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Front-Line Physicians Are Not Waiting for Polished Antiviral Research

April 6, 2020 (EIRNS)—While rigorous, polished, double-blind studies have not been concluded to demonstrate the effectiveness of hydroxychloroquine, azithromycin, steroids, or the monoclonal antibody tocilizumab; and although media pundits and bureaucrats complain that there is no actual proof of the effectiveness of these treatments, healthcare professionals—through word-of-mouth and their own first-hand experience in treating patients—are using promising pharmaceutical interventions as part of an “all hands on deck” approach to try to save every patient they can.

At this point, numerous hospitals around the United States—including in the New York City area, as well as in nearby Yale New Haven Hospital in Connecticut—are using hydroxychloroquine and azithromycin for a large portion of confirmed COVID-19 cases. And Yale’s protocol, as updated over the weekend, calls for the use of tocilizumab for cases showing ARDS (acute respiratory distress syndrome).

Background on two of these drugs: (1) Hydroxychloroquine has a hypothesized mechanism of action in preventing SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) from entering cells, a mechanism of action that has been observed directly in vitro. (2) Tocilizumab, which is a prescription drug used to treat rheumatoid arthritis, is a monoclonal antibody. It binds to interleukin-6 (IL-6), a small protein that serves a signalling function in the body. COVID-19 patients entering the secondary phase on the infection, in which lung damage is caused in part by the body’s own immune system, have been found to have very high levels of IL-6. By binding to (and thereby deactivating) IL-6, tocilizumab is believed to be able to shut down the devastating immune response. It is being used now, off-label, by physicians treating patients in moderate or severe condition.

Enough preliminary studies have been performed that front-line doctors are using the tools they have available to save lives. If tocilizumab (or the very similar sarilumab, which is currently being tested in U.S. trials) is successful in reducing the lung problems that kill sufferers of advanced cases of COVID-19, the death rate will be reduced, even if the infection rate is not. Although not certain, this could be a significant partial victory in the race to prevent and cure the disease.

Fortunately, physicians caring for patients are not as susceptible to the politicization surrounding hydroxychloroquine since Trump lauded its potential, nor to those who insist that steroids not be used to reduce inflammation. In these cases of drugs with well-known dosing and side-effects, many doctors believe that—in the case of patients for whom they are not contraindicated—the danger of inaction surpasses the potential downsides of using these medications.

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