Malaria drug Hydroxychloroquine fails to prevent COVID-19 in a rigorous study

News Network
June 4, 2020

Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

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News Network
June 11,2020

Jun 11: The total death toll in the US from the novel coronavirus pandemic could hit the grim figure of 200,000 by September and expecting a dramatic decrease in COVID-19 cases in the country will be a "wishful thinking , an eminent Indian-American professor has warned.

Ashish Jha, the head of Harvard's Global Health Institute, told CNN on Wednesday that he is not trying to scare people to stay at home rather urged everyone to wear masks, adhere to the social distancing rules and called for ramping up testing and tracing infrastructure.

Anybody who's expecting a dramatic decrease in cases is almost surely engaging in wishful thinking. And if it (COVID numbers) stays just flat for the next three months, we're going to hit 200,000 deaths sometime in September and that is just awful, Jha said.

Jha said the 200,000 death toll is not just a guess . Currently 800-1000 people are dying daily in America from the virus and all data suggest that the situation is going to get worse.

We're gonna have increases, but even if we assume that it's going to be flat all summer, that nothing is going to get worse... even if we pick that low number of 800 a day, that is 25,000 (deaths) a month in three and a half months. We're going to add another 88,000 people and we will hit 200,000 sometime in September, Jha said.

The United States is by far the hardest-hit country in the global pandemic, in terms of both confirmed infections and deaths.

According to data by the Johns Hopkins University, the number of coronavirus cases in the US currently is nearly two million and about 112,900 people have died in the country, the most in the world.

When asked about an improvement in states like New York, which had been the epicenter of the COVID19 pandemic in the US, Jha said while coronavirus cases are declining in New York, New Jersey, Connecticut and Massachusetts, the numbers are increasing in states such as Arizona, Florida, Texas, North and South Carolina while the country as a whole is pretty flat.

He said, people should take measures as that will help suppress the virus and ensure people could get back outside safely but he voiced concern that this was not the situation in reality.

We're not doing that and so we're going to unfortunately have another 25,000 deaths a month until September, and then it'll keep going. It's not going to magically disappear. We've got a turn around. This is not the future I want, he said.

Jha said he had expected the situation to improve in the summer months but on the contrary the numbers have continued to rise even in the warm weather.

Summer was supposed to be our better months - warmer weather, people outside, a little less transmission. This is not the time (summer) I was expecting a lot more cases. We're seeing a lot more cases, especially in states like Arizona where the numbers look really scary, he said.

Jha added that he was hopeful that maybe the summer months would give us more of a break. I think I may have been too optimistic on that.

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News Network
June 6,2020

Washington, Jun 6: US President Donald Trump has said that countries like India and China would have much more coronavirus cases than America, the worst-hit country in the world, if they conduct more tests.

Trump, in his remarks at Puritan Medical Products in Maine, said that the US has carried out 20 million tests.

Compared to the US, Germany is at four million and much talked about South Korea is about three million tests, he said on Friday.

According to Johns Hopkins Coronavirus Resource Center, the US has reported nearly 1.9 million cases and over 1,09,000 deaths, making America the worst affected country, while the total number of coronavirus cases in India and China stand at 2,36,184 and 84,177 respectively.

India has so far conducted over 4 million coronavirus tests, according to the health ministry.

Commenting on the COVID-19 tests in the US, Trump said: "We will be well over 20 million tests. Remember this, when you test more, you have more cases.

"I say to my people every time we test; you find cases because we do more testing. If we have more cases, if we wanted to do testing in China or in India or other places, I promise you there would be more cases... you are doing a fantastic job in getting out the swabs".

Puritan is one of the only manufacturers in the world producing the high-quality medical swabs that are crucial for rapid testing.

"And every swab you make at Puritan is proudly stamped with the beautiful phrase made in the USA."

"Thanks to the testing capacity that you are making possible, our country is reopening and our economy is recovering like nobody would've thought possible," he said.

Referring to the latest monthly employment numbers, Trump said that the economy is now back on track.

"We absolutely shattered expectations, and this is the largest monthly jobs increase in American history, think of that; that's a long time.

"I think it's more than double or about double of what our highest was before so this is the largest monthly job increase in American history. And we're going to have a phenomenal next year. We're going to have a tremendous couple of months prior to the election on November 3 very, very important date," the president said.

Seeking re-election for his second consecutive term, Trump is pitted against Democratic presidential nominee Joe Biden in November 3 presidential elections. Most of the opinion polls shows that Biden is several points ahead of Trump.

"It's going to be a very important election because the only thing that can screw it up is if you get the wrong president and they raise your taxes, and they open up your borders so that everybody pours into our country," Trump said.

Reiterating that he has built a strong economy in the last three years, Trump vowed to bring the economy back on track, which has been badly hit by the coronavirus pandemic.

Describing the fight against coronavirus as the greatest national and industrial mobilisation since the World War II, Trump said that his administration has marshaled the full power of the US government and US industry to defeat the invisible enemy.

"It is indeed an enemy. It came from China, should have been stopped in China. They didn't do that," he alleged.

The administration, he said, has delivered over 1.5 billion pieces of personal protective equipment to doctors and nurses on the front lines. "We slashed the red tape to speed up the development of vaccines. And vaccines are coming along incredibly well, wait till you see, and therapeutics. And we partnered at private sector leaders such as Puritan to build the largest and most advanced testing capacity on the face of the earth, like this one," he said.

The Puritan factory in Maine, he said, quickly ramped up the production to produce nearly 20 million foam tipped swabs each month.

"Then in April, my administration invoked the Defence Production Act to help you scale up even more. Under a USD 75 million public-private partnership, Puritan will soon double production to 40 million swabs per month," Trump added.

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News Network
January 23,2020

Jan 23: Pakistan's Prime Minister Imran Khan called on Wednesday for the United Nations to help mediate between nuclear armed India and Pakistan over the disputed territory of Kashmir.

"This is a potential flashpoint," Khan said during a media briefing at the annual meeting of the World Economic Forum in Davos, Switzerland, adding that it was time for the "international institutions ... specifically set up to stop this" to "come into action".

The Indian government in August revoked the constitutional autonomy of Indian-administered Kashmir, splitting the Muslim-majority region into two federal territories in a bid to integrate it fully with the rest of the country.

Kashmir is claimed in full by both India and Pakistan. The two countries have gone to war twice over it, and both rule parts of it. India's portion has been plagued by separatist violence since the late 1980s.

Khan said his biggest fear was how New Delhi would respond to ongoing protests in India over a citizenship law that many feel targets Muslims.

"We're not close to a conflict right now ... What if the protests get worse in India, and to distract attention from that, what if ..."

The prime minister said he had discussed the prospect of war between his country and India in a Tuesday meeting with US President Donald Trump. Trump later said he had offered to help mediate between the two countries.

Khan said Pakistan and the United States were closer in their approach to the Taliban armed rebellion in Afghanistan than they had been for many years. He said he had never seen a military solution to that conflict.

"Finally the position of the US is there should be negotiations and a peace plan."

In a separate on-stage conversation later on Wednesday, Khan said he had told Trump in their meeting that a war with Iran would be "a disaster for the world". Trump had not responded, Khan said.

Khan made some of his most straightforward comments when asked why Pakistan has been muted in defence of Uighurs in China.

China has been widely condemned for setting up complexes in remote Xinjiang province that Beijing describes as "vocational training centres" to stamp out ""extremism and give people new skills.

The United Nations says at least one million ethnic Uighurs and other Muslims have been detained.

When pressed on China's policies, Khan said Pakistan's relations with Beijing were too important for him to speak out publicly.

"China has helped us when we were at rock bottom. We are really grateful to the Chinese government, so we have decided that any issues we have had with China we will handle privately."

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