The past two months have seen a battle fought out in the media over which drugs might work for coronavirus. Two divergent views have emerged of one candidate, a long-used malaria pill called hydroxychloroquine. President Trump touted it early on after small studies in China and France showed positive results, and frontline doctors reported they have had success when administering it to sick patients early after their symptoms manifest.
But many Trump critics became hydroxychloroquine critics, saying the drug is unproven and potentially dangerous. A paper published online in mid-April cast doubt on the drug’s safety by claiming that it didn’t help numerous veterans treated by the Veterans Administration and was linked to increased deaths.
Meantime, popular support in the media has built behind a new I.V. drug called remdesivir, administered as a fluid into the veins. It was developed to use against Ebola, but never approved for any use when other medicines proved to be more effective. A draft version of a study was accidentally published last month showing remdesivir did not help most coronavirus patients and caused such serious side effects, 18 test subjects were taken off the drug.
Still, Dr. Anthony Fauci of the White House coronavirus task force began promoting remdesivir as “quite important” after other data that proved no lifesaving benefits but indicated it helped coronavirus patients recover four days faster.
“The data shows that remdesivir has a clear cut significant positive effect in diminishing the time to recover,” said Dr. Fauci on April 29.
We set out to find the facts about the promise and harm of these potential coronavirus treatments, minus the spin.
Cardiologist Dr. William O’Neill is a medical director at the Henry Ford Health System in Detroit, Michigan where they’re studying both remdesivir and hydroxychloroquine.
“I’ve never seen science [so] politicized in 40 years of practice,” Dr. O’Neill told me.
“President Trump touted [hydroxychloroquine] early and so then the media set out to disprove and discredit it without any regard for science. I think those of us that are actually involved in the scientific endeavor feel that there is some value to it and it has to be tested.”
Dr. O’Neill says he’s prescribed hydroxychloroquine to help numerous coronavirus patients and saw improvement in all of them. He’s less impressed, so far, by remdesivir, calling the data on that drug (so far) “a big Ho Hum.”
The biggest promise of hydroxychloroquine, he says, could be as a medicine to prevent Covid-19. He’s leading a study to find out if it works but says the bad press generated about the drug is making it difficult to get answers.
“Now people are scared to use the drug, without any scientifically valid concern. We’ve talked with our colleagues at the University of Minnesota who are doing a similar study, and at the University of Washington, we’ve treated 400 patients that haven’t seen a single adverse event. And what’s happening is because of this fake news and fake science, the true scientific efforts are being harmed because people now are so worried that they don’t want to enroll in the trials,” says Dr. O’Neill.
Meantime, a government advisory panel and the FDA seem to give remdesivir the edge. On May 1, the FDA allowed emergency use for severely ill coronavirus patients while stepping up cautions against hydroxychloroquine and its sister drug saying they should only be taken in the hospital or as part of a formal study due to reports of “serious heart rhythm problems.”
However, numerous scientists I spoke to say they think there could be financial incentives to promote the expensive, new, unapproved I.V. medicine remdesivir over the cheap, generic approved malaria pill hydroxychloroquine. These scientists question the report about veterans who were supposedly harmed by hydroxychloroquine saying it was not a peer-reviewed study, it was a collection of case reports with key details missing and no way to know what patients really died of or exactly how sick they were before getting hydroxychloroquine. They add hydroxychloroquine should be given early in the illness, not in the latter stages of coronavirus infection.
“I think we have to look at the money,” says Dr. Jane Orient of the American Association of Physicians and Surgeons. “There’s no big profits made in hydroxychloroquine. It’s very cheap, easy to manufacture, been around for 70 years. It’s generic. Remdesivir is a new drug that could be very expensive. And very lucrative if it’s ever approved. So I think we really do have to consider there’s some financial interest in remdesivir.”
I checked financial ties among experts on the government panel devising coronavirus treatment guidelines— guidelines that had the effect of dialing back hydroxychloroquine use and giving an edge to remdesivir.
Of eleven members reporting links to a drug company, nine named relationships to remdesivir’s maker Gilead. Seven more, including two of the committee’s leaders, have ties to Gilead beyond the 11 months they had to disclose. Two were on Gilead’s advisory board. Nobody reported ties to hydroxychloroquine, which is now made by numerous generic manufacturers and is so cheap, analysts say even a spike in sales would not be a financial driver for the companies.
It’s important to note that neither drug has been FDA approved to treat or prevent coronavirus. Numerous studies are underway regarding both drugs. Scientists I spoke to say that a lot more will be known about their safety and effectiveness, when it comes to Covid-19, at the end of summer.
We asked Dr. Fauci and Gilead (the maker of remdesivir) for interviews but they did not wish to speak to us for this story. We also contacted a dozen scientists who support remdesivir or criticize hydroxychloroquine, but they also declined to be interviewed.