(Note: This piece was originally written and published a couple of weeks before the first tests on Hydroxychloroquine ended in abject failure…)
Since it is much in the news as a possible, maybe, potential treatment for corona virus, I thought I should share my personal experience with this drug. First, I have no formal medical training, I am just reporting my experience as someone who took the drug for about 3 years under medical supervision.
Chloroquine is a common drug often prescribed as a prophylaxis for malaria. Malaria is not a virus; it is a single celled parasite. Why it could be effective as an anti-viral drug totally escapes me.
As a US Peace Corps volunteer in Yemen in 1989, I was basically required to take chloroquine on a weekly basis. I also took it during my year in Pakistan. I suffered no serious side effects, but many of my fellow volunteers did—and some refused to take it. Side effects seemed to be insomnia, disturbing dreams, skin irritations, stomach upset and so on. Chloroquine is also known to occasionally interact with other drugs in bad ways. It can also apparently cause heart rhythm disturbances and can be hard on the liver.
It is hard to separate cause from effect, but a few observations may be useful here: bad dreams can lead to insomnia (or vice versa). Both can contribute to anxiety and depression. Most of us who watch the news are already depressed. Nausea and constant irritation don’t lead to good sleep either. All of these things can lead to increased stress on the heart and the whole system.
The seriousness of taking this drug was only brought home to me after I was evacuated from Yemen. In my final medical exam, I was suffering from a mild scalp irritation. The doctor glanced at this for a moment and said it could be seborrhea, eczema or psoriasis. He wrote down (without any testing) psoriasis. That had profound consequences. A month or so later I was offered a reposting to Sri Lanka. I accepted, but a few weeks later I was told that I had been ruled out. The medical staff said that people with psoriasis who took chloroquine could have very serious, possibly life-threatening, side effects. They didn’t care that I had been taking the drug without serious issues for over a year. Though most people associate psoriasis with skin disorders, it is a problem with deeper, systemic implications.
There are areas where malaria has become resistant to chloroquine. When I travelled in these areas, I also took additional, newer anti-malarial drugs. I have always been prone to respiratory problems. I must say that during all my time taking chloroquine I continued to get colds and flus and even bronchitis. If chloroquine had any mitigating effect on these viral bugs, it certainly wasn’t very obvious.
President Trump has advocated a drug cocktail now known as a Z-pac. Apparently, this is a combination of chloroquine, zinc, and azithromycin (an antibiotic). I have used the latter. It was certainly effective when secondary bacterial infections set in, but as far as I know, it does not actually treat viruses. I think there are also side effects when an antibiotic (anti-bacterial) is used in the presence of a viral infection. I also regularly take zinc. I have strong reason to believe that zinc really helps my boost my resistance to common colds. That is just my experience.
Next, even if these drugs help against coronavirus (covid-19), it is not at all clear what dosages would be effective. As a prophylactic against malaria in Yemen and Pakistan, I took about 300 mg of chloroquine (Aralen) once a week. Doses for actually curing malaria or other problems were much higher.
It is true that chloroquine has been widely used in a huge part of the world, but if there were credible evidence that it could block or treat viruses, I think that would probably have been noticed by now. I believe a study into the use of z-pac in Brazil has already been cancelled due to obvious serious side-effects. Other studies continue. As far as I know, there are still no proven benefits to the drug as a treatment for the coronavirus.
People should think very hard about the numbers they hear and how they process them. Covid-19 has a fatality rate of about 1-2%. Very recently a heart specialist at the Mayo Clinic went on record stating that some 90% of people could probably take hydro-chloroquine without serious side effects. That means 10% are at risk. He thought the risks were quite serious. That means if just ONE million people started taking chloroquine, we might see 100,000 new hospital cases. Talk about a cure that might be worse than the disease.
I share this information because chloroquine is being pushed so hard by some in the Trump administration (but not really his medical advisors)! I certainly don’t think it would be prudent to take Chloroquine without serious evidence that it works AND professional medical supervision. Lots of people may have psoriasis, and underlying heart and liver problems and not really know it. Taking Chloroquine is certainly better than getting a case of malaria, but that is not the choice most Americans face.
Another key point should be obvious: prescribing a useless drug or placebo may deter people from looking for, or waiting for, a treatment that is truly effective.
Finally, a note on drug prices. Before I went to Pakistan in 1996, I tried to buy chloroquine here in the US. The price was about $8 for one weekly dose. In Pakistan and India, I paid about 2 dollars for 6 weeks’ worth of the drug. Trump has boasted that he has 29 million doses of chloroquine (and some of it is coming from India). I wonder what people will be charged for that dirt-cheap drug when final health costs are finally tabulated.
Sure, we all want a cure or treatment for the corona virus—wishful thinking and bad science won’t get us there. So, I am not giving medical advice, but I strongly urge people to get medical advice before experimenting with chloroquine.
Note: The following five pieces were written during the Ukraine Impeachment trial. At that time (late December 2019 and into January 2020) the White House was already being briefed on the dangers of the coming pandemic. It is interesting to consider how the course of modern American History would have been changed if the GOP senate had simply recognized what the record clearly proved: Trump was abusing his office to fix the 2020 election. His methods were corrupt, his understanding of the Constitution and his duty deeply defective, and the good of the Nation was the last thing that interested him. I am no fan of Mike Pence; his intellect is probably on par with several kinds of lower invertebrate. Nonetheless, I think if he had taken over in January, in the wake of Trump’s impeachment, he probably would have taken the advice of medical experts and much of the damage of this current pandemic would have been avoided.