Public warned vs self-medication for COVID-19

Christian V. Esguerra, ABS-CBN News

Posted at Mar 27 2020 06:16 PM

MANILA —Two malaria drugs touted by US President Donald Trump as a possible “game-changer” are still undergoing tests to determine if they can actually work against the new coronavirus, which has killed more than 20,000 people worldwide.

Without any conclusive study so far, medical experts are warning people against self-medicating with chloroquine and hydroxychloroquine, which can have harmful side effects to those with heart problems.

“If you have a heart disease or you’re taking other medication, it can cause an arrhythmia and your heart can stop and you can die,” said Dr. Edsel Maurice Salvaña, an infectious disease specialist at the University of the Philippines’ National Institutes of Health. 

Both chloroquine and hydroxychloroquine are available in the Philippines, the latter also used to treat autoimmune diseases such as lupus.

But for use against COVID-19, tests are still limited, and the one conducted in France for hydroxychloroquine involved a very small sample where the drug showed promising results.

In the meantime, and with Trump’s endorsement, there was concern that demand for the malaria drug would rise despite its unproven efficacy for the new coronavirus.

“What we’re really concerned about is that people might look at this and say, ‘Oh it’s already a cure,’ and they self-medicate and they die because of the drug, not because of the coronavirus,” said Salvaña, who heads an experts’ group advising the Philippine government on strategies against the new coronavirus.

With all the talk about the malaria drugs' supposed effectiveness against COVID-19, he warned that some people might seek them out of fear for the new coronavirus, even if they’re showing mild symptoms or don’t even have it yet. 

“Remember that these drugs are not yet proven with very preliminary data and they can have side effects,” he said. 

CLINICAL TRIAL

The World Health Organization has begun pooling scientific data across countries battling COVID-19 in search for a drug that could actually work against the fast-spreading virus.

Among those being tested are drugs currently for HIV and malaria. 

The clinical trial in France involving hydroxychloroquine can be considered “pretty good given the extreme circumstances,” said Fr. Nicanor Austriaco, a microbiologist who holds a Ph.D. from the Massachusetts Institute of Technology. 

“Yes, it was a small trial, but if you read the paper, it was rigorous for what it wanted to do, which is to be a pilot study. And it showed that HCQ (hydroxychloroquine) significantly shortened the time for the patient to clear virus from his or her system,” he wrote.

Austriaco, a Dominican priest now based Manila, also cited an independent study from a laboratory in China, which “demonstrated that hydroxychloroquine can prevent viral reproduction in a test tube.”

COMPASSIONATE USE

Speaking of both the France and China studies, he acknowledged that evidence was “minimal” but “that is not unexpected in a pandemic.”

“But the minimal evidence is actually pretty solid, given the practical limits of doing clinical trials in a global crisis,” he wrote.

Dr. Rontgene Solante, an infectious disease specialist, said chloroquine was also being used for some COVID-19 patients under strict protocols.

“How good and effective this drug is remains to be seen but hopefully it can help,” he told ABS-CBN News.

In cases where a malaria drug is used for COVID-19 treatment, it’s done with a patient’s full consent and under the government’s regulations for “compassionate use,” said Salvaña.

“We do have mechanisms in which to use these but in a controlled fashion to limit the risk to patients,” he said.