E-DRUG: How false hope spread about hydroxychloroquine to treat covid-19 ?
and the consequences that followed
-----------------------------------------
[the attention for (hydroxy) chloroquine as a potential treatment in
COVID-19
has become a serious problem:
- the evidence for its usefulness is very weak; the original study
has
several weaknesses
- this essential medicine is now very hard to get as everybody wants
it;
the price has gone up
- this endangers patients that really need it (for treating Lupus or
Rheumatoid Arthritis, or for certain types of malaria)
- the efficacy is doubtful, but the side-effects are real: people
taking
HCQ or CQ without proper medical advice are at risk of serious cardiac
side-effects (QT prolongation)
- fake news has been spreading, especially after president Trump
recommended its use in national press briefings
- websites spreading the correct scientific evidence are ignored or
not
heard
- some governments are even trying to get local production going in
Africa.
Let us analyze how this fake news came about. The Fact Checker team of
Washington Post has done a great job to get to the bottom of this story.
We can learn lessons from this!
Watch the video or read the long-read?
Copied as fair use. WB]
by Elyse Samuels
Washington Post
[Trump statements removed]
The world is looking for answers in the search for a treatment for
covid-19,
the disease caused by the novel coronavirus, which has claimed more than
100,000 lives across the globe. President Trump has repeatedly touted the
anti-malarial medications hydroxychloroquine and chloroquine as that
much-needed solution.
Even before Trump started talking about the drugs, studies abroad sparked
interest in them as a potential cure. News about the drugs spread quickly
online, percolated to the media and the White House.
Scientists have since pointed to major flaws in those original studies and
say
there is a lack of reliable data on the drugs. Experts warn about the
dangerous
consequences of over-promoting a drug with unknown efficacy:
Shortages of hydroxychloroquine have already occurred, depriving lupus and
rheumatoid arthritis patients of access to it. Doctors say some patients
could
die of side effects. Other potential treatments for covid-19 could get
overlooked with so much concentration on one option.
The Fact Checker video team has reconstructed how the claim spread online
and
illustrates the troubling consequences of such misleading hope in the drugs.
The Facts
Conversation around hydroxychloroquine and chloroquine as potential
treatments
for covid-19 started in China in late January. According to Kate Starbird
of
the University of Washington?s Center for an Informed Public, tweets from
media
organizations ? including Chinese state outlets ? and investors highlighted
past studies in which the medications were tested as cures for severe acute
respiratory syndrome. (The 2005 tests never made it to human trials.) They
also
pointed to statements from the coronavirus research center in Wuhan, China,
suggesting the drugs could be used to fight covid-19.
Ren?e DiResta, technical research manager at the Stanford Internet
Observatory,
found similar trends on Facebook and Instagram in February. The number of
total
posts and interactions increased, and Internet speculation spread beyond
China
to Nigeria, Vietnam and France.
A large portion of activity online at the end of February and early March
appeared in French and centered on a study published by French researcher
and
doctor Didier Raoult.
The spread in the U.S.
Raoult?s findings helped bring the theory to the United States. However,
scientists have since discredited the trial, pointing to major flaws in the
way
it was conducted. The journal that published the study announced on April 3
that it did not meet its standards.
Yet before the record could be set straight, the hypothesis spread widely
on
U.S. social media. The Fact Checker has refrained from linking to original
posts on the drugs to avoid giving further oxygen to misleading information.
According to Starbird, the first viral tweets were posted by Paul Sperry, a
staunchly conservative author, on March 9 and 11. A blockchain investor,
James
Todaro, then tweeted a link to a Google document he co-wrote with Gregory
Rigano about the potential cure on March 13. Tesla chief executive Elon
Musk
retweeted that Google doc on March 16, writing, ?Maybe worth considering
chloroquine for C19.?
The faulty research then appeared in the Gateway Pundit, Breitbart and the
Blaze. It ultimately made its way to Fox News, first appearing on Laura
Ingraham?s program on March 16. Fox News shows hosted by Sean Hannity and
Tucker Carlson went on to promote the drugs and continue to do so.
On March 19, Trump first mentioned hydroxychloroquine at a White House news
briefing. DiResta?s analysis showed that the following week, the claim
started
to spike in the United States, with 101,844 posts on Facebook. Starbird
reports
Trump?s first mention set off a surge in attention, seeing tens of
thousands of
tweets per hour in late March.
Data from Brandwatch, a digital consumer intelligence company, as well as
DiResta and Starbird, show the total number of mentions about
hydroxychloroquine and chloroquine increased in late March and early April.
Trump and his allies, including his son Donald Trump Jr. and his personal
attorney Rudolph W. Giuliani, tweeted about the drugs in late March. These
posts saw the highest percent of reach, according to Brandwatch data, at
some
of the sharpest spikes in social media mentions online.
Trump again spoke about the drugs at news conferences on April 3, 4 and 5.
Mentions on Twitter skyrocketed on April 6.
The science
As attention on the drugs became even more prolific ? online, in the media
and
from the president ? scientists say there is only ?anecdotal evidence? on
the
drugs. To a layperson, that may not sound bad, but it?s actually an insult
in
the scientific community.
Anecdotal evidence refers to people?s personal stories about taking the
drugs
and has no basis in scientific data. It?s akin to a Yelp review. Anthony S.
Fauci, director of the National Institute of Allergy and Infectious
Diseases
and a member of Trump?s coronavirus task force, has consistently said there
is
not enough evidence to support the drugs as a viable treatment for covid-19.
The Centers for Disease Control and Prevention conducted tests on the drugs
in
treating SARS in 2005. Results showed the drugs had anti-viral effects on
cell
cultures. However, it did not work in studies on mice. According to David
Boulware, professor of medicine at the University of Minnesota, that ?is a
little bit of a red flag.? Moreover, it was ?not a clinical trial and did
not
look at the effect of chloroquine on humans,? according to a CDC spokesman.
Boulware is conducting a clinical trial on using hydroxychloroquine for
prevention or early treatment of covid-19 in humans, but he says it is too
early to know whether the drug works.
?That?s our goal, to really rapidly identify as quickly as possible, does
this
actually work or not? Because there?s a lot of hubbub about it now,?
Boulware
said. ?But there?s very little evidence that we actually have that this has
a
clinical benefit, which is kind of bad for something that?s being very
heavily
promoted. We should probably have some data and some science behind it.?
Yet the World Health Organization, university labs and governments around
the
world are conducting larger clinical trials of hydroxychloroquine and
chloroquine in treating covid-19.
Asked whether chloroquine was a possible cure for covid-19, Janet Diaz of
WHO
told reporters on Feb. 20 that the organization was prioritizing other
therapeutics:
?For chloroquine, there is no proof that that is an effective treatment at
this
time. We recommend that therapeutics be tested under ethically approved
clinical trials to show efficacy and safety.? A few weeks later, both
chloroquine and hydroxychloroquine were included in a mega-trial WHO
launched.
The Food and Drug Administration granted an emergency use approval to
distribute millions of doses of the drugs to hospitals across the country
on
March 29.
?During the evaluation of the criteria under which to issue an EUA, it was
determined, based on the scientific evidence available, that it is
reasonable
to believe that the specific drugs may be effective in treating COVID-19,
and
that, given there are no adequate, approved, or available alternative
treatments, the known and potential benefits to treat this serious or
life-threatening virus outweigh the known and potential risks when used
under
the conditions described in the EUA,? an FDA spokesman told the Fact
Checker in
an email.
Luciana Borio, the former head of medical and biodefense preparedness at
the
National Security Council, criticized the FDA?s EUA announcement and has
called
for a randomized clinical trial of the drugs.
?I think that it was a misuse of emergency authorizations of the authority
that
the FDA has. Because it gives this credence that the government is actually
backing, and it?s so common for people to equate that with an approval,?
Borio
said.
When asked whether any of the completed studies have provided substantial
evidence that the benefits of the drugs outweigh the risks, Borio
responded,
?Not at all. No study was done in a way that would allow that conclusion.?