By Dr. Anthony Policastro

In summary hydroxychloroquine appears to have no clinical benefit. It also appears to have significant heart rhythm side effects.

I was watching a news video recently. It was about a protest over COVID-19 restrictions on Long Island.

The protestors were not wearing masks. One of them approached the reporter. The reporter asked him to keep his distance. His response was: “It’s okay. I’m on hydroxychloroquine.”

Actually his response was a stupid answer. There is no evidence anywhere that hydroxychloroquine prevents COVID-19.

There was at one time a single study that showed that patients with COVID-19 only shed the virus for six additional days.

That means the drug did nothing for the first six days. It also means that the person had to have an infection for that to happen.

Whenever we prescribe a medication we talk about risks, benefits and alternatives. That is what makes us decide whether to treat or not to treat.

Alternatives are abundant in the medical field. We use them to decide on the right antibiotic. We use them when choosing blood pressure medication.

Sometimes the only alternative is to use a drug or not to use a drug. That is the case with hydroxychloroquine for COVID-19. The only alternative is to use either that or no drug at all. There is no substitute at this time.

The next question is related to the benefits of hydroxychloroquine. After the one study that showed decreased virus shedding after six days, there have been multiple uses for patients.

When there are multiple studies done on a subject, we sometimes do what is called a meta-analysis. This means taking the data from all the studies and putting it together. It helps arrive at a conclusion.

One of these was published on May 17, 2020. Its results were: “This systematic review and meta-analysis not only showed no clinical benefits regarding HCQ treatment with/without azithromycin for COVID-19 patients.”

Thus there is no real evidence of COVID-19 responding clinically to hydroxychloroquine. There is also no evidence of it preventing the illness.

There is no evidence of it preventing someone from spreading the illness. In summary, there are no benefits to taking hydroxychloroquine for COVID-19.

That takes us to risks. Hydroxychloroquine is not a benign drug. A study a few years ago was done in lupus and rheumatoid arthritis patients.

Half of the users had significant side effects. In one-third of them the side effects were so bad that the drug had to be stopped.

The meta-analysis quoted above showed a higher mortality for patients with hydroxychloroquine treatment. It was even higher if azithromycin was added to the regimen.

Hydroxychloroquine has significant effects on the heart rhythm. A study in Brazil had to be stopped six days into it because of abnormal EKG’s on so many patients.

Another study showed 40 patients with cardiac changes. Four of them died.

In summary hydroxychloroquine appears to have no clinical benefit. It also appears to have significant heart rhythm side effects.

One may wonder what medical school the protestor on Long Island attended. It probably didn’t matter what school he attended.

There is no way he was smart enough to graduate.

COVID-19 Update

National rates are fairly steady with between 17,000 and 30,000 new cases every day since May 2.

Since it takes about 10 days for changes to take effect, it will be interesting to see if the numbers jump any this week with the opening of activities across the country. We are approaching that ten-day point since the changes.

We are also approaching the point at which we will be able to tell if the virus is going to be seasonal and become less evident during the summer.

By the time the Star is published this week, the national death toll will have exceeded 100,000.

Locally there has been good news. From May 6 until May 18 new cases in Sussex County ran between 54 and 244 per day.

Since May 19 new cases have been 61 or lower with less than 20 new cases on both May 24 and May 25. Some of that may be related to less testing, but the lower numbers still look good.