithromax combination. Tempered optimism is justified, so the FDA and NIH have approved HCQ for apparently open trials in New York state. Much more data, and thus more reliable information, will flow from these trials, although they too are somewhat uncontrolled. Still, under the present circumstances – which are far from normal – it's worth a try.
But a word on the nomenclature: Hydroxychloroquine (HCQ) is an improvement on chloroquine, which is in turn an improvement on quinine. (The medical reality is more complex than that, but you get the idea.) All are antimalarials, but they are not the same drug. Malaria isn't a viral disease but, as it happens, both chloroquine and HCQ have shown some antiviral potency. In the case of SARS-CoV-2, the virus that causes COVID-19, HCQ shows the best potential. HCQ isn't perfectly safe, but according to the NIH's Dr. Fauci its side-effects are usually manageable. Other drugs, e.g. Gilead's Remdesivir, are also interesting, but they don't have the long-term safety record of HCQ, so more careful testing is required there. As always, ‘First, do no harm.’ This will take time which, well, damn it.
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I suppose it's predictable, but since the public mention of HCQ as a possible cure for COVID-19, some doctors and, in one case, a dentist (!), have prescribed HCQ for family and friends. This is unethical and extremely unhelpful. The panic is leading to shortages of HCQ which is is also prescribed for other conditions, e.g. lupus. One hopes that the misbehaving medical ‘professionals’ will receive a serious official spanking.
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