Now that President Trump has extended the social distancing guidelines through the end of April, it’s time we got used to this new normal. New and faster methods of testing for the virus are being rapidly developed and this certainly will help us make more informed decisions about how to prevent its spread.
But the more important question is how to treat this virus. Fortunately, only about 1% of all those infected will require hospitalization and advanced medical treatment. However, for that one percent, effective treatment is critical, even life-saving.
I happen to live next door to a neurosurgeon who is married to an intensivist – a doctor whose entire practice is taking care of the critically ill in intensive care units. About two weeks ago he told me she was having great results treating those in the ICU with corona virus with a new combination of drugs, hydroxychloroquine (HC) and azithromycin (AZ). She had found 90% of those on this combination made a recovery and were discharged.
Why are these drugs effective?
HC is a drug that has been around for many years, commonly used to treat malaria and lupus. It has been shown in laboratory tests to block the replication of RNA viruses like Covid-19 Corona Virus in invitro testing. Remarkably, during the initial Chinese outbreak, doctors observed that patients with lupus did not develop Covid-19 infection. In one study, 178 hospital patients tested positive for Covid-19, but none had lupus and none were receiving HC. They then studied 80 patients from the dermatology department with known lupus taking HC and found none were testing positive. They hypothesized that long-term use of HC may be protective for Covid-19 infection.
The idea for using HC in combination with AZ came from a French hospital study. Their study showed that 57% of 14 Covid-19 patients receiving HC without AZ tested negative for the virus on a nasal swab on day six. But 100% of the six patients who received both HC and AZ tested negative on day six. This compared favorably with 16 infected patients from another hospital nearby who didn’t receive these drugs. On day six only 12% were testing negative.
These early results were followed by additional data published last week from the same French authors. An additional 80 hospitalized patients received the combination of HC and AZ. By day eight of treatment, 93% were testing negative for the virus. This paved the way for rapid discharge of patients from the ICU in an average of five days.
In other anecdotal reports, Dr. Zev Zelenko of Monroe, N.Y., has treated over 500 Covid-19 patients with a combination of HC, AZ, and Zinc. Zinc is known to slow viral replication within the cell. All patients were positive for the virus and had shortness of breath symptoms or were in the high-risk categories with mild symptoms. All patients were treated as outpatients with oral medication for five days. He reports No deaths and No hospitalizations. Side effects of the drugs have been limited to occasional nausea and diarrhea.
The beauty of these reports is not just the impressive results seen with HC and AZ, but that these drugs have been in use for other purposes for decades. Zinc is commonly sold OTC for the common cold. Because HC has been in widespread usage for lupus and malaria, and AZ (Z-Pak) for influenza and other respiratory illnesses, they are known drugs with known track records of few side effects. This makes usage of them in new ways less risky. This past week the FDA authorized the usage of both drugs for treatment of the Covid-19 pandemic.
There are other drugs being considered for treatment and other combinations in trial usage, but none has shown as much promise as the combination of HC and AZ. They may go a long way toward getting control of this virus, especially for those most vulnerable for respiratory failure.
(For more on these and other drugs being used for Covid-19 treatment, see an article by Jeff Colyer in The Wall Street Journal entitled More Promising Data on a Corona Virus Treatment.)