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
July 14,2020

Washington, Jul 14: The United States has the biggest Covid-19 testing programme in the world, better than big countries like Russia, China, India and Brazil, President Donald Trump said on Monday, asserting that America has "just about the lowest mortality rate" due to the disease in the world.

"We have one of the lowest mortality rates anywhere," Trump said at a White House roundtable. More than 34 lakh Americans have tested positive for Covid-19 so far and over 1,37,000 have died due to the disease, both of which are the largest numbers among all the countries.

The huge number of positive cases, the president said, is due to the massive testing efforts undertaken by his administration, more extensive than any other country.

"We test more than anybody by far. And when you test, you create cases. So we have created cases. I can tell you that some countries, they test when somebody walks into a hospital sick or walks into maybe a doctor's office, but usually a hospital. That is the testing they do, so they do not have cases, whereas we have all these cases. So, it is a double-edged sword," he said.

At the same time, the United States has the lowest mortality rate or just about the lowest mortality rate due to the disease in the world, Trump added. "We are doing a great job. We are doing very well with vaccines and we are doing very, very well with therapeutics. I think we are going to have some very good information coming out soon," he said in response to a question.

"But we have the best and certainly, by far, the biggest testing programme anywhere in the world. If you tested China or Russia or any of the larger countries, if you just tested India, as an example, the way we test, you would see numbers that would be very surprising. Brazil too. You know, Brazil is going through a big problem, but they do not do testing like we do," Trump said.

"So we do the testing and by doing the testing, we have tremendous numbers of cases. As an example, we have done 45 million tests. If we did half that number, you would have half the cases probably -- around that number. If we did another half of that, you would have half the numbers. Everyone would be saying, 'Oh, we are doing so well on cases'," he added.

Responding to a question, Trump said what China did to the world should not be forgotten.

"I think what China has done to the world with what took place -- the China plague -- you can call it the China virus, you can call it whatever you want to call it. It has about 20 different names. What they did to the world should not be forgotten," he said.

The trade deal with China that was signed early this year remains intact, the president said. "It is intact, they (China) are buying. Whether they buy or not, that is up to them. They are buying," he said.

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News Network
February 4,2020

Kuala Lumpur, Feb 4: Malaysia said on Tuesday that India's move to cut back on palm oil purchases is "temporary" and will be resolved amicably between the two nations.

Last month, India restricted imports of refined palm oil and asked importers to avoid purchases from Malaysia after its criticism of actions in Kashmir and a new citizenship law.

"Having long-standing bilateral ties, the two nations will overcome the current challenges, and prevail towards mutual and beneficial outcomes," the Malaysian Palm Oil Council said in a statement, citing Primary Industries Minister Teresa Kok.

Malaysia's push to implement B20 biodiesel starting this month will also help sustain high crude palm oil prices, the statement read.

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News Network
March 12,2020

Beijing, Mar 12: The number of fresh infections at the epicentre of China's coronavirus epidemic dropped to a new low on Thursday but the country imported more cases from abroad.

Another 11 people died, the lowest daily increase since late January, bringing the toll in China to 3,169 deaths, according to the National Health Commission.

There were only eight new cases in Wuhan, the city where the virus first emerged in December before growing into a national crisis and a pandemic.

It is the first time that new cases in Wuhan, the capital of Hubei province, have fallen to single-digits since figures started to be reported in January.

With cases falling dramatically in recent weeks, authorities this week began to loosen some restrictions on Hubei's 56 million people, who have been under quarantine since late January.

Healthy people living in low-risk areas of the province can now travel within Hubei. While Wuhan is not included, some of the city's companies were told they could resume work.

Only one other non-imported case was recorded elsewhere in the country.

But as global hotspots emerge elsewhere, China fears that cases arriving from abroad could undermine its progress.

On Thursday there were six more imported cases reported, bringing the total of infections from overseas to 85, health officials said.

Beijing has ordered a 14-day quarantine for everyone arriving in the city from any country.

Travellers flying into Beijing Capital International Airport from high-risk countries are now handled separately from other passengers.

A total of 80,793 people have now been infected in China.

President Xi Jinping said this week during his first visit to Wuhan since the crisis erupted that the spread of the disease has been "basically curbed" in China.

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