• Since last week, President Donald Trump has lauded chloroquine and hydroxychloroquine as potential treatment options for COVID-19.
• While there is some evidence that supports their effectiveness against the virus, health officials warn that not enough testing has been done to approve their widespread use.
• Still, people have begun trying to acquire the potential antiviral, leading to shortages for people who need it for it’s already approved treatments for lupus and rheumatoid arthritis.

Shortages of Hydroxychloroquine for People Who Need It

While panic buying has to lead to toilet paper and cleaning supplies shortages across the nation, it’s now also making it harder for some people to get their hands on medicine they’ve taken for years.

An influx of worried Americans are rushing to get ahold of hydroxychloroquine, a drug that treats diseases and disorders such as malaria, rheumatoid arthritis, and lupus. It’s also been hailed by President Donald Trump as an effective drug against COVID-19.

But that’s still unknown.

While there is evidence to support hydroxychloroquine or the similarly-touted chloroquine’s effectiveness against the pandemic, there is currently still not enough evidence to prove it should be used as a widespread treatment against COVID-19.

Even though both drugs have received approval from the Food and Drug Administration, the approvals are not for COVID-19. To be used on a widespread basis, the drugs would need approval following clinical trials.

Still, that hasn’t stopped some people from trying to acquire the potential antiviral by any means possible.

“Well it finally happened to me,” pharmacist Katherine Rowland said on Twitter. “A dentist just tried to call in scripts for hydroxychloroquine + azithromycin for himself, his wife, & another couple (friends). NOPE. I have patients with lupus that have been on [hydroxychloroquine] for YEARS and now can’t get it because it’s on backorder.”

According to the University of Utah, several doctors tried writing prescriptions for both themselves and for family friends to hoard in case they contracted the virus. The university refused to fill their prescriptions.
Because of stories like that, however, many people who need the drug for other conditions are finding themselves without.

According to The New York Times, 47-year-old Toni Grimes was told on Monday that she would have to wait until March 30 to refill her chloroquine prescription meant to treat her lupus. She said this is the first time she hasn’t been able to get her prescription refilled in the 13 years she’s been on it.

Grimes also runs a Phoenix-area Lupus Foundation support group and said another member also has yet to receive their refill, as well.

Such shortages have spurred the Lupus Foundation to release a statement, reading:

“The Foundation applauds the commitment of pharmaceutical companies that have pledged to increase production and supply of [vital] medications. We call on all manufacturers of hydroxychloroquine and chloroquine to do the same. However, increased production must not solely be done for the purpose of responding to COVID-19, but also to meet the existing needs of people with lupus.”

In fact, the scramble to obtain these drugs has grown so rapidly that four of the seven companies that make generic hydroxychloroquine are facing shortages. While the other three could have provided some cushion, they previously stopped making the drug altogether.

Because of the shortages, the Ohio Board of Pharmacy has banned the hoarding of these drugs. Now, people in Ohio can’t buy it unless they have lupus, rheumatoid arthritis, or a confirmed case of COVID-19.

People Are Dying Because They’re Self-Medicating

Ultimately, that may prove to be a beneficial move not only for people in Ohio who need these drugs but also for the people who don’t.

While not in the United States, reportedly, three people in Nigeria have all overdosed on the drug after self-medicating.

Because of that, Nigeria’s Centre for Disease Control issued a statement urgently warning people not to self-medicate, as such a move could lead to harm or even potential death.

In the U.S, an Arizona man died after reportedly ingesting chloroquine; however, instead of using the medical form of chloroquine, both this man and his wife took chloroquine that was supposed to be used to treat parasite infections for fish.

That woman is still alive, but she’s in critical care.

In an interview with NBC News, she said she and her husband—both of whom were in their 60’s—took it after watching several reports on television, including watching Trump laud the drug from the White House Press Room.

“I saw it sitting on the back shelf and thought, ‘Hey, isn’t that the stuff they’re talking about on TV?'” she said. “We were afraid of getting sick.”

Unfortunately, this couple’s goals were flawed from the start. Neither hydroxychloroquine nor chloroquine are being used as vaccines; rather, they are being investigated as potential antivirals. The difference here is that while vaccines prevent a person from getting the disease, antivirals are only meant to treat the disease after you already get it.

Chloroquine and Hydroxychloroquine in Clinical Trials

For widespread use, scientists need to prove that these drugs are not only effective against COVID-19 but also that the benefits outweigh the risks.

While this is a normal goal for any drug, scientists are playing especially close attention to these drugs as governments try to rapidly push them through clinical testing.

“Chloroquine is an extremely toxic drug with a terrible side effect profile,” Meghan May, a microbiologist at the University of New England College of Osteopathic Medicine, said in a written email to The New York Times. “Hydroxychloroquine is far safer, but its side effects are still significant. If it is not abundantly clear that it is beneficial, giving this drug to a critically ill patient feels risky.”

Those side effects include heart rhythm problems, severely low blood pressure, as well as muscle or nerve damage.

As reported in the journal Nature Medicine, researchers found evidence that hydroxychloroquine impedes the coronavirus’ ability to enter cells; however, that alone doesn’t mean it would do the same thing in a person or that a person could tolerate the doses used in the lab.

In a clinical trial conducted in February, scientists in China reported that chloroquine helped more than 100 patients at 10 hospitals. Because of that, the drug reportedly saw widespread use both there and in South Korea.

Still, this trial is also not enough to prove chloroquine’s effectiveness against COVID-19. Reportedly, with this study, the treated patients all had various degrees of the illness and were all treated with different doses for different amounts of time.

The trial also didn’t contain any control groups, which means that it’s also possible people could have just recovered on their own without the drug.

Another study from France has also captured many eager ears, including Trump’s. There, doctors gave hydroxychloroquine to 26 people who had been infected with the coronavirus.

Of those 26 people, six were also given an antibiotic called azithromycin, but before that study was completed, six other people dropped out. Of those, three people wound up in intensive care and one died. That’s not necessarily to say chloroquine killed them, because like that study from China, there was a lot of variation between each case. Some had been asymptomatic while others were symptomatic.

At the end of the trial, none of the six patients who had received both hydroxychloroquine and azithromycin had detectable levels of the virus. Meanwhile, over half who had received only hydroxychloroquine had no detectable levels, and only 12.5% of people who received neither drug had no detectable levels.

Once again, this single trial or even all three studies together are not enough to prove the effectiveness of these two drugs. National Institute of Allergy and Infectious Diseases Director Anthony Fauci has called such trials only anecdotal at the moment. In fact, clinical trials could take months.

Trump’s Calls for Chloroquine and Hydroxyquine

Scientists have been eyeing these drugs as potential treatments for most of the outbreak’s lifespan, but their names gained household usage after Trump announced last week that he was asking the FDA to cut “red tape” around their usage.

“It’s very powerful, but the nice part is that it’s been around for a long time so we know that if things don’t go as planned, it’s not going to kill anybody,” Trump said of chloroquine on Thursday.

Over the weekend, Trump continued to prop up those drugs, saying on Twitter, “HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine… Hopefully they will….be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST, and GOD BLESS EVERYONE!”

Trump announced Monday that the federal government was working to obtain large quantities of chloroquine. It has already received 3 million doses from Bayer.

On Tuesday, New York state began two trials, one focusing on chloroquine and another focusing on hydroxychloroquine with the azithromycin.

See what others are saying: (The New York Times) (NBC News) (Politico)