Results from a controlled clinical trial from China on the use of hydroxy chloroquine as a treatment for Covid-19 have shown no significant differences in health outcomes between the control group and patients who received the experimental drug. 

Thirty patients hospitalized for Covid-19 participated in the trial. Fifteen were treated with 400mg of chloroquine for five days and fifteen received standard supportive care. A week after the treatments started both groups were evaluated and results showed that no measurable difference in the progression of the disease. There are still important lessons to draw from the results.

We must redouble our efforts towards the best and quickest medical solution — the development of therapeutic antiviral drugs that treat infection and prophylactic antiviral drugs that prevent infection. In the wake of the SARS and MERS outbreaks, a number of highly promising drug candidates emerged, though none of them were brought to fruition due to a glaring lack of funding and flagging interest in coronaviruses once each outbreak ended.

Now, with renewed interest and resources, these drug candidates are moving quickly to clinical trials. Recently a small trial was held to determine whether lopinavir-ritonavir, a combination HIV treatment that inhibits coronavirus proteases, would deter the virus in Covid-19 patients. Unfortunately, as researchers recently reported in an article for the New England Journal of Medicine, the drug failed to cure or diminish infection. 

But those early and unimpressive results aren’t conclusive and, more importantly, the clinical trial only focused on only one of the virus’ most promising targets, the protease. SARS-CoV-2 has favorable targets for antiviral drugs: the proteases, the helicase, and the RNA-dependent RNA polymerase. 

A second takeaway from the Shanghai hydroxy chloroquine study is also critical — while medical solutions are promising, they are no guarantee. It is far too soon for us to abandon more aggressive actions that can be implemented immediately and effectively to slow the spread of Covid-19 in the United States. 

To date, our response to Covid-19 has been among the worst in the world. Testing per capita here lags far behind other developed nations — including countries like Italy and the United Kingdom who are faring poorly in the face of this disease. In countries like Singapore and South Korea, aggressive contact tracing combined with widespread testing and selective isolation and quarantine has contained their outbreaks, dragging down the number of new infections each day and helping those countries avoid the extreme lockdown measures that have been used elsewhere, including here the United States. 

There are now more than 55,000 cases of Covid-19 in the United States. In New York, the number of cases is doubling every three days. Thousands lie in hospital beds. Hundreds have already lost their lives. This is not the time for excuses or inaction – we must test, we must trace the contacts of those infected, and we must isolate all those at risk of spreading the disease further. And while we do so, we wait for a medical solution that will hopefully soon be at hand.

Tara Haelle discussed the Chinese hydroxy chloroquine study in an earlier post today.