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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Agencies
June 16,2020

Washington, Jun 16: The United States will reduce its troop strength in Germany from the nearly 52,000 at present to 25,000, President Donald Trump has said in Washington.

In an interaction with reporters at the White House on Monday, Trump attributed the move to high costs and Germany being "delinquent" in its payment to NATO.

"We have 52,000 soldiers in Germany. That's a tremendous amount of soldiers. It's a tremendous cost to the United States and Germany, as you know, is very delinquent in their payments to NATO.

"They are paying one per cent and they're supposed to be a two per cent. And then two percent is very low. It should be much more than that. So they are delinquent of billions of dollars," Trump alleged.

"So, we're putting the number down to 25,000 soldiers. We'll see what happens, but Germany has not been making payments. In addition to that, I was the one that brought it up. Everybody talks about Trump with Russia. Well, I brought this up a long time ago. Why is Germany paying Russia billions of dollars for energy and then we're supposed to protect Germany from Russia? How does that work? It doesn't work," the US president said.

US soldiers, he said, are paid well. "They live in Germany. They spend vast amounts of money in Germany. Everywhere around those bases is very prosperous for Germany. So, Germany takes. And then on top of it, they treat us very badly on trade. We have trade with the EU, Germany being the biggest member, and very, very badly on trade and we are negotiating with them on that. But right now, I'm not satisfied with the deal they want to make," Trump said.

"They've cost the United States hundreds of billions of dollars over the years on trade," he said.

The US protects them and then they take advantage of America on trade, the president said.

"So we are working on a deal with them, but it's very unfair and I would say by far, the worst abuser is Germany," he said.

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Agencies
May 4,2020

Washington, May 4: Anxious for an economic recovery, President Donald Trump fielded Americans' questions about decisions by some states to allow nonessential businesses to reopen while other states are on virtual lockdown due to the coronavirus.

After more than a month of being cooped up at the White House, Trump returned from a weekend at the Camp David presidential retreat in Maryland and participated in a “virtual” town hall, hosted Sunday night by Fox News Channel, from inside the Lincoln Memorial.

He pushed for an economic reopening, one his advisers believe will be essential for his reelection chances this November.

“We have to get it back open safely but as quickly as possible," Trump said.

The president acknowledged fear on both sides of the issue, some Americans worried about getting sick while others are concerned about losing jobs.

Though the administration's handling of the pandemic, particularly its ability to conduct widespread testing, has come under fierce scrutiny, the president defended the response and said the nation was ready to begin reopening.

“I'll tell you one thing. We did the right thing and I really believe we saved a million and a half lives,” the president said.

But he also broke with the assessment of his senior adviser and son-in-law, Jared Kushner, saying it was “too soon to say" if the federal government was overseeing a “success story."

Trump's impatience also flashed. While noting that states would go at their own pace in returning to normal, with ones harder hit by the coronavirus going slower, he said that “some states frankly I think aren't going fast enough" and singled out Virginia, which has a Democratic governor and legislature.

And he urged the nation's schools and universities to return to classes this fall.

But many public health experts believe that cannot be done safely until a vaccine is developed.

Trump declared Sunday that he believed one could be available by year's end although his own pandemic task force has predicated it could be another 18 months.

Federal guidelines that encouraged people to stay at home and practice social distancing expired late last week.

Debate continued over moves by governors to start reopening state economies that tanked after shopping malls, salons and other nonessential businesses were ordered closed in attempt to slow a virus that has killed more than 66,000 Americans, according to a tally of reported deaths by Johns Hopkins University.

The U.S. economy has suffered, shrinking at a 4.8 per cent annual rate from January through March, the government estimated last week. It was the sharpest quarterly drop since the 2008 financial crisis.

Roughly 30.3 million people have filed for unemployment aid in the six weeks since the outbreak forced employers to shut down and slash their workforces. It was the worst string of layoffs on record.

Larry Kudlow, Trump's top economic adviser, on Sunday predicted a “spectacular 2021” — with “the right set of policies” — on top of a rebound from July through December of this year.

He said on CNN's "State of the Union" that the administration would "pause” to review the effectiveness of trillions in economic relief spending before making any decision on whether additional aid is needed.

House Speaker Nancy Pelosi, D-Calif., said Thursday that state and local governments are seeking up to USD 1 trillion for coronavirus costs, The Senate planned to reopen Monday, despite the Washington area's continued status as a virus hot spot and with the region still under stay-at-home orders.

The House remains shuttered. The pandemic is forcing big changes at the tradition-bound Supreme Court: The justices will hear arguments, beginning Monday, by telephone for the first time since Alexander Graham Bell patented his invention in 1876.

Congressional Republicans are resisting calls by Democrats for emergency spending for states and local governments whose revenue streams all but dried up in recent weeks.

The GOP is counting on the country's reopening and the rebound promised by Trump as their best hope to forestall another big round of virus aid.

The leaders of California and Michigan are among governors under public pressure over lockdowns still in effect while states such as Florida, Georgia and Ohio are reopening.

Michigan Governor Gretchen Whitmer, a Democrat, said Sunday that the armed protesters who demonstrated inside her state's Capitol “depicted some of the worst racism” and “awful parts” of US history by showing up with Confederate flags, nooses and swastikas.

Trump had tweeted “LIBERATE” and named Michigan and other states in mid-April. In a new tweet Friday, he urged Whitmer to “make a deal” with the protesters. “These are very good people, but they are angry.

They want their lives back again, safely!” Trump said.

Despite the opposition of Michigan's Republican-controlled Legislature, Whitmer has extended a state of emergency declaration and directed most businesses statewide to remain closed.

Some people participating in other public protests across the US have not kept their distance from one another and have rallied without masks, not heeding public health recommendations.

Deborah Birx, coordinator of the White House coronavirus task force, called that behavior “devastatingly worrisome.”

She said people will feel guilty for the rest of their lives if they end up infected and unwittingly spread the virus to vulnerable family members.

“We need to protect each other at the same time we're voice our discontent,” she told CNN's “State of the Union.”

An overwhelming majority of Americans support stay-at-home orders and other efforts to slow the virus' spread, according to a recent survey from The Associated Press-NORC Center for Public Affairs Research.

Asked about states that are reopening before they meet benchmarks laid out in federal guidelines she helped write, Birx said the guidelines “are a pretty firm policy of what we think is important from a public health standpoint.”

She added that she and others have made it clear that people must continue practising social distancing, “scrupulous” hand washing and other measures to protect themselves and others.

Fox News Channel said it asked viewers to submit questions about reopening the country on the network's Twitter, Facebook and Instagram accounts for a chance to appear on the rare broadcast from the Lincoln Memorial. Trump spoke from the memorial's steps last July Fourth.

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News Network
February 18,2020

Beijing, Feb 18: A hospital director at the epicentre of China's virus epidemic died on Tuesday, state media said, the latest medical worker to fall victim to the new coronavirus spreading across the country.

The COVID-19 virus, which is believed to have originated in Wuhan late last year, has infected more than 72,000 people and killed nearly 1,900.

Liu Zhiming, the director of Wuchang Hospital in Wuhan, died Tuesday morning after "all-out rescue efforts failed," state broadcaster CCTV reported.

China said last week that six medical workers had died from the virus, while 1,716 have been infected.

Liu's death was initially reported by Chinese media and bloggers shortly after midnight on Tuesday -- but the stories were later deleted and replaced with reports that doctors were still trying to save him.

After initial reports of his death were denied, the hospital told AFP on Tuesday morning that doctors were giving him life-saving treatment.

Liu's death has echoes of that of Wuhan ophthalmologist Li Wenliang, who had been punished by authorities for sounding the alarm about the virus in late December.

Li's death prompted a national outpouring of grief as well as anger against the authorities, who were accused of mishandling the crisis.

People took to social media to mourn Liu on Tuesday, with many users on the Twitter-like Weibo platform drawing critical comparisons between Liu's death and Li's.

In both cases their deaths were initially reported in state media posts -- later deleted -- and their deaths denied, before being finally confirmed again.

"Has everyone forgotten what happened to Li Wenliang? They forcefully attempted resuscitation after he died," one Weibo commenter wrote.

Another commenter said, Liu "already died last night, (but) some people are addicted to torturing corpses".

A hashtag about Liu's death had 29 million views by Tuesday afternoon.

Doctors in Wuhan face shortages of masks and protective bodysuits, with some even wearing makeshift hazmat suits and continuing to work despite showing respiratory symptoms, health workers have told AFP.

Hubei province and its capital Wuhan have been the hardest hit by the virus, accounting for nearly 1,800 of the deaths from the virus so far.

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