Brazil’s Bolonaro lives to fight another day – having recovered from COVID.
And to make matters even more tragic for the left, the Brazilian president does a Trumpish thing:
Brazilian President Jair Bolsonaro announced on Saturday he has tested negative for the new coronavirus more than two weeks after being diagnosed on July 7, attributing his recovery to an unproven malaria drug.
“RT-PCR for Sars-Cov 2: negative. Good morning everyone,” the 65-year-old tweeted, along with a photo of himself smiling and holding a packet of hydroxychloroquine. Its effectiveness against Covid-19 has not been demonstrated in clinical trials.
There are only three sentences in that quote, but there are at least two lies (or errors, or misrepresentations). The first is “unproven malaria drug.” It certainly is an extremely proven malaria drug. From the CDC:
Hydroxychloroquine (also known as hydroxychloroquine sulfate) is an arthritis medicine that also can be used to prevent malaria…Hydroxychloroquine can be prescribed for either prevention or treatment of malaria…Hydroxychloroquine can be prescribed to adults and children of all ages. It can also be safely taken by pregnant women and nursing mother.
Both adults and children should take one dose of hydroxychloroquine per week starting at least 1 week before traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving…
Hydroxychloroquine can only be used in places where chloroquine (a related medicine) is still effective. There are only a few places left in the world where hydroxychloroquine is still effective including parts of Central America and the Caribbean.
So, to recap: it’s a malaria drug, quite proven, but only good in certain areas. It is also used for arthritis (and, if memory serves me, for certain other auto-immune diseases like lupus).
Ah, but maybe they meant “unproven in treating COVID”? Maybe they did, but that’s not what they wrote. However, that is more or less what they wrote in the last sentence I quoted from the Bolsonaro article: “Its effectiveness against Covid-19 has not been demonstrated in clinical trials.”
Which is confusing and misleading to the average reader, who almost certainly doesn’t know what a “clinical trial” is and how it differs from other types of studies that might show a drug’s efficacy. Let’s just say that clinical trials are a particular type of research, that they take longer to perform, and that in the case of hydroxychloroquine and COVID, the results of the bogus Lancet study (that one that had to be withdrawn) caused the panicked stoppage of a host of clinical trials around the world. And so clinical trials for the use of the drug against COVID have been even slower to come out.
Here’s one that still seems to be in the early stages, and so far they’ve only tested for safety and found it to be safe in COVID patients. Here’s another which, by the headline, seems to have found the drug not to be helpful with COVID, but if you read the actual study you might wonder – as I did – why it was even done, because the researchers did not use zinc. The people I’ve seen advocating the drug as a treatment for early cases of COVID have all emphasized that zinc must be part of the protocol. But that is often ignored. As one of several commenters to that study wrote: “This study and all others left out daily Zinc supplements! And it was given too late, meaning many patients already had a fatal viral load. Study is designed to fail.”
I don’t know about “all others.” But I’ve found plenty of studies (I’m not sure if they were all clinical trials, though) that have those two flaws as well.
Actually, the efficacy of hydroxychloroquine has been demonstrated in a number of studies (not necessarily clinical trials), particularly ones that use it early in the course of the illness, in the right dose, and which include zinc.
In addition, here’s one example of good results with the drug even in sicker patients, and even when taken without zinc:
Treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19 – and without heart-related side-effects, according to a new study published by Henry Ford Health System.
In a large-scale retrospective analysis of 2,541 patients hospitalized between March 10 and May 2, 2020 across the system’s six hospitals, the study found 13% of those treated with hydroxychloroquine alone died compared to 26.4% not treated with hydroxychloroquine. None of the patients had documented serious heart abnormalities; however, patients were monitored for a heart condition routinely pointed to as a reason to avoid the drug as a treatment for COVID-19.
The study was published today in the International Journal of Infectious Diseases, the peer-reviewed, open-access online publication of the International Society of Infectious Diseases (ISID.org)…
“The findings have been highly analyzed and peer-reviewed,” said Dr. Marcus Zervos, division head of Infectious Disease for Henry Ford Health System, who co-authored the study with Henry Ford epidemiologist Samia Arshad. “We attribute our findings that differ from other studies to early treatment, and part of a combination of interventions that were done in supportive care of patients, including careful cardiac monitoring. Our dosing also differed from other studies not showing a benefit of the drug. And other studies are either not peer reviewed, have limited numbers of patients, different patient populations or other differences from our patients.”
So although these patients were sick enough to be hospitalized, they were treated early, and attention was paid to giving the right dose. On the other hand, zinc doesn’t seem to have been part of the study, and yet the results were good.
The bottom line is that results are encouraging in quite a few studies, particularly ones that involve less sick patients, but there haven’t been sufficent clinical trials to say that the drug has been proven to help COVID. This type of situation is not unusual with drugs, but in the case of COVID the political aims of the press have overshadowed any ability to report fairly on the results of studies of this drug.
NOTE: Speaking of the press – later in the Bolsonaro article you can read this:
The pandemic has exploded in Brazil, the country with the most infections and deaths from Covid-19 anywhere in the world except the United States.
A relatively meaningless statistic, meant to sound worse than it is. Both the US and Brazil have large populations. The most meaningful number to look at is deaths per million of population. That metric puts the US and Brazil either even with or behind most of the countries of western Europe. Even Peru and Chile – if you’re going to look just at Latin America – have had more deaths per capita than Brazil.