Data is clear on hydroxychloroquine “lack of efficacy” for COVID-19

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Is it? Presently, the University of Minnesota has a clinical trial underway to answer that question, which would reportedly be the first of its kind. This morning on CNN, however, Dr. Anthony Fauci cast a deluge of cold water on the prospects for hydroxychloroquine as either a treatment or preventative. The existing scientific data shows its “lack of efficacy,” although Fauci doesn’t call for stopping further studies of the drug:

National Institute of Allergy and Infectious Diseases Director Anthony Fauci on Wednesday became the first Trump administration official to say definitively that hydroxychloroquine is not an effective treatment for the coronavirus, based on the available data.

“The scientific data is really quite evident now about the lack of efficacy,” Fauci — the U.S. government’s top infectious disease expert — said on CNN.

But he stopped short of calling for an outright ban of the drug, which President Trump said he was taking last week as a preventative measure after a top White House aide was diagnosed with the coronavirus.

CNN’s Jim Sciutto springboarded his question off of a decision in France to halt its own studies and use of hydroxychloroquine for treating COVID-19. Their health minister based that decision on reports of adverse outcomes in the testing, and a lack of any promising results that would offset the risk:

France has banned the use of the controversial anti-malarial drug hydroxychloroquine to treat people with COVID-19, the diseased caused by the new coronavirus. The move follows the publication of initial findings from a large-scale study that found the drug offered no benefit to patients, and could in fact be harmful. …

France’s health minister responded to the findings the next day by asking the French High Council for Public Health (HCSP) to review the situation, and it recommended halting the use of the drug.

The findings also prompted the World Health Organization (WHO) to announce Monday the temporary suspension of the malaria drug from a global trial looking at various potential COVID-19 treatments, pending a safety review.

Again, though, the data didn’t come from a complete clinical trial of the drug in application for COVID-19. It has been in use for decades for other diseases — lupus and malaria, among others — so the side effects and contraindications are already well known. The UM study has produced few if any negative consequences for its sample, Dr. David Boulware reported last week, in part because they knew not to include subjects with existing heart disease in the study sample.

Politico also notes the lack of reliable clinical study data available for this question:

There is no data yet from randomized, controlled clinical trials of hydroxychloroquine — the gold standard for evaluating potential treatments. But Fauci was unequivocal on Wednesday, saying that “the data are clear right now.”

Thus far the data has not been encouraging, but it’s mostly anecdotal data, and some of that has argued the opposite. This is why scientists conduct clinical studies — to determine with a large degree of confidence whether a drug is effective and safe. Anecdotal data in either direction doesn’t cut it. A scientist like Fauci might be able to sift through most of that data and get a pretty good sense of where it’s going, but it takes a clinical study to settle the question.

Of course, we usually don’t have politicians and media politicizing the efficacy of drugs, either. Trump started it by promoting its use without proper clinical data, after which the media and his critics compounded the politicization with hysterical warnings of mass deaths over its use … after having been in use for decades without any such impact. It is still a prescribed medicine, not an over-the-counter drug, which means doctors still supervise its use. It would be much better for all sides to shut up about this until we get valid clinical-study data to determine whether we have an effective COVID-19 treatment with it or a dead end.

Thus far, Trump hasn’t commented on Fauci’s skepticism. Trump stopped taking hydroxychloroquine, perhaps out of a growing lack of confidence or merely because the prophylaxis period had passed. We’ll see if Trump takes the cause up again, but perhaps everyone should wait until Boulware completes his work.

Fauci had lots more to say in the CNN interview, some of which Karen Townsend will have later this evening, but he did give Trump one reason to cheer. It’s too early to cancel the political conventions, Fauci told Sciutto:

This, however, might be outside Fauci’s domain. He’s talking about this as though a decision on the national conventions can wait until just before they happen. The logistics of these events are already under way, though, and people will have to start shelling out cash for travel and accommodations very soon — perhaps in the next couple of weeks at the latest. That’s money they won’t get back if a last-minute cancellation takes place. The scientific go/no-go call might be able to wait until the beginning of August, but not the logistical go/no-go.





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