Coronavirus UPDATE #5 made simple (as your friendly neighborhood ER Doc)! Since my last post, a few people have contacted me with a few more questions. I am happy to try to answer a few of them. The questions are getting more complicated! AND I LOVE IT! Because of that, I am going break them up a bit.
Today: Why are doctors hesitant to use Chloroquine to treat COVID-19?
I remember discussing a study in medical school that showed that more people died in a specific hospital when there were more than 10 red cars in the parking lot. (OK, it was a long time ago and I may have made up the number 10) That result is a study proven, statistical fact…but, what does that mean? Do parked red cars actually kill hospital patients? Of course not. But numbers don’t lie, right? We know that the number of red cars has no direct impact on the health of patients inside the hospital, but there is a statistical relationship somehow! This study was to show us that there is a difference between a ‘correlation’ and ‘cause & effect.’
I bring this up to discuss why doctors don’t seem to be as excited about the use of medications like Chloroquine & Hydroxychloroquine to treat COVID-19. I won’t bore you with the details of the problems with the studies that have been done, but they are showing that these medications are a bit like the red cars in the parking lot. There seems to be a correlation, but we can’t exactly say there is a cause & effect relationship. Doctors across the country are furiously doing good studies to see if these drugs are just red cars or if they actuallytreat the disease…and I HOPE that these drugs turn out to be good treatments!
With the current research about these medications…I can say that I would not prescribe Chloroquine or Hydroxychloroquine for a family member or a friend if they tested positive. While it is absolutely true that these drugs are old and have been used for years. It is also true that these drugs have real side effects, and some are REALLY dangerous (can cause fatal heart rhythms). This discussion changes if someone is on their last breath on a vent in the ICU…I would ABSOLUTELY enroll anyone at that point in one of any number of medication trials to hope that it helps and to find answers. But, don’t forget, the current researchshows that 94-98% of everyone that gets this infection is going to recover on their own! I could not live with myself if I gave a drug to a family member that then died from a medication side effect, knowing that they were 94-98% likely to have recovered without any medications at all.
You should also know that we are not just testing these medications! There are many other medications and treatment protocols unknown to the public being tested as we learn more about this virus.
Tomorrow: Are the numbers over-estimating or under-estimating the COVID-19 death rate?
Gavin H. Inglis, MD FACEP is an Emergency Medicine Physician. As a partner in St. Vincent Emergency Physicians, INC, he has been practicing in Indianapolis, IN at a Level 1 Trauma Center for more than 20 years.