*Authors Note: This is a resource regarding an evolving situation. Any information included in this article may change at a later date as new information emerges. Please stay abreast of new and changing information regarding COVID-19 from the CDC and WHO.
As the number of cases – and subsequent deaths – related to COVID-19 skyrocket around the United States, one treatment option has captured the public’s attention: Hydroxychloroquine.
What is this medication, can it work against COVID-19, and how are physicians responding to the ongoing coverage of this treatment option?
During a pandemic, every glimmer of positive news is a reason to hope that the end is near. Whether it’s the updates on the efficacy of a vaccine or ongoing information regarding treatment protocols, the world has been sitting on the edge of its collective seat to hear good news.
The antimalarial prescription drug hydroxychloroquine has been heralded by government officials from the early stages of the pandemic outbreak in the US. The voices leading the call for mass use of hydroxychloroquine include President Donald Trump, who, on May 19, told reporters he was taking the medication as a preventative measure.
Yet, leading health researchers and scientists working on the front lines of COVID-19 treatment continue to warn against the use of the drug. Some have even reported an increased chance of death related to known side effects of taking the medication. This has led to confusion among the public regarding the use of hydroxychloroquine – should one be seeking the drug to be safe, or is it dangerous?
Understanding Hydroxychloroquine & It’s Risks
As the pandemic continues to rage and various treatments take the spotlight, physicians and healthcare professionals will likely encounter patients interested in hydroxychloroquine. Here is a primer related to the drug itself:
- Hydroxychloroquine is administered as an oral tablet
- The drug is available as both a brand-name drug known as Plaquenil and in a generic format
- Hydroxychloroquine is primarily prescribed by physicians to treat malaria, lupus erythematosus, and rheumatoid arthritis.
- Hydroxychloroquine was given FDA emergency-use authorization on April 5, and revoked the authorization on June 15.
Following the President’s claims regarding hydroxychloroquine’s ability to treat and prevent COVID-19, millions began to seek the drug for themselves. This led to a shortage of the drug from manufacturers and kept the life-saving medication from reaching lupus and rheumatoid arthritis patients currently using the medicine.
Unfortunately for the drug’s proponents, studies quickly began to emerge regarding the lack of the drug’s effectiveness. Not only did the drug appear to do nothing for COVID-19 patients, but it was also causing deadly adverse effects in some when the drug was combined with azithromycin- leading to concerns that the drug cocktail could lead to drug-induced cardiac death.
Since these reports emerged, many healthcare facilities have stopped using the drug to treat COVID-19 patients due to the risk involved. On June 15, the FDA revoked the emergency authorization of hydroxychloroquine due to a lack of research-based proof that the drug worked to help patients.
Grasping For Hope Amid COVID-19
So if hydroxychloroquine never truly proved to help coronavirus patients, what led to the drug’s quick promotion and acceptance by many leaders and civilians?
In her groundbreaking work, “On Death and Dying,” psychologist Elizabeth Kübler-Ross defined the five stages of grief that accompany any tragedy or traumatic experience. Of those five, a middle stage known as bargaining is marked by those undergoing the trauma having an increased willingness to accept any shred of hope to put an end to suffering – even if that hope is based on little truth or reality.
Similarly, this same bargaining strategy is happening on a macro-level across the globe. When the first reports of hydroxychloroquine helping patients recover emerged, many were willing to accept the drug as a miracle cure without the necessary scientific research or peer-reviewed study expected of these kinds of medical claims. Looking for an immediate way out of the pandemic, many government officials seemed willing to jump on a possible cure to bring hope to citizens trapped in a negative situation.
As a physician, it is essential to remember that many patients are making decisions or seeking help out of a sense of helplessness or fear. The desire to receive a prescription for hydroxychloroquine – or next week’s miracle cure – is likely coming from a sense of denial or bargaining rather than informed knowledge. Helping patients walk through their understanding of the risks of hydroxychloroquine (as well as the revoking of the medication by the FDA) can help them better understand their need for a different option for treating the disease. Working with patients to help them understand basic prevention methods and effective treatment options can help bring a sense of calm and hope in a scary moment.
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