What We Have to Lose

Beyond the Curve: Dr. Peter Lurie's COVID-19 Blog

A diagram of the molecular structure of hydroxychloroquine
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In war, truth is the first casualty.

              —Aeschylus

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By now you’ve heard the President promote the drugs chloroquine and hydroxychloroquine in the treatment of COVID-19. Why wouldn’t he, when he has a crack medical team comprised of the likes of Fox News host Laura Ingraham, Rudy Giuliani and White House economist Peter Navarro? In a rare brush with the truth, he said “I’m not a doctor,” but continued “but I have common sense.” Separately he asked, “What do you have to lose? I’ll say it again: What do you have to lose? Take it. I really think they should take it.”

As I lay out with my colleague Dr. Joshua Sharfstein, Vice Dean for Public Health Practice and Community Engagement at the Johns Hopkins Bloomberg School of Public Health, in this piece in the British Medical Journal, you may well have a lot to lose. Hydroxychloroquine is a well-known cause of sometimes-fatal heart arrhythmias. The FDA also warns of other adverse effects, including kidney, liver and eye toxicity. And there is already evidence that because the Food and Drug Administration committed 29 million doses of the two drugs to the Strategic National Stockpile (under pressure from the President), patients with lupus and rheumatoid arthritis, for whom the drugs are known to be effective, are having difficulty obtaining supplies.

In fact, the evidence that hydroxychloroquine performs any more effectively than a sugar pill is non-existent. As we conclude in the article, “Amid the urgency of a crisis, it is tempting to cast aside the scientific method and adopt interventions offering even a glimmer of hope. But history instructs us otherwise. Effective treatments are not identified by anecdote, wishful thinking, or lobbying; they are instead the product of the systematic application of the very scientific principles that for decades have delivered so many safe and effective treatments.”

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