Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day eighty nine
Speaker 1: since coronavirus was declared a global pandemic. Our main story
Speaker 1: the ongoing drama over hydroxy chloroquine. Studies have shown conflicting
Speaker 1: information about the value of using hydroxy chloroquine to fight
Speaker 1: the coronavirus. The flip flopping raises questions about not just
Speaker 1: the drugs efficacy and safety, but also on the reliability
Speaker 1: and accuracy of the scientific review process itself. But first,
Speaker 1: here's what happened today. Transmission of the coronavirus by people
Speaker 1: who aren't showing symptoms is quote very rare. The World
Speaker 1: Health Organization said Monday that contradicts earlier speculation by public
Speaker 1: health officials and researchers that disease was being spread by
Speaker 1: people who weren't shown signs of illness. New York City
Speaker 1: on Monday opened up non essential retail stores for the
Speaker 1: first time in months. Governor Andrew Cuomo says a little
Speaker 1: more than one percent of New Yorkers tested Sunday were
Speaker 1: infected with the new coronavirus, the lowest rate since the
Speaker 1: pandemic began. The UK death toll rose by fewer than
Speaker 1: one hundred for the second straight day, and London reported
Speaker 1: no new fatalities for the first time since its lockdown began.
Speaker 1: But worldwide infections from the coronavirus surpassed seven million. That's
Speaker 1: up by one million cases in just a little more
Speaker 1: than a week. The surge is driven by hotspots including
Speaker 1: Brazil and India. That worrisome trend adds weight to the
Speaker 1: value of social distancing. A report showed that lockdowns and
Speaker 1: other public health measures may have prevented about half a
Speaker 1: billion infections in six countries, including China and the US,
Speaker 1: And now our main story. Hydroxychloroquine is back in the news.
Speaker 1: In the early days of the pandemic, the antimalarial drug
Speaker 1: was touted by President Trump and some doctors as an
Speaker 1: effective treatment for COVID nineteen, but the drug has largely
Speaker 1: been discredited for use against the virus. Now the studies
Speaker 1: dismissing the drug have also been thrown into doubt. So
Speaker 1: what's the truth about this controversial drug? I spoke to
Speaker 1: Bloomberg Health and Science reporters Michelle Cortes and Robert Langrath
Speaker 1: for some answers. Thank you both for joining us UM
Speaker 1: you know in the news. We have heard a lot
Speaker 1: about this drug, hydroxy chloroquin in terms of whether or
Speaker 1: not it can treat COVID nineteen, but we've also heard
Speaker 1: that it's an actually antimalarial drug. Can you maybe walk
Speaker 1: us through the narrative here about how this drug began
Speaker 1: being touted as a potential treatment for COVID nineteen. When
Speaker 1: coronavirus first started circulating around the world, we had nothing
Speaker 1: for it at all. It was a brand new virus
Speaker 1: and the entire world was a vulnerable So drug companies
Speaker 1: and academic researchers started combing through all the evidence that
Speaker 1: they had, looking at every type of drug. They looked
Speaker 1: at antibiotics, they looked at other anti virals, they looked
Speaker 1: at anti fungals, they looked at at immune system drugs,
Speaker 1: they looked at everything. And in laboratory tests, it looks
Speaker 1: like this drug actually makes it more difficult for the
Speaker 1: virus to penetrate a healthy cell. And that's where it
Speaker 1: all started. When we saw something that effectiveness, it was approved.
Speaker 1: They believed that there was an acceptable amount of side
Speaker 1: effect risk. They moved forward with it, and as hydroxy
Speaker 1: chloroquine has been this new potential in terms of a
Speaker 1: treatment for COVID nineteen. Obviously, we've seen many new reports
Speaker 1: being issued, a lot of discussion about its efficacy, and
Speaker 1: I was wondering if you might be able to explain
Speaker 1: a little bit about some of these reports and some
Speaker 1: of the conflicting evidence that we seem to be getting
Speaker 1: from the reports about whether it is indeed defective. Very
Speaker 1: early on, some researchers in France tested them the medicine
Speaker 1: and patients, and they found that it dramatically lowered the
Speaker 1: amount of virus in patients who are affected with coronavirus,
Speaker 1: and so they believed that that would translate to a benefit.
Speaker 1: If you have less virus in your body, you're likely
Speaker 1: to have fewer symptoms and less likely to get deadly ill.
Speaker 1: Then there were other smaller studies that were coming out.
Speaker 1: There were anecdotal reports. A doctor said that they gave
Speaker 1: the medicine to patients and within hours and days they
Speaker 1: were getting miraculously better. The thing is, in these cases
Speaker 1: they didn't have comparison patients, and most patients with coronavirus
Speaker 1: do get better, so it wasn't clear whether or not
Speaker 1: they were getting better because of this medicine or just
Speaker 1: because of time and their bodies taking care of the virus.
Speaker 1: And then what happened there was there's this giant study
Speaker 1: he suddenly published a couple of weeks ago in the LANDSTUH,
Speaker 1: a well known medical journal, and it was led lead
Speaker 1: author was a you know, big name Harvard professor UH.
Speaker 1: And it purported to do kind of the mother of
Speaker 1: all data gatherings from around the world and UH. And
Speaker 1: they purported to gather data from nine patients from around
Speaker 1: the world on all continents, hundreds and hundreds of hospitals,
Speaker 1: from all sorts of different electrotronic medical records UH providers
Speaker 1: UH and combine them to one joint report of how
Speaker 1: patients who got I draw c clorkin did. And it
Speaker 1: said that not only was it not working, UH, it
Speaker 1: was causing all sorts of harms, including increasing the risk
Speaker 1: of heart disease and death. So what beyond that it
Speaker 1: didn't work and said it was dangerous? And what was
Speaker 1: the upshot of this study? This caused a great concern
Speaker 1: and caused the Double World Health Organization to pause a
Speaker 1: trial clinical trial hydroxychloricin UH that was going on. So
Speaker 1: there's a very very big impact to this study. But
Speaker 1: A problem with this study is that as data researchers
Speaker 1: and kind of online sluice doctors and places around the
Speaker 1: world and the internet started, Internet started looking more carefully
Speaker 1: at the data behind this study. They found a large
Speaker 1: number of inconsistenccies and red flags and things that just
Speaker 1: didn't add up. And one of the most basic ones was,
Speaker 1: how could uh this Uh, this small group of researchers
Speaker 1: gather all this data on from so many hospitals and
Speaker 1: around the world, with so many different privacy research privacy
Speaker 1: laws and rules, and put it all together in such
Speaker 1: a short period of time. Uh. And then it turned
Speaker 1: out that the data all came from one tiny company
Speaker 1: that nobody had ever heard of, called service Fare, that
Speaker 1: was led by a vascular surgeon in Illinois with a
Speaker 1: very few employees and very little up presence. Uh. It
Speaker 1: just seemed highly implausible to outside researchers that this tiny
Speaker 1: little company could have gathered all this that nobody had
Speaker 1: ever heard of, could have just gathered all this data
Speaker 1: in the midst of the pandemic and done such a
Speaker 1: giant study so fast. But what else do we know
Speaker 1: about this small company that otherwise we would never have
Speaker 1: heard about? Yeah, we know very little about it. It's
Speaker 1: very mysterious. It's very few employees are the main person associated,
Speaker 1: which appears to be this vascular surgeon, Zapandasi, who Illinois
Speaker 1: based vascular surgeon. Uh, but you know, we know very
Speaker 1: little about the company. It's very mysterious. And so as
Speaker 1: people started asking questions about this data, uh, the Harvard
Speaker 1: researchers on the top researchers on the paper that his
Speaker 1: collaborators went back and said, we need an independent audit
Speaker 1: to verify that this data is real and where it
Speaker 1: came from, there's not problems with it and what and
Speaker 1: uh he uh. Dr Desi said at first that he
Speaker 1: would cooperate with the audit, but then apparently he wouldn't
Speaker 1: provide the raw data, names of the hospitals, and that's
Speaker 1: when the paper was retracted. How did then this get published? Um?
Speaker 1: I mean, what were the circumstances that the Lancet was
Speaker 1: willing to accept clearly something that was very problematic in
Speaker 1: terms of its data sources. Well, yeah, I mean that
Speaker 1: is exactly the question. It is, you know, pretty unbelievable
Speaker 1: in retrospect that these studies got got published and there's
Speaker 1: not just one study by this group. There's a second
Speaker 1: study that had to end up being retracted in the
Speaker 1: New England Journal Medicine. So this group got multiple studies
Speaker 1: into multiple major journals. And one of the things that
Speaker 1: it may be happening is that in this rush to
Speaker 1: come out with new data and you know, healthful information
Speaker 1: COVID nineteen because it's new virus, and because we know
Speaker 1: so little and have so few treatments, you know, the
Speaker 1: journal also appearing the major medical journals also appeared to
Speaker 1: be pushing out you know, stuff quicker than ever before,
Speaker 1: and that appears to be leading to some mistakes, including
Speaker 1: some major mistakes here such as this. This leads me
Speaker 1: to kind of too related questions in terms of what
Speaker 1: is the fallout from this um Both from the sense of,
Speaker 1: you know, this report had seems to have had significant
Speaker 1: impact in halting other clinical trial programs, other um studies
Speaker 1: involving hydroxy chloroquine. What is going to be the impact
Speaker 1: of this one report being retracted and also, i mean
Speaker 1: one of the longer, perhaps more broader impacts in terms
Speaker 1: of well, certainly the reputation of the lancet. But again,
Speaker 1: this this rush to research and rush to publication as
Speaker 1: far as what we can find out about how to
Speaker 1: treat COVID nineteen. When it comes to hydroxy chloroquine, we
Speaker 1: can see that this imperfect and very fast science has
Speaker 1: really had an impact across the board. In the early
Speaker 1: days when we were grasping for anything and President Trump
Speaker 1: got on board with this, we saw use of hydrox
Speaker 1: chloroquine go through the roof. Then we started seeing some
Speaker 1: pulling back, and after the lance At trial, we actually
Speaker 1: saw the w h O and others halt their trials because,
Speaker 1: of course, the idea that patients were actually being harmed
Speaker 1: by this medicine is terrifying. You don't want to make
Speaker 1: people who are already critically ill even worse. The questions
Speaker 1: that are surrounding all of these drugs, though, are leaving
Speaker 1: us just with unanswered issues of what do we do
Speaker 1: going forward. The University of Minnesota did do a trial.
Speaker 1: It was double blind, randomized. It was a trial to
Speaker 1: see if people who had been exposed to the virus
Speaker 1: could get protection from coming down with it from actually
Speaker 1: be coming infected if they take hydroxychloroquin and it did
Speaker 1: not find that. It found that it didn't help those
Speaker 1: patients avoid getting infected, but it also didn't cause significant
Speaker 1: side effects. So where that leaves us now is just
Speaker 1: in the same unknown space that we were in the
Speaker 1: very beginning. There are some people who really believe this
Speaker 1: is going to work, and there are other people who
Speaker 1: really believe that it doesn't work. If it does anything,
Speaker 1: it's not significant, it's not worth the time and effort,
Speaker 1: and patients should be moving on to other treatments that
Speaker 1: might give them more benefit. Yeah, so I think this
Speaker 1: is a major warning sign for some of the medical journals,
Speaker 1: including the lance of the England Journal of Medicine, which
Speaker 1: also had a retraction on a different uh subject matter
Speaker 1: but from the same tiny company. Um this is a
Speaker 1: warning sign that they need to perhaps move a little
Speaker 1: bit slower to make as to make sure that the
Speaker 1: data coming out about this virus is really true and
Speaker 1: correct data. It has really just been kind of a
Speaker 1: perfect storm when it comes to this early suggestions of
Speaker 1: possible benefit, this environment where we didn't have anything except
Speaker 1: for some fear data set that appeared at least initially
Speaker 1: to be good doctors who wanted to be helpful and
Speaker 1: get out information right away. But Bob's point is exactly
Speaker 1: exactly right. We actually need to make sure that our
Speaker 1: data is accurate and safe and that doctors are making
Speaker 1: decisions based on things that are scientifically true. And the
Speaker 1: other thing to keep in mind is this virus is
Speaker 1: not going away. This is going to be with us
Speaker 1: for months, perhaps years, and we need to know the
Speaker 1: right answers, not just the fast ones. That was Michelle
Speaker 1: Cortez and Robert Langrath, and that's our show today. For
Speaker 1: coverage of the outbreak from around the world, visit Bloomberg
Speaker 1: dot com slash coronavirus and if you like the show,
Speaker 1: please leave us a review and a rating on Apple
Speaker 1: podcast Us or Spotify. It's the best way to help
Speaker 1: more listeners find our global reporting. The Prognosis Daily edition
Speaker 1: is produced by Topher Foreheads, Jordan Gaspoure, Magnus Hendrikson, and
Speaker 1: me Laura Carlson. Today's main story was reported by Michelle
Speaker 1: Cortes and Robert Langrith. Original music by Leo Sedrin. Our
Speaker 1: editors are Francesco Levi and Rick Shine. Francesco Levi is
Speaker 1: Bloomberg's head of Podcasts. Thanks for listening.