There are two steps the U.S. must take to control the coronavirus pandemic, according to health officials: First we must contain it, and then we must treat it.
On containment, the vast majority of health officials agree: social distancing works. In New York, for example, the hospital discharge rates increased and the number of deaths per day went down for the first time this past weekend. It’s still to early to declare victory, as Gov. Andrew Cuomo pointed out, but the results are hopeful.
Treating COVID-19 is another question entirely, and one that has prompted a good deal of disagreement among health officials. At the center of debate are two commonly prescribed anti-malarial drugs, hydroxychloroquine and azithromycin (often sold as Z-Pak). Dozens of doctors have shared stories over the past few weeks that describe how a combination of these drugs has helped COVID-19 patients. But there is little scientific data to back these anecdotal claims. The result has been a clash between the cautious skeptics and the optimistic innovators.
Both sides have taken things to the extreme. In Michigan, Gov. Gretchen Whitmer forbade physicians from prescribing hydroxychloroquine to COVID-19 patients, threatening “administrative action” against those who defied her administration’s order. She later reversed course, claiming that the warning had been a miscommunication. She has since asked the federal government to supply the state with a hydroxychloroquine stockpile after the Food and Drug Administration granted emergency authorization for the drug’s use.
Then there’s Trump, who has regularly touted hydroxychloroquine during his press briefings as a potential cure. “They say take it,” Trump said. “I’m not looking at it one way or the other, but we want to get out of this. If it does work, it would be a shame if we didn’t do it early.” After all, he continued, “what do you have to lose?”
Neither of these approaches will work moving forward. We need some sort of middle ground, in which caution and optimism can work together.
The person who best represents that balanced approach is Dr. Anthony Fauci, one of the leading officials on Trump’s Coronavirus Task Force. Fauci has been very clear that more testing is needed to establish hydroxychloroquine’s medicinal value in regard to COVID-19. But he hasn’t ruled it out entirely, either.
“We’re trying to strike a balance between making something with a potential of an effect to the American people available … under the auspices of a protocol that would give us information to determine if it’s truly safe and truly effective,” Fauci explained during a press briefing.
Fauci’s strategy has been to avoid definitive statements where he cannot justify them — an approach our health officials should seek to imitate. Hydroxychloroquine and azithromycin might indeed work, but they also might not work. Thus, our approach will require caution and optimism. Caution, because promising a cure when there is none would be disastrous. Optimism, because hydroxychloroquine is a familiar prescription drug, which means its side effects and interactions are also well-known, and the anecdotal evidence supporting its use is largely positive.
The good news is that our medical community is already running clinical trials to evaluate whether hydroxychloroquine and azithromycin do indeed work. Until these trials provide sufficient scientific data, we shouldn’t treat the anti-malarial drug combination like it’s a game changer. Then again, we shouldn’t deny COVID-19 patients a potentially therapeutic treatment — not while there is still hope that it could work.
