If you’re a doctor Down Under, you could now face a $13,000 fine for prescribing hydroxychloroquine for COVID-19 patients — and you can probably guess the genesis of this.
According to the Brisbane Times, doctors in the Australian state of Queensland are now banned from prescribing the anti-malarial drug for coronavirus patients as of Tuesday.
The drugs can only be dispensed to patients who take it for one of its other approved uses or who are part of a clinical trial.
Failure to comply? A fine of $13,000 Australian dollars, which translates to about $8,300 American.
It’s not just doctors, either.
“The new law, introduced under public health powers granted to the state’s top doctor, Chief Health Officer Jeannette Young, is also aimed at stopping pharmacies and GP clinics from stockpiling the medication,” the Brisbane Times reported.
“Under the public health order, only some specialists are allowed to prescribe the drug and it must be for the ongoing treatment of a chronic disease or as part of a clinical trial.”
The health minister in Australia, Greg Hunt, has said that the drug has shown “some promising research so far.” That said, trials are mixed — but the drug does a very good job stopping the virus in test tubes.
Professor David Paterson, an infectious diseases expert at the University of Queensland — where a large-scale clinical trial is about to begin — said that the drug showed promise on a very small scale when the disease first hit Australia.
“Prior to the clinical trials going ahead, the medications were given to some of the first patients in Australia infected with COVID-19, and all have completely recovered without any trace of the virus left in their system,” he said.
“However, we know that most people with COVID-19 recover completely, thanks to their immune system, so random anecdotal experiences of some people need to be replaced by rigorous clinical trials.”
In addition to antiviral drug Remdesivir, hydroxychloroquine (and its older relative, chloroquine) has been one of the more promising routes of treatment for coronavirus patients. That doesn’t mean there aren’t risks, but coronavirus is a serious risk. So why stop doctors from prescribing it in certain cases?
Officially, it’s because hydroxychloroquine is used to treat patients suffering from autoimmune conditions, including lupus and rheumatoid arthritis. Demand for the drug as a treatment for COVID-19 could make it difficult for patients who need it for those conditions to get it — at least that’s how the argument is most often presented.
But the implicit blaming of Trump, and the implication that he’s hyping the drug without any foundation, gives the game away.
The Brisbane Times’ article included a bit that should have told you what you needed to know in terms of that: “Worldwide shortages were caused after US President Donald Trump tweeted about the drug’s potential last month,” they noted.
“Mr Trump [promoted] the drug again at the weekend and urged Americans to take it despite a lack of strong evidence the medication is safe to use in COVID-19 patients.”
Ah yes — him. It’s not just the Brisbane Times, either. Here’s the first sentence in a March 23 article from the Royal Australian College of General Practitioners about hydroxychloroquine: “After US President Donald Trump touted hydroxychloroquine and chloroquine as a possible ‘cure’ for coronavirus, there has been a rush for the drugs – even though the top US infectious diseases expert Dr Anthony Fauci has cautioned evidence is minimal.”
First sentence. They literally couldn’t even describe why hydroxychloroquine was being tested as a possible treatment for COVID-19 before mentioning Trump. They just jumped right in.
It’s almost as if he just came up with this drug on his own. And knowing how people in the media tend to feel about the president, of course he didn’t come up with this through research.
Here’s what they feel would be a more plausible explanation for it: One day, while Dr. Fauci was off doing some TV spot, Trump broke into his office and ganked Fauci’s Physicians’ Desk Reference. He then dropped it on the Oval Office floor, letting it open to a random page. From behind the Resolute Desk, he blindfolded himself and threw darts at it until he heard the thwack of one hitting its target. He then picked it up and looked at which drug it hit.
“Hydra … hybri …. hydro … Jared! Get in here and tell your father-in-law what this means,” the president yelled.
“Hydroxychloroquine?” Jared Kushner said. “That’s an anti-malarial drug. Why are you–“
“Don’t you worry your little head off about it,” Trump said, leaving the room.
You may not be surprised that didn’t happen. Researchers looked at a plethora of drugs, and the science and test-tube results behind chloroquine and hydroxychloroquine appeared to be the most promising.
The science goes like this: Viruses replicate by entering host cells, which they take over to work as virus factories. In terms of the novel coronavirus, the theory is that they enter it through an acidic compartment. Chloroquine and hydroxychloroquine change the acidity of that compartment, making it more difficult to enter, according to TheScientist.com.
That’s the theory. Hydroxychloroquine may not work as well as everyone, including President Trump, hopes. Recent studies have tempered hopes somewhat, but we’re still dealing with one of the more promising treatments.
Remdesivir is another one; it’s an investigational antiviral drug which has also worked in small-scale studies like hydroxychloroquine has, something which has many calling for authorities to allow compassionate use of treatment.
We don’t know Remdesivir’s safety profile, given that it’s an investigational drug and not one approved for use. It would have to be rushed into production and may come with significant side effects. It can’t be used off-label. And yet, nobody seems particularly concerned about all of that. Watch Trump start touting it, though, and see how quickly there’s an outcry.
There are ways to handle shortages and stockpiling of hydroxychloroquine that don’t involve making it so that people with COVID-19 can’t be prescribed the drug if their doctor thinks the benefit outweighs the risks. We’re all dealing with terra nova here. This isn’t helping.
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