Thread by @DrChristineMann

There seems to be a lot of confusion and misinformation about the idea of hydroxychloroquinine and azithromycin for treating #COVID19

A thread.

This idea started because of a very small study published in France that showed apparent benefit from the drug combination. Similar reports have come out of China.

mediterranee-infection.com/hydroxychloroq…

There are some things to note about this:

1. It was very very small.
2. It was open-label and not randomized.

Non-randomized, open-label studies are often prone to significant bias.

ncbi.nlm.nih.gov/pmc/articles/P…

Not all study designs are created equally. Here’s a pretty good explainer:

google.com/amp/s/www.vox.…

The number of success stories from drugs that come from tiny studies like this is small: around 10-14%:

google.com/amp/s/mobile.r…

There are a number of reasons that this is important:

1. The idea that there is a cure coming soon can lead people to ignore standard precautions, fail to self-isolate, and take unnecessary risks because they think a cure is imminent.

2. The mixture of these drugs can be extremely dangerous, and NO ONE should be promoting this at this time. Prolonged QT syndrome is *life threatening*. There are reports of deaths from this already.

webmd.com/drugs/2/drug-1…

3. The Texas Board of Pharmacy held an *emergency meeting* to sound the alarm and warn pharmacists about this and limit prescribing and dispensing of these drugs, and to only allow them for *known* effective diseases. This limits the drugs to a two week supply.

4. I have already heard from colleagues that they are having to do insurance prior authorizations to get these drugs to people who *actually benefit* from the medication before they can get these drugs to their patients. People with Rheumatoid Arthritis, Luous, etc.

5. It is possible that we will see people miss out on their needed medication because of these barriers to care.

6. Doctors and pharmacists will be spending considerable time explaining to patients and their loved ones why they cannot give them these drugs, time taken away from providing care to people whose lives are hanging in the balance.

7. The timeframe for taking a drug from these very early stages to widespread use could be months to years to decades depending on various factors. It may be offered to a very small number of people in very select situations.

8. Most people will not have access to this combination for a very long time.

9. There is a gulf between providing people hope and giving them wildly misleading information. Sadly, there are many in the public who are doing the latter.

End.