With media solemnly spotlighting the passing of the 200,000 mark in deaths attributed to COVID-19 in the United States, a physicians assocation has a question.
"Why is the death rate about 75 percent lower in many countries?" asked Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons.
The reference is to a country-based analysis updated Sept. 20 that shows a gap between countries that treat COVID-19 early or prophylactically with hydroxychloroquine and those that, like the U.S., discourage or prohibit its use.
The answer to Orient's question can be found in a white paper published by the Economic Standard this month titled "Hydroxychloroquine and the Burden of Proof: An Urgent Call to Depoliticize Medicine in the COVID-19 Pandemic."
"The COVID-19 pandemic struck America nine months before a presidential election, turning basic medical activities like testing and treatment into partisan battlegrounds," writes Economic Standard Editor-in-Chief Erik Sass in the overview. "No subject has been more distorted than hydroxychloroquine (HCQ), a safe, versatile medicine that has treated hundreds of millions of people for numerous diseases for seven decades."
Sass notes the paper was written in close collaboration with practicing physicians and infectious disease specialists in the United States and around the world.
Most Americans became aware of the drug in March, when President Trump mentioned it during a press conference, saying it showed "very, very encouraging early results" and "could be a game changer."
However, "political opponents defied longstanding scientific and medical consensus to portray HCQ as harmful and Trump as a mortal danger to public health," Sass writes. "Flawed and even falsified studies were published and promoted by media outlets eager to discredit Trump, while positive studies were impugned or ignored."
"This campaign persists even as evidence of HCQ’s benefit against COVID-19 grows – including scores of observational controlled trials showing therapeutic effect when administered early in disease progression."
The paper points out that hundreds of drugs have been approved for both indication-specific and general usage on the basis of similar observational trials, "especially when conducted in large numbers and subject to careful meta-analysis."
"The U.S. is an international outlier on HCQ," says Sass. "Right now, doctors around the world are prescribing HCQ to treat COVID-19 outside of hospitals, as well as prophylactically to prevent infection among healthcare workers and vulnerable populations."
The paper argues that hydroxychloroquine "has met the appropriate burden of proof and urges members of the U.S. news media, public health community, and regulatory agencies to stop politicizing the use of this medicine."
"Tens of thousands of lives still hang in the balance."
Some of the key lessons:
- Flawed and even falsified studies were published and promoted by media outlets eager to discredit Trump, while positive studies were impugned or ignored.
- HCQ is commonly prescribed for at least 25 indications in addition to malaria.
- The drug's prolongation of the QT interval is in the mid-range of 30 commonly used drugs.
- Hundreds of drugs have been approved without randomized controlled trials, including the tetanus vaccine, insulin, tetracycline, warfarin, heparin, prednisone, Keflex and high-dose penicillin for neurosyphilis.
- Only 8.5% of the American Heart Association's guidelines are supported by randomized controlled trials.