As many of my followers know, I am a Johns Hopkins-trained doctoral-level epidemiologist and a former military public health physician. I am among a growing number in my field who believe our approach to COVID-19 will likely cause more morbidity and mortality than it prevented. This is a controversial opinion, but the evidence for this is beginning to accumulate. The risk of this is clearly not in the near-term, but out several years as potential economic and second-order health effects are taken into account.

For those following the interest in hydroxychloroquine (Plaquenil) for COVID-19, here is a brief review of what is known of the drug's neuropsychiatric adverse effect profile, particularly as compared to that of other quinoline antimalarials, such as chloroquine. The synthesis of hydroxychloroquine was first reported by Surrey and Hammer in 1950, as part of an effort to develop an antimalarial drug "superior" to chloroquine, a drug which had itself been rediscovered during an urgent WWII-era drug discovery program.

I am no fan of chloroquine. It can cause lasting neuropsychiatric adverse effects in some people, likely as a result of idiosyncratic neurotoxicity. But the drug’s properties also appear to make it effective as antiviral, and quite likely against COVID-19. sciencedirect.com/science/articl… Chloroquine’s long-term adverse effects are underappreciated. Widespread use of the drug against malaria has likely contributed to prevalent mental illness and mild neurological dysfunction in treated populations. For decades, these effects have been mostly overlooked.

For those unable to register for today’s webinar, I will be live tweeting developments from the National Academies meeting on quinism beginning at 1 p.m. I have shared my disappointment with the meeting organizers that registration was closed early and at the limited space here. One notable observation as we begin is that despite in-person registration having been closed to veterans due to capacity there are plenty of uniformed military personnel observing and plenty of empty seats. Let the record note that several veterans wished to attend but couldn’t.