More evidence against hydroxychloroquine

New data shows hydroxychloroquine does not help COVID-19 survival rates, as Australian doctors plead with employers not to require medical clearance

US researchers have found more evidence that hydroxychloroquine – with or without azithromycin – does not reduce the risk of ventilation or death in COVID-19 patients.

The researchers, from the Columbia VA Health Care System, the University of South Carolina, and the University of Virginia School of Medicine, also found the drug combination was associated with around a third longer hospital stay.

This analysis, published in the journal Med, is the first in the US to report data on hydroxychloroquine outcomes for COVID-19 from a nationwide integrated health system.

It included data from 807 people hospitalised with COVID-19 at Veterans Affairs medical centres around the United States, of whom 395 did not receive hydroxychloroquine at any time during their hospitalisation.

Among those who did, 198 patients were treated with hydroxychloroquine and 214 were treated with both hydroxychloroquine and azithromycin. Most of the patients given hydroxychloroquine, about 86%, received it before being put on a mechanical ventilator.

After adjustment for clinical characteristics, the risk of death from any cause was higher in the hydroxychloroquine group but not in the hydroxychloroquine plus azithromycin group when these were compared with the no-hydroxychloroquine group.

The researchers also found that the length of hospital stay was 33% longer in the hydroxychloroquine group and 38% longer in the hydroxychloroquine plus azithromycin group than in the no-hydroxychloroquine group.

Pre-existing conditions such as cardiovascular disease, chronic obstructive pulmonary disease, and diabetes were relatively common and similar across all groups.

Hydroxychloroquine for COVID-19 has remained controversial since US President Donald Trump recommended its use in preventing the disease, later revealing that he had been taking it prophylactically.

A Lancet study was recently retracted after concerns about the veracity of the data and analysis were raised.

The World Health Organization and other researchers temporarily suspended the hydroxychloroquine arms of their COVID-19 trials as a result of this, though the WHO has since recommenced this arm of its trial.

Clearance requests waste of time

Meanwhile in Australia, the Royal Australian College of General Practitioners has urged employers, school principals and day care manager to stop requiring employees, students and parents to provide a “medical clearance” or certificate stating that they do not have the novel coronavirus.

The RACGP has told members to communicate in writing that they cannot routinely provide patients with such a clearance.

It said testing resources should only be available to people who have had close contact with a confirmed case of COVID-19, patients who have symptoms of the disease, and health care workers.

RACGP president Dr Harry Nespolon said such requests were a waste of time.

“This is another COVID-19 myth that must be busted,” he said. “An employer, principal or day care manager is not allowed to dictate that an employee, child or student must have a certificate to return safely to a workplace, primary school, secondary school or day care facility.”  

Victoria is currently stepping up its targeted coronavirus testing, focusing on communities where it may be more likely or where testing numbers are relatively low.

Minister for Health Jenny Mikakos said targeted testing – in addition to ongoing testing – would help provide vital intelligence and inform the further easing of restrictions.

The targeted testing program will run until the end of August and focus on Local Government Areas with low testing rates, communities with high case numbers, high-risk workforces and vulnerable groups.

It will be rolled out in four three-week waves across different locations and LGAs, with the first starting in Mildura, Kyabram, Dandenong and Brimbank.

Other LGAs and areas to be targeted include inner-city Melbourne, Moreland City Council, City of Melton, Colac Otway Shire, City of Whittlesea, Surf Coast Shire, Hume City and Wyndham City.

“If Victoria was a nation, our per capita testing rate would be one of the best in the world. But as we gradually ease restrictions, we won’t take any chances,” said Minister for Health Jenny Mikakos.

“Our massive testing blitz saw Victorians come out in huge numbers to get tested. Now, we’re strategically targeting specific communities to make sure we get the full picture.”

NSW Health reports that as at 8pm Saturday 13 June 2020, there had been nine new cases of COVID-19 diagnosed in the previous 24 hours.

It said that of the nine new cases in that time, eight were returned travellers in hotel quarantine.

The ninth case is a female teacher at Laguna Street Public School in Caringbah, which has been closed for on-site learning until June 24.

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