Written by: Sophia da Silva 🇧🇷
A poster from the Nigeria Centre for Disease Control and Prevention (NCDC) states that the use of Hyddroxychlorine is not recommended for use except when used as part of approved clinical trials taken in Oakland Hall at the University of Maryland on Feb. 16, 2023 (Justin Guzman)
During the peak of the COVID-19 pandemic, it was evident that the panic surrounding the disease led to rash decisions regarding public health in Brazil. One of these decisions included the push of hydroxychloroquine into the spotlight as a treatment for the illness.
Hydroxychloroquine, or HCQ, is an affordable and accessible medication developed to treat malaria and Lupus. As COVID-19 has been proven to cause inflammation, leading to other triggering effects, HCQ was believed to be an effective treatment due to its anti-inflammatory properties in arthritis treatments.
Data from in-vitro studies indicated that HCQ would block the entry of SARS-CoV-2, the virus that causes COVID-19, in mammalian cells. The scientific community interpreted these results with hope that HCQ could effectively treat COVID-19, which greatly comforted people in such a difficult time. In Brazil, the accumulated outbreak of cases led to a new protocol for doctors to prescribe the medication to COVID-19 patients Although in-vitro studies supported the use of this medicine, it was quickly observed to be non-effective in individuals. Dr. Cyro Martins, a professor at the University of the State of Rio de Janeiro, UERJ, and emergency room doctor, explained that in-vitro uses high doses of medications in a sterile environment. When doses are adjusted to the human body and its many variables the results may greatly vary.
As more clinical trials were done, including ones by the NIH, results showed HCQ wasn’t as effective as once thought.
In scientific communities, approval for HCQ therapy was immediately revoked. The FDA took action in June 2020, leaving the United States with a stockpile of 63 million doses. In Brazil, it was no longer protocol for doctors to prescribe HCQ to COVID-19 patients.
However, this information was not properly shared with the public. Claudia Papaléo D.D.S., an odontological dentist for the city of Nova Iguaçu, recalls the administration of president Jair Bolsonaro continuously encouraging the use of HCQ to keep the economy going and essentially ignoring the pandemic.
For this reason, there was limited official and clear information about the changes in HCQ usage. People often went searching for their own information on the internet, leading to confirmation bias and the proliferation of fake news.
. Vaccination area at CVS located in College Park, MD on Feb.14, 2023 (Justin Guzman)
“Some patients became extremely frustrated and even aggressive in relation to this. Almost demanding the treatment of hydroxychloroquine,” Martins describes in Portuguese his experience as an emergency room doctor during the pandemic.
The responsibility rested on individual doctors to inform patients of HCQ changes, and new ways of treatment, without the backing of official government information. “There was an aggressiveness at the time to request the treatment because they believed they were being exposed to the virus and there was nothing being done,” Martins elaborates on the struggle of informing fearful patients.
This is not as much of an issue nowadays because there are more effective treatments available to people. Very few doctors still prescribe it according to geriatric doctor, Dr. Maria Nazaré Terra, and it is seen largely as a political action.
In Brazil, their large vaccination rates helped diminish the spread of the virus and these debates. In my conversation with Papaléo, she describes the Brazilian Unified Healthcare System, SUS.
Health workers from SUS go to people’s houses to talk to families, examine the household’s health, and inform and administer treatment and vaccinations. They send doctors to those unable to leave the house and provide transportation to and from hospitals to those in need. They even go to isolated and rural communities, as this is a free service to all Brazilian residents.
SUS could have been better utilized to inform the public about HCQ, but the Bolsonaro administration did not support SUS, and even wanted to end it.
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