Hydroxychloroquine: The unproven 'corona drug' Trump is threatening India for
hydroxychloroquine
US President Donald Trump has said the US could "retaliate" if India does not release stocks of a drug he has called a "game-changer" in the fight against Covid-19.
Mr Trump had called India's Prime Minister Narendra Modi on Sunday, a day after the country banned the export of hydroxychloroquine, which it manufactures in large quantities.
Local media said the government was "considering" Mr Trump's request and a decision is expected on Tuesday.
The US President's comments, made at the White House press briefing on Monday, haven't gone down well with many in India, with critics pointing out that there was no need for him to be so abrasive when Mr Modi has already agreed to help.
The two leaders are on friendly terms and Mr Trump had made a high-profile trip to India recently.
But is India really in a position to help the US? And does hydroxychloroquine even work against the coronavirus?
What is hydroxychloroquine?
Hydroxychloroquine is very similar to Chloroquine, one of the oldest and best-known anti-malarial drugs.
But the drug - which can also treat auto-immune diseases like rheumatoid arthritis and lupus - has also attracted attention over the past few decades as a potential antiviral agent.
President Trump said that the US Food and Drug Administration (FDA) had approved it for treating coronavirus, something the organization has denied. Mr Trump later said that it had been approved for "compassionate use" - which means a doctor can give a drug that is yet to be cleared by the government to a patient in a life-threatening condition.
Doctors are able to prescribe chloroquine in these circumstances as it's a registered drug.
So, can India really help President Trump?
Hydroxychloroquine could be bought over the counter and is fairly inexpensive. However, its purchase and use has been severely restricted ever since it was named as a possible treatment for Covid-19.
On Saturday, India banned the export of the drug "without any exception". The order came even as the number of positive cases of Covid-19 spiked in the country. India has now recorded 3,666 active cases of the virus with more than 100 deaths, according to the latest data released by the ministry of health.
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But now it seems the government could be reconsidering this stance, possibly following Mr Trump's call to Mr Modi. Local media quoted government sources as saying that a decision on this could be taken as early as Tuesday after considering what domestic requirements could look like in the near future.
The two leaders have a warm personal relationship
But does India - one of the world's largest manufacturers of the drug - have the capacity to actually supply other countries as well?
Yes, according to Ashok Kumar Madan, of the Indian Drug Manufacturer's association.
"India definitely has capacity to cater to both global and local markets. Of course, domestic considerations must come first, but we have the capacity," he told the BBC.
Mr Madan also denied reports that China had severely limited the export of the active pharmaceutical ingredient (API) that is used to manufacture hydroxychloroquine. He acknowledged that 70% of all the APIs needed by India to manufacture drugs come from China, but said that supplies from China had steadily continued "by both sea and air".
But does it work?
Many virologists and infectious disease experts have cautioned that the excitement over hydroxychloroquine is premature.
"Chloroquine seems to block the coronavirus in lab studies. There's some anecdotal evidence from doctors saying it has appeared to help," James Gallagher, BBC health correspondent, explained.
But crucially there have been no complete clinical trials which are important to show how the drug behaves in actual patients, although they are under way in China, the US, UK and Spain.
Even so, some are sceptical about how successful they will prove to be.
"If it truly has a dramatic effect on the clinical course of Covid-19 we would already have evidence for that. We don't, which tells us that hydroxychloroquine, if it even works at all, will likely be shown to have modest effects at best," Dr Joyeeta Basu, a senior consultant physician, told the BBC.
American scientists have begun a trial to see if chloroquine will help treat coronavirus
Raman R Gangakhedkar, a senior scientist with the Indian Council of Medical Research, said the policy at the moment is that the drug is not to be used by everyone.
"It is being given to doctors and contacts of lab confirmed cases. When their data will be complied only then a call can be taken whether it should be recommended to everyone," he told reporters last week.
Despite the fact trials are yet to conclude, people have begun to self-medicate - with sometimes disastrous consequences.
There have been multiple reports in Nigeria of people being poisoned from overdoses after people were reportedly inspired by Mr Trump's enthusiastic endorsement of the drug.
An article in the Lancet medical journal also warns hydroxychloroquine can have dangerous side-effects if the dose is not carefully controlled.
This lack of certainty has prompted social media sites like Facebook and Twitter to delete posts that tout it as a cure - even when they are made by world leaders.
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Opinion: Looks like Rudy Giuliani is now advising Trump on COVID-19 and hydroxychloroquine. Yikes
With the COVID-19 pandemic intensifying and the economy cratering, can the United States survive another injection of Rudy Giuliani?
It looks like we’re about to find out. The Washington Post reports that the former mayor of New York City is taking time off from his relentless pursuit of Hunter Biden and the Ukrainian hiding spot of the Democratic National Committee’s email server to become a medical researcher for President Trump.
That’s going to end well, I can just feel it.
According to the Post, Giuliani has been lobbying Trump in favor of treating COVID-19 with a cocktail of the controversial antimalarial drug hydroxychloroquine and antibiotics that has been reported to be effective in a small number of patients — but ineffective in more rigorously designed studies. A lawyer by training, Giuliani told the Post that “he now spends his days on the phone with doctors, coronavirus patients and hospital executives promoting the treatment, which Trump has also publicly lauded.”
Granted, Giuliani is hardly the only Trump whisperer who is pushing drugs of dubious efficacy as a potential magic bullet. Seemingly every Fox News Channel personality has touted them. The president’s other favorite source of Trump-friendly journalism, One America News, has also given the drugs a full-throated endorsement, as has Elon Musk.
Trump has always been unusually welcoming to inexpert advice from perceived loyalists; witness the outsize role that his son-in-law, Jared Kushner, plays in ... everything, including the pandemic response. But Trump is particularly susceptible now, because the positions advocated by mainstream medical experts and embraced by a growing number of governors are sending the United States over an economic cliff.
The Wall Street Journal reported Monday that eight out of 10 U.S. counties accounting for nearly 96% of U.S. GDP have ordered residents to shutter all nonessential activities, cutting the country’s daily output by almost 30% in one month. Last week, economic forecaster IHS Markit predicted that the U.S. economy would shrink by 26.5% in the April-June quarter — a reduction three times larger than the worst seen during the last recession.
So Trump is caught in a really tough position of having to battle a killer disease with weapons that are wrecking the livelihoods of millions of Americans. It’s a challenge that would test even a deft executive, and Trump is under a lot of pressure to find an approach to the coronavirus that’s less toxic to commerce than the stay-at-home orders have been.
That’s where Giuliani and the other hydroxychloroquine advocates come in. Unlike some early critics of the state and local lockdowns, they’re not claiming that medical experts (and the media) are making a mountain out of a virus molehill. (That sort of argument isn’t very potent after the daily death toll crosses 1,000. ) Instead, Team Hydroxychloroquine is suggesting that medical experts (and the media) are playing down what a “game changer” this drug could be, to borrow the president’s coinage.
And you know what? If there was an effective treatment for COVID-19 in plentiful supply, we could all go back to work, school, church and everything else we’ve been assiduously avoiding.
It’s certainly possible that hydroxychloroquine will prove to be the cure that Giuliani suggests that it is. Well, it will probably never be 100% effective, as Giuliani once claimed in a tweet that quoted another Trump supporter with no medical credentials, Charlie Kirk (Twitter forced the deletion of that one). But even if it’s effective in only 50% of the cases, that’s a heck of a lot better than where we are now.
The problem is that we don’t know anything about these drugs’ effectiveness against our current pandemic, at least not in a way the healthcare industry trusts. The skepticism from medical experts and the mainstream media stems from the fact that hydroxychloroquine hasn’t received any rigorous and scientifically testing yet as a treatment for COVID-19, although such tests are under way. The evidence in its favor comes either from anecdotes or from small trials using dubious methodologies; other small but better designed trials suggest the drug is ineffective.
One thing we do know is that the drugs aren’t plentiful enough to make them available to everyone who may need them. Already, the demand for hydroxychloroquine has caused shortages among the people who use it as directed to treat lupus (a potentially lethal autoimmune disease) and arthritis.
We may eventually be confident enough about a drug or drugs — be they hydroxychloroquine, remdesivir or another of the therapies now being tested — to be able to go back to the office and start rebuilding the economy. But we’re not there yet, and if Giuliani is telling Trump otherwise, heaven help us all
With the COVID-19 pandemic intensifying and the economy cratering, can the United States survive another injection of Rudy Giuliani?
It looks like we’re about to find out. The Washington Post reports that the former mayor of New York City is taking time off from his relentless pursuit of Hunter Biden and the Ukrainian hiding spot of the Democratic National Committee’s email server to become a medical researcher for President Trump.
That’s going to end well, I can just feel it.
According to the Post, Giuliani has been lobbying Trump in favor of treating COVID-19 with a cocktail of the controversial antimalarial drug hydroxychloroquine and antibiotics that has been reported to be effective in a small number of patients — but ineffective in more rigorously designed studies. A lawyer by training, Giuliani told the Post that “he now spends his days on the phone with doctors, coronavirus patients and hospital executives promoting the treatment, which Trump has also publicly lauded.”
Granted, Giuliani is hardly the only Trump whisperer who is pushing drugs of dubious efficacy as a potential magic bullet. Seemingly every Fox News Channel personality has touted them. The president’s other favorite source of Trump-friendly journalism, One America News, has also given the drugs a full-throated endorsement, as has Elon Musk.
Trump has always been unusually welcoming to inexpert advice from perceived loyalists; witness the outsize role that his son-in-law, Jared Kushner, plays in ... everything, including the pandemic response. But Trump is particularly susceptible now, because the positions advocated by mainstream medical experts and embraced by a growing number of governors are sending the United States over an economic cliff.
The Wall Street Journal reported Monday that eight out of 10 U.S. counties accounting for nearly 96% of U.S. GDP have ordered residents to shutter all nonessential activities, cutting the country’s daily output by almost 30% in one month. Last week, economic forecaster IHS Markit predicted that the U.S. economy would shrink by 26.5% in the April-June quarter — a reduction three times larger than the worst seen during the last recession.
So Trump is caught in a really tough position of having to battle a killer disease with weapons that are wrecking the livelihoods of millions of Americans. It’s a challenge that would test even a deft executive, and Trump is under a lot of pressure to find an approach to the coronavirus that’s less toxic to commerce than the stay-at-home orders have been.
That’s where Giuliani and the other hydroxychloroquine advocates come in. Unlike some early critics of the state and local lockdowns, they’re not claiming that medical experts (and the media) are making a mountain out of a virus molehill. (That sort of argument isn’t very potent after the daily death toll crosses 1,000. ) Instead, Team Hydroxychloroquine is suggesting that medical experts (and the media) are playing down what a “game changer” this drug could be, to borrow the president’s coinage.
And you know what? If there was an effective treatment for COVID-19 in plentiful supply, we could all go back to work, school, church and everything else we’ve been assiduously avoiding.
It’s certainly possible that hydroxychloroquine will prove to be the cure that Giuliani suggests that it is. Well, it will probably never be 100% effective, as Giuliani once claimed in a tweet that quoted another Trump supporter with no medical credentials, Charlie Kirk (Twitter forced the deletion of that one). But even if it’s effective in only 50% of the cases, that’s a heck of a lot better than where we are now.
The problem is that we don’t know anything about these drugs’ effectiveness against our current pandemic, at least not in a way the healthcare industry trusts. The skepticism from medical experts and the mainstream media stems from the fact that hydroxychloroquine hasn’t received any rigorous and scientifically testing yet as a treatment for COVID-19, although such tests are under way. The evidence in its favor comes either from anecdotes or from small trials using dubious methodologies; other small but better designed trials suggest the drug is ineffective.
One thing we do know is that the drugs aren’t plentiful enough to make them available to everyone who may need them. Already, the demand for hydroxychloroquine has caused shortages among the people who use it as directed to treat lupus (a potentially lethal autoimmune disease) and arthritis.
We may eventually be confident enough about a drug or drugs — be they hydroxychloroquine, remdesivir or another of the therapies now being tested — to be able to go back to the office and start rebuilding the economy. But we’re not there yet, and if Giuliani is telling Trump otherwise, heaven help us all
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