This Monday, April 6, 2020, photo shows an
arrangement of hydroxychloroquine pills in Las Vegas. (AP Photo/John Locher)
On Tuesday, the results of a study on the benefits of
hydroxychloroquine as a treatment for the coronavirus were released. The study
analyzed the impact of hydroxychloroquine with and without the antibiotic
azithromycin and compared that to patients receiving standard care.
The study
found there were "more deaths" among those given hydroxychloroquine
than those who just received standard care.
As you could expect, the media pounced on the study.
The Washington Post, CNN, Salon, TIME Magazine, and plenty of others were just
itching to claim that Trump had been wrong or even irresponsible for touting
hydroxychloroquine in the first place. International Business Times even wrote: "Trump's Hydroxychloroquine Caused More
Deaths, Study Reveals."
But, if you actually read through the reporting, even
read through the study itself, it becomes clear that the media, which
was quick to downplay or ignore earlier studies showing the drug worked, were
too quick to hype this study's findings.
Here are five problems with the study
that should give you pause before you turn your back on hydroxychloroquine.
5. It was a small, non-peer-reviewed study,
not a clinical trial
Previous studies showing the promise of
hydroxychloroquine in treating the coronavirus have been downplayed by the media
because they were small studies, not large-scale clinical trials.
This study
was not a controlled clinical trial, but an analysis of medical records, and it
hasn't been reviewed by other scientists yet.
Even the Associated Press noted that the difference in fatality between those
given hydroxychloroquine plus azithromycin "was not considered large
enough to rule out other factors that could have affected survival." You
think?
I'm willing to bet that upon peer review, scientists will
acknowledge similar faults with this study that I've identified.
4. The patients were not representative of
the entire population
By now there are a number of things we've learned about
the coronavirus: It has a higher fatality rate with males, older people are
more likely to be affected by it, most who die from it had other illnesses.
The patients
whose records were analyzed for this study were all male. The patients' ages
ranged from 59 to 75, with a median age of 70 (for those treated with
hydroxychloroquine), 68 (for those treated with hydroxychloroquine and
azithromycin), and 69 (for those receiving standard treatment alone).
The
patients were also disproportionately black. According to the census, 13.4
percent of United States population is black, but in the study, 68% (HC), 59%
(HC+AZ), and 65% (No HC) of the patients were black. There is a known racial disparity in how the coronavirus
impacts those who contract it that isn't fully understood yet.
The prevalence of comorbidities in those who have died
from the coronavirus tell me that a study done on VA hospital patients was
never going to give an accurate representation of the drug's efficacy.
This
study was exclusive to a high-risk group of individuals, involving a drug that,
like every other drug, has side effects. Could hydroxychloroquine or
hydroxychloroquine plus azithromycin have side effects that are
disproportionately more severe, or even marginally fatal, to older patients?
Maybe it does. That wouldn't make it unique. But this study doesn't tell
us anything about how the drug works with the overall population.
3. The most severe cases disproportionately
received the drug
The study itself acknowledges that "hydroxychloroquine,
with or without azithromycin, was more likely to be prescribed to patients with
more severe disease." In such a small study that isn't representative of
the entire population, this would likely impact the results. For starters, there
is a direct correlation between advanced age and the severity of side effects.
If more
severe cases were more likely to be prescribed the drug, it's possible that
these patients were more likely to be fatal cases regardless of the treatment,
and perhaps the drugs weren't administered early enough to alleviate the
symptoms to result in recovery.
"The findings should not be viewed as
definitive because the analysis doesn’t adjust for patients’ clinical status
and showed that hydroxychloroquine alone was provided to VA’s sickest COVID-19
patients, many times as a last resort," a spokeswoman for the Department
of Veterans Affairs told Fox News.
2. Other studies and anecdotal reports
suggest it helps
As PJM's Tyler O'Neil noted
earlier this month, "Doctors and patients across America have reported
positive results" with hydroxychloroquine in treating the coronavirus. Dr.
Anthony Cardillo, the CEO of Mend Urgent Care in Los Angeles, reported seeing
"significant success" with the drug in treating coronavirus patients.
New York Governor Andrew Cuomo even requested more hydroxychloroquine from the
Trump administration after seeing promising results.
Democratic Michigan
state Rep. Karen Whitsett says
the drug saved her life.
Were they all just lucky? Unlikely. while these
studies were small, and the reports anecdotal, I'd be willing to bet the
patient base for all of them were more demographically diverse than the VA
hospital study.
1. The study concluded that controlled trials
are still needed
The study's conclusion states quite clearly that
"These findings highlight the importance of awaiting the results of
ongoing prospective, randomized, controlled studies before widespread adoption
of these drugs."
It seems to me that the authors of the study were aware
of its faults when they published. This study was too small and
non-representative of the population. Yet we saw the media pounce on its
results so they could fault him for promoting hydroxychloroquine.
The bottom
line here is that we now have studies that say it works and that it doesn't
work. Hydroxychloroquine might not be as effective as the small studies with positive
results that say it is, and it most likely isn't as ineffective as this VA
hospital study suggests. Obviously, it's worth getting a reliable answer.
_____
Matt Margolis is the author of Trumping Obama: How President
Trump Saved Us From Barack Obama's Legacy and the bestselling
book The Worst President in History: The Legacy of Barack Obama.
You can follow Matt on Twitter @MattMargolis
