August 31, 2020
There are currently no proven treatments for the deadly respiratory disease caused by the new coronavirus (COVID-19), although many countries are in trials for existing and experimental drugs. So far, only one — the antiviral remdesivir — has been shown, in randomized control trials, to have some potential to speed up recovery. Most recently, convalescent plasma has been given emergency authorization to treat the virus.
There have been many claims of a cure made around the world. Some of the most interesting include:
- Drinking cow urine and coating oneself in cow dung. All urine and dung may only come from cows in India.
- USB flash drives being sold for $370 as a “5G Bioshield”, purportedly offering protection from the non-existent threat of infection transmitted via 5G mobile telephone radio waves.
- Inhaling 0.5-3% hydrogen peroxide solution using a nebulizer.
- Gargling with saltwater.
- Drinking warm water or hot baths/heating to 26–27 °C (79–81 °F).
- Wearing the color white as it may have a harmful effect on coronavirus, as claimed in a widely shared Facebook post.
- A mix containing amphetamines, cocaine, and nicotine, on sale on the dark web for US $300, was presented as a vaccine against COVID-19.
- A claim that cannabis could protect against the coronavirus appeared on YouTube, along with a petition to legalize cannabis in Sri Lanka.
- “Virus Shut Out Protection” pendants, supposedly from Japan, worn around one’s neck, have been sold with claims that they prevent infection.
- A suggestion that COVID-19 could be prevented by applying a cotton ball soaked in violet oil to the anus.
- Drinking bleach.
As medical professionals wade through the more mainstream claims on how to treat Covid-19, the WHO provides the following guidelines:
“It can be ethically appropriate to offer individual patients experimental interventions on an emergency basis outside clinical trials, provided that no proven effective treatment exists; it is not possible to initiate clinical studies immediately; the patient or his or her legal representative has given informed consent; and the emergency use of the intervention is monitored, and the results are documented and shared in a timely manner with the wider medical and scientific community.”
“The decision to offer a patient an unproven or experimental treatment is between the doctor and the patient but must comply with national law. Where it is possible and feasible for the treatment to be given as part of a clinical trial, this should be done unless the patient declines to participate in the trial.”
“If it is not possible to give the treatment as part of a clinical trial, appropriate records of the use of the medicine must be kept, in compliance with national law, and outcomes for patients should be monitored and recorded.”
A doctor is not negligent if they act in accordance with a practice accepted, at the time, as proper by a reasonable and respected body of medical opinions, even if other doctors might have acted differently based on other acceptable medical opinions.
The concern is that not all treatment is based on science and clinical trials. In many instances politics has played a role in which medications have been brought to the forefront. Avigan and Hydroxychloroquine are two examples.
The flu drug Avigan, produced by the Japanese company Fujifilm, has been embraced by several governments despite limited evidence that it works to treat COVID-19. The drug’s side effects may include increased risk of birth defects if it is taken by pregnant women.
Prime Minister Abe of Japan has been one of Avigan’s leading proponents. His administration has called for the drug, which has only conditional approval in Japan for serious infectious diseases such as Ebola, to be approved as a coronavirus treatment and for millions of doses to be stockpiled.
Interestingly, Abe is a personal friend of Fujifilm’s chairman Shigetaka Furumori, and has lobbied heavily for the drug’s international use, including offering it for free to up to 20 countries through a grant to the United Nations.
China and Indonesia have been two of Avigan’s biggest users. A senior Chinese health official endorsed the drug in March of 2020 as “very safe and clearly effective” after a trial on 200 patients, and Indonesia has imported millions of doses to treat its citizens.
At the same time, South Korea resisted its use, saying the evidence reviewed by its experts was unpersuasive.
“Avigan has not only not shown efficacy during test studies but also there is no data on clinical trials conducted on patients,” Oh Myoung-don, a South Korean infectious disease expert, told Yonhap news agency on April 4, 2020, weeks after China’s endorsement: “The drug has also shown serious side effects, such as fetal deaths in animal studies.”
Abe has reportedly lobbied President Trump, personally, to promote Avigan in the U.S. The White House then pressed the FDA to approve emergency use of the drug as an experimental Covid-19 treatment, according to Politico on March 31, 2020.
On April 7, 2020, the FDA granted approval to three hospitals in Massachusetts to launch the first US clinical trials of Avigan.
President Trump and several Fox News personalities promoted the anti-malaria drugs, hydroxychloroquine and chloroquine, as COVID-19 treatments for weeks, encouraging patients to try them out.
“I think it could be something really incredible,” President Trump stated on March 19, 2020.
The drug was widely used in VA hospitals. The analysis of hospital data, done by independent researchers at two universities with VA approval, was not a rigorous experiment. Researchers analyzed medical records of 368 older male veterans hospitalized with confirmed coronavirus infection at VA medical centers who died or were discharged by April 11, 2020.
About 28% of veterans who were given hydroxychloroquine, plus usual care, died in comparison to the 11% of those getting routine care alone.
Several weeks later, the hype fizzled. A trial conducted by U.S. government researchers among patients at the Veterans Administration found that subjects treated with hydroxychloroquine experienced no benefits and higher death rates than patients who received standard treatment. The drug’s side effects included an increased risk of potentially lethal heart failure.
A few days later, the FDA issued a safety communication warning against the use of both anti-malaria drugs for COVID-19.
In the interim, the drugs were widely disseminated not only in the U.S., but internationally, posing risks that have so far have not been investigated or quantified.
The coronavirus is different, of course: the pressure is coming from all sides. An effective medicine could save millions of lives. Yet, the risks of moving too fast, with too little science, can put doctors in a situation where they are doing more harm than good. It typically takes years of studies and trials to get accurate results from testing medicines, as well as vaccines, and it is crucial to let the scientists and medical professionals treat this disease from a scientific perspective rather than from a place of political pressure.
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