As to be expected, President Donald Trump took to Twitter over the weekend to try to ease public fears about COVID-19 by promoting several experimental drug treatments. In an all-caps tweet, Trump urged the Food and Drug Administration (FDA) to “move fast” to approve a combination of hydroxychloroquine, an anti-malaria drug, and azithromycin, an antibiotic, as a potential treatment for COVID-19, the disease caused by the novel coronavirus. On Twitter, Trump served as hypeman for this medical cocktail, writing that these drugs “have a real chance to be one of the biggest game changers in the history of medicine.”
For someone with no background in medicine, Trump is weirdly convinced of the efficacy of these drugs. Last week, in a press conference, Trump said he felt “good” about the possibility of chloroquine, another related anti-malaria drug, and hydroxychloroquine as potential treatment for COVID-19. Today, he shared an article from the New York Post about a man surviving COVID-19 thanks to hydroxychloroquine. Yet anecdotes should not be confused for statistics; most scientists, researchers and doctors will tell you that one anecdotal story from the New York Post does not constitute clinical evidence that any of these drugs can, or should, be used to treat COVID-19.
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According to a study published on the web site bioRxiv, there have been 69 drugs identified, including chloroquine, that could treat the respiratory disease that has caused 16,359 deaths and mass economic disruption worldwide. The World Health Organization is looking into both hydroxychloroquine and chloroquine as possible ways to slow or kill the virus, but there are plenty of unknowns that prevent it from being a “game changer,” as Trump called it. Science magazine details the concerns in a recent report. Similar to Trump’s previous dangerous rhetoric, his claims have the possibility to cause more harm than good. As NPR reported, some pharmacists are concerned about people hoarding the drugs. “Our members are definitely seeing more demand for this medication and possibly some people trying to hoard the medication,” Todd Brown, executive director of the Massachusetts Independent Pharmacists Association, told NPR. “Pharmacists are seeing an increase in requests and prescriptions for them, in instances where it’s not clear why the patient needs it at this time.” Health officials in Nigeria said that three people have overdosed on the drug.
Salon spoke with Rodney J.Y. Ho, a professor and director of the Targeted, Long-acting and Combination Anti-Retroviral Therapy (TLC-ART) program at the University of Washington, about both hydroxychloroquine and chloroquine as potential drugs to treat COVID-19.
As usual, this conversation has been edited for clarity.
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First, what are these drugs?
Chloroquine is the original malaria drug that was introduced many many years ago. And it’s been distributed widely in malaria-rampant areas. Hydroxychloroquine is slightly different, so it has additional benefits [as a treatment]. People found out over time that hydroxychloroquine can be used for rheumatoid arthritis. Another way people use it is for lupus. The difference is that hydroxychloroquine, [as] you can read in the name, has been oxygenated.
So chloroquine and hydroxychloroquine are both malaria drugs. You’ve probably heard about this from people that they’re accessible because they are FDA approved. But it’s not a drug that you buy over the counter, it’s a pill that’s prescribed— so that’s a very important distinction — because that means it has side effects that need to be managed by pharmacists and by relations.
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And what are those side effects?
So there are many different side effects, but the big ones are when it’s taken with another drug. So it can be as simple as being on a contraceptive that can change the drug levels, then that becomes toxic, so that’s what needed to be managed.
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So what do we know about how these drugs treat COVID-19?
We can kill the virus at the level that can be achieved in patients taking hydroxychloroquine or chloroquine in their blood. Based on that, people have been using it as one of the four or five experimental medications [but] because it’s not proven, nothing has been tested thoroughly by the FDA. But because it’s available by prescription and it’s a pill, you can order it.
So because it shows promise in a test tube, does that mean it can be that success can be easily transferred to a human body?
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The virus can kill people in many different ways. [We can observe that it is] killed in the test tube, [but] then you need to go through a long test to make sure that [it will happen] in the patient at the right stage, and the right place that you can use this [drug]. And we don’t know that yet. And what other things that the virus is doing, we don’t know.
What we do know is that the virus will kill the lung cells. Our lung cells are very big. Think of lung cells as balloons with pockets of cells inside them. These cells are loaded with blood. That’s how we exchange oxygen. So when the lung cells are infected, they will kill and collapse those balloons. At some stage, the whole lungs collapse and other cells attack the immune system. Sp, that’s when the hydroxychloroquine might have an effect, but the question is, when is there no point of return? And we don’t know that yet. So you can imagine the complications of how to treat this virus, and when to treat it. We don’t know how long and how quickly people can die from this — we need to help them by isolating and preventing the number of infections.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
