NEW HAVEN — While President Donald Trump may be taking hydroxychloroquine as a preventative measure, doctors from Yale New Haven Health not only don’t recommend it, they’ve taken it off the list of drugs used for COVID-19 patients.
Dr. Thomas Balcezak, chief clinical officer for the health system, said Tuesday that, as of Monday, “we have moved it from a possible drug to a not-recommended drug.”
Hydroxychloroquine has been used to treat malaria, but it comes with significant side effects, including heart arrythmias, and “has significant toxicities associated with it,” according to Dr. Richard Martinello, medical director of epidemiology and infection prevention.
Martinello said “a small number of patients” have developed complications. “And because we haven’t seen any clear benefit either in the care that we’ve provided, in the medical research that’s been performed to date, and because we are very aware of these potential risks that this drug has … it’s been removed from our recommendations for treatment for patients.”
Trump told reporters on Monday that he’s been taking the drug for about 10 days, along with zinc, after being in close contact with staff members who have tested positive for COVID-19.
Balcezak, asked about Trump’s use of the drug, said he would not respond directly about the president’s taking it.
“My personal recommendation is I think it’s a mistake,” he said. “We’ve used hydroxychloroquine, but we’ve used it in a setting where the patient has been in the hospital, on a heart monitor and monitored. … And if it’s not effective against the virus, which the scientific consensus now is that it is not effective against the virus in humans, then we shouldn’t be using it.
Balcezak said the health system has been using remdesivir, a drug originally developed to treat hepatitis C and Ebola and which has shown some effectiveness against other coronaviruses, such as SARS and MERS.
“We have an adequate supply now to treat all patients who qualify for remdesivir within our health system,” Balcezak said. “The efficacy of that drug, how it changes the natural history and the course of this disease, is relatively modest. It shortens length of stay by a couple of days and hasn’t yet been proven to change the risk of mortality. And I think it’s important for all of us to remember that we are searching for a magic bullet, whether it’s a virus or a drug, and yet right now we have none of those things.”
He said the more important treatments are oxygenation of patients with diminished lung capacity, “proning” — lying patients face down to avoid using a ventilator and supportive care.
“Our treatment has demonstrated that we are at least as good if not better at treating these patients, as evidenced by our mortality rate, than virtually anyplace else that has seen the volume of patients that we’ve seen,” Balcezak said.