The Hydroxychloroquine Controversy
Among our most fundamental and sacred rights is the right to medical freedom. But in the curious case of hydroxychloroquine, it seems that the government, media, and pharmaceutical industry have been fighting tooth and nail to make the drug unavailable – despite overwhelming evidence that it can prevent and treat COVID-19. In Ohio, however, a ban on hydroxychloroquine is being reversed. Thanks to the strong leadership of governor Mike DeWine, the State of Ohio Board of Pharmacy has reversed a rule that would prohibit the sale of hydroxychloroquine for the treatment or prevention of coronavirus. It could mean the difference between life and death for high-risk patients. The Hydroxychloroquine Controversy Starting in August, pharmacies, clinics and other medical institutions were to be prohibited from dispensing or selling the drugs to treat COVID-19, according to regulations issued by the State of Ohio Board of Pharmacy. They could still be used in clinical trials, said Cameron McNamee, director of policy and communications for the board. Proponents of the ban (which has been instituted in other states across the nation) insist that HCQ is not an effective treatment for COVID-19, citing potential side effects as the reason for the ban. Under the regulation, pharmacists in Ohio found to be selling or dispensing the drug to treat COVID-19 could have faced disciplinary action ranging anywhere from a warning or fine to a temporary suspension of their license. But Governor DeWine has a unique perspective on the issue. “I agree with the statement from Dr. Steven Hahn, Commissioner of the [Food and Drug Administration], that the decision about prescribing hydroxychloroquine to treat COVID-19 should be between a doctor and a patient,” the governor said in a statement via Twitter. “The Ohio Board of Pharmacy and @ohiomedboard should revisit the issue, listen to the best medical science, and open the process up for comment and testimony from experts.” And he’s exactly right: medical interventions are a personal decision in which the government has absolutely no business meddling. This is especially encouraging given the extremely political (and at times inexplicable) war that has been fought around the malaria drug. The controversy became mainstream after President Trump announced in May that he was using hydroxychloroquine as a preventative measure to ward off the novel coronavirus. The Hydroxychloroquine Timeline Since then, there have been conflicting reports and studies on the efficacy and risk of using HCQ (along with zinc and Zithromax) to prevent or treat COVID-19. On May 7, a study became available in the The New England Journal of Medicine showing COVID-19 patients who were treated with hydroxychloroquine did not experience lower risk of death compared to coronavirus patients who received other treatments. Later that month, Anthony Fauci discredited the drug in an interview on CNN, saying, “The scientific data is really quite evident now about the lack of efficacy for it.” One day later, research published in The Lancet showed that cancer patients with COVID-19 who received hydroxychloroquine and azithromycin experienced a risk of death 2.89 times greater within 30 days than those who did not receive the drugs. However, just a few days after the study was released, Richard Horton, editor of The Lancet, tweeted about the validity of the study the medical journal published claiming a higher risk of death for patients who received hydroxychloroquine. “Serious questions have been raised about the reliability of the findings reported in this paper,” he said. That same day, the Arizona-based Association of American Physicians and Surgeons sued the US Department of Health and Human Services for preventing physicians from prescribing hydroxychloroquine as a COVID-19 preventative. Two days later, on June 4th, The Lancet retracted the study it published May 22 that claimed hydroxychloroquine was linked to higher mortality rates in COVID-19 patients. On the same day, The New England Journal of Medicine retracted a separate study showing that blood pressure medications were safe to take for COVID-19 patients. Both studies used data from analytics company Surgispher, which refused to share its raw data with study authors or a third-party auditor after questions about its accuracy arose. On July 2nd, the International Journal of Infectious Diseases published a study conducted by researchers at Detroit-based Henry Ford Health System that claimed COVID-19 patients who received a small dose of hydroxychloroquine within the first two days of their hospital stay were more likely to survive. On July 27th, a group of frontline doctors gathered on the steps of the Supreme Court to share their success in treating COVID-19 patients with HCQ. Dr. Stella Immanuel, who currently runs a practice in Houston, says that she has treated over 350 patients with the drug with zero fatalities. Other doctors shared their belief that masks are ineffective and that children are not susceptible and should return to school in the fall. She cited a study which had recently been published in the American Journal of Emergency Medicine evaluating if hiccups were a symptom of COVID-19. In the study, patients who tested positive for COVID-19 were treated with hydroxychloroquine. The use of HCQ in this study implies its efficacy in treating the disease itself, Immanuel pointed out. Within hours, the video had been completely deleted or covered with a “fake news” label by virtually every social media platform. Major news outlets scrambled to discredit the doctors, focusing on Dr. Immanuel’s unconventional religious beliefs as proof that her observation must not be true. (Dr. Immanuel continues to practice as a licenced primary care physician in good standing with the Texas Medical Board, and there is no evidence that her experience in treating patients with hydroxychloroquine is untrue.) On July 29th, Ohio’s board of pharmacy prohibited pharmacists from dispensing or selling hydroxychloroquine to treat COVID-19. After a request from Governor DeWine just a day later, the state’s board of pharmacy reversed its ban on hydroxychloroquine for use in COVID-19 patients and said it will reexamine the issue. Politics vs Medicine On August 3rd, two Henry Ford Health System executives wrote in an open letter that the persisting political climate has made any objective discussion about hydroxychloroquine “impossible.” The following is an excerpt from that letter: “The most well-accepted and definitive method to determine the efficacy of a treatment is a double-blind, randomized clinical trial. However, this type of study takes a long time to design, execute and analyze. Therefore, a whole scientific field exists in which scientists examine how a drug is working in the real world to get as best an answer as they can as soon as possible. These types of studies can be done much more rapidly with data that is already available, usually from medical records. Like all observational research, these studies are very difficult to analyze and can never completely account for the biases inherent in how doctors make different decisions to treat different patients. Furthermore, it is not unusual that results from such studies vary in different populations and at different times, and no one study can ever be considered all by itself. Our promising Henry Ford treatment study should be considered as another important contribution to the other studies of hydroxychloroquine that describes what the authors found in our patient population. We – along with all doctors and scientists – eagerly support the need for randomized clinical trials. We also want to point out that scientific debate is a common occurrence with almost every published study. In part, this is what fuels the advancement of knowledge – challenging one another on our assumptions, conclusions and applications to get to a better place for the patients we collectively serve. You can read the original study here and the senior author’s letter to the editor here. Unfortunately, the political climate that has persisted has made any objective discussion about this drug impossible, and we are deeply saddened by this turn of events. Our goal as scientists has solely been to report validated findings and allow the science to speak for itself, regardless of political considerations. To that end, we have made the heartfelt decision to have no further comment about this outside the medical community – staying focused on our core mission in the interest of our patients, our community, and our commitment to clinical and academic integrity.” The politicizing of potentially life-saving treatments, along with the overreach of our government in banning or mandating these interventions, is the single greatest issue in American medicine today. This issue is much bigger than the simple question of “does hydroxychloroquine work?” It’s a matter of fundamental medical freedom and bodily autonomy. Sadly, we are often at the mercy of our leaders in government to protect us from this kind of medical tyranny. Fortunately, there are still some leaders that will answer the call to protect our liberty – even in the face of heavy opposition. Governor Mike DeWine is one of those heroes. “The Board of Pharmacy and the State Medical Board of Ohio should revisit the issue, listen to the best medical science, and open the process up for comment and testimony from experts,” DeWine said in a prepared statement. It is IMPERATIVE that we support leaders on either side of the aisle who are willing to stand up for our freedoms and protect doctors who work with patients instead of against them. Please take a moment to join our movement today, and discover how you can affect REAL CHANGE in the fight against medical tyranny.