The claims about the promise of hydroxychloroquine as a cure for COVID-19 made by doctors in a viral video are at odds with the best available evidence.
The group, which calls itself America’s Frontline Doctors, gained enormous attention for a Monday event in front of the Supreme Court in which they said that they’d had success treating COVID-19 patients with hydroxychloroquine. Hundreds of thousands of people shared a video of the press conference on social media, including President Trump.
Soon, the video was pulled by YouTube, Facebook, and Twitter on the grounds that it spread misinformation about the coronavirus. Twitter even suspended the account of Donald Trump Jr. after he shared a video of the event.
An examination of the claims made at the press conference about a treatment for COVID-19 finds that while there is conflicting evidence about the benefits of hydroxychloroquine for people infected by the virus and researchers are still studying the question, their claims do not hold up well.
Dr. Stella Immanuel, a pediatrician from Houston, repeated multiple times that a cure exists for COVID-19. “This virus has a cure,” she said at one point. “It is hydroxychloroquine, zinc, and Zithromax.”
Hydroxychloroquine is an anti-malarial drug that is also used to treat lupus and rheumatoid arthritis. It gained popularity as a possible treatment for COVID-19 in April, when the president promoted it as a treatment.
“There is no reputable evidence that hydroxychloroquine has been effective,” said Dr. Otto Yang, an infectious disease expert at the David Geffen School of Medicine at UCLA.
Yang noted the Outcomes Related to COVID-19 study, conducted by the National Institutes of Health using a randomized controlled trial, often considered the gold standard for research. That study found no added benefit for patients treated with hydroxychloroquine.
The Food and Drug Administration listed seven studies in a June letter in which it revoked a March emergency use authorization for use of the drug for COVID-19. None of those studies found any effect either, and two were also randomized controlled trials. The FDA’s decision does not prevent physicians from prescribing the drug.
At the press conference, Dr. Simone Gold, an emergency physician from California and head of America’s Frontline Doctors, said that studies that found hydroxychloroquine ineffective were flawed because the drug wasn’t used properly.
“They’re inaccurate because [the drug is] given at the wrong time, the wrong dose, the wrong patient,” she claimed.
Immanuel said she had successfully treated 350 COVID-19 patients in the early stages of the disease. She could not be reached for comment.
While it is generally true that antiviral drugs are more effective if given at the early stages of the infection, that appears not to be the case for hydroxychloroquine.
Dr. David Sullivan, a professor at the Bloomberg School of Public Health at Johns Hopkins University, cited the study conducted at the University of Minnesota, which treated patients with hydroxychloroquine within four days after exposure to the virus.
“In the Minnesota trial, it did nothing,” he said. He also noted that hydroxychloroquine had proven ineffective at preventing other types of viral diseases in the early stages.
Gold did not respond to requests for an interview.
Zithromax, also known as azithromycin, is an antibiotic that came to prominence when the International Society of Antimicrobial Chemotherapy released a study in March showing that it was effective at treating COVID-19 in combination with hydroxychloroquine. But the research was widely criticized for having a small sample.
“There is absolutely no reason, theoretically, that azithromycin would help,” said Yang. “It does not interfere with anything in a cell that should even in theory stop a virus.”
A recent study published in the New England Journal of Medicine also found that azithromycin had no effect on COVID-19 patients.
Still, there are respected experts who disagree. Dr. Harvey Risch, a professor of epidemiology at the Yale School of Public Health, maintains there are benefits for outpatients with COVID-19 symptoms who can be treated at the early stages of the disease. However, none of the studies he has cited employed randomized controlled trials. Studies of outpatients using that methodology are in progress but aren’t expected to report results until September. Thus far, studies using randomized trials have focused on inpatients.
Risch also claims that hydroxychloroquine is being disregarded because it has become highly politicized.
Research on the effect that zinc might have is also ongoing. But experts are not optimistic, given the research on the effect that zinc has on common cold viruses.
“There is a little bit of data that zinc reduces the common cold, which is rhinoviruses and the coronaviruses, but only by maybe a day or two,” said Sullivan.
Yang added, “There is no reason to think that zinc will have a marked impact. Enough people have been trying it, and if it had some miracle effect on COVID, we’d know about it by now.”
