Amid the hustle to find a cure for the Covid19 pandemic, an anti-malarial drug from the 1940s — hydroxychloroquine (HCQ) — was championed as the miracle cure worldwide. While Trump continued to promote the drug as “one of the biggest game changers in the history of medicine,” the French study that had shot the drug to prominence was retracted by its publisher. However, Maharashtra is gearing up to administer HCQ pills to slum-dwellers in Mumbai as a prophylaxis, or preventive measure, to check community spread.
HCQ is a drug currently used in the treatment of malaria, lupus and rheumatoid arthritis. On March 20, the International Journal of Antimicrobial Agents, had published the now-controversial study about HCQ demonstrating anti-viral activity against coronaviruses, especially the new virus. However, the findings drew global censure as the study was neither double-blind nor randomized-controlled — which are standard steps taken to reduce biases and ensure accurate results in drug trails. At present, the study has been withdrawn and is going through an additional round of independent peer-review with medical professionals using terms like “pathetic” and “complete failure” to describe the study.
However, Maharashtra, which has been the worst hit by Covid19 in India, is planning to roll out the drug as part of a seven-week-long prophylactic course to residents of containment areas like Dharavi and Worli Koliwada, which have 50,000 people each. Medical experts from the All India Institute of Medical Sciences and NITI Aayog have already signed off on this venture, Suresh Kakani, municipal commissioner at the BMC, told The Hindu yesterday.
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“…there have been instances of it being used in the U.S. as a preventive medicine against the coronavirus. We plan to use it in areas like Dharavi where the risk of virus is high,” Rajesh Tope, Maharashtra Health Minister, told News18, adding that the drug will only be handed out to high-risk individuals, and people who are either in government quarantine, or in contact with infected patients.
Moreover, HCQ comes with a fatal risk factor: the drug affects the heart, potentially leading to arrhythmias and sudden death. In fact, a research trial of coronavirus patients in Brazil had to be halted after patients taking a higher dose of HCQ developed irregular heart rates. There is a very fine line between the drug being effective, and the drug proving fatal, making it all the more precarious. Understandably, experts have been worried about people self-medicating with HCQ. Last month, buying into the HCQ-frenzy, a man in the U.S. ingested a fish tank cleaning additive made with the same active ingredient as the medication, and it lead to his death.
In the meantime, India, which manufactures 70 percent of the world’s supply of HCQ, has ramped up its production in light of the Covid19-induced surge in its demand. However, the hype around HCQ has already lead to people stockpiling it, Dr. Deepak Natarajan, a cardiologist based in New Delhi, wrote for The Wire. In addition to using HCQ without a medical prescription posing a fatal risk to many, stockpiling the drug is also likely to jeopardize the health of patients of malaria, lupus, and rheumatoid arthritis, who actually been need the drug.