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The politicization of the drug hydroxychloroquine by U.S. President Donald Trump as a potential preventative measure against COVID-19 is putting a legitimate international clinical trial run out of the University of Manitoba at risk.
Over the weekend, Trump announced to the world that he was taking the malaria drug to defend himself against the novel coronavirus, despite a continued lack of proof that the medication provides any protection. (It still could provide protection, but the scientific evidence simply isn’t in.)
The clinical trial that is being led by researchers at the University of Minnesota, in partnership with the University of Manitoba and McGill University in Montreal, is seeking to test its effectiveness by using it as a prophylactic medication on health-care workers who may then be exposed to the virus through their work.
But those medical professionals are hesitant to sign up for such a study.
"This medication for a number of reasons has been heavily politicized and certainly that’s had an impact on our trial’s ability to recruit participants, because of all of the attention that it’s gotten in the press thus far," said Lauren MacKenzie, the lead investigator for the Canadian branch of the research.
MacKenzie said the trial will need at least 3,500 nurses, doctors, ancillary staff and triage personnel to sign up in order to have a large enough test group for the data collected in the trial to be relevant. Currently there are about 1,500 signed up and only a handful of them came from Manitoba in the first week of registration, she said.
"It just seems to be like a lightning rod and very controversial, which is very unfortunate because (hydroxychloroquine) has a great safety track record and people have been using it in rheumatology, since the 1950s. It’s a relatively safe medication to take," MacKenzie said.
She says the low number of COVID-19 cases in Manitoba has likely also played a role in low turnout here.
Dylan MacKay, a clinical trialist at the George and Fay Yee Centre for Healthcare Innovation in Winnipeg, said this is the "weirdest trial" he’s ever been involved in. He has heard the full spectrum of reasons that people don’t want to participate in the study — from those who dislike Trump and therefore refuse to participate in a study that could possibly prove him right, to Trump supporters who have gone rogue and started taking the medication on their own already, and are thus ineligible for the study. Still others have insisted simply because Trump said it could work, it must not. Some people have said they’re afraid of the drug because they’ve heard experts warn in the media against its use.
"So we just can’t win," MacKay said. "This kind of stuff could lead to us never getting enough people and then us never knowing the answer, and it will end up just depending on your political beliefs whether or not you think the medication works or not. And that is definitely not the outcome we want to have. We want to have a nice clear answer — it works, or it doesn’t. And for that, we need participants."
MacKenzie wanted to emphasize that the drug is safe when taken under the advisement of a medical professional, who can deal with any possible side effects — as is provided in the clinical trial.
But there are three reasons a person shouldn’t try taking the medication on their own, she said. First, there is a safety risk if hydroxychloroquine is taken with the absence of medical followups and understanding of possible drug interactions with other medications. Second, if a person takes it on their own, it doesn’t contribute to the scientific knowledge base. Lastly, there is high demand for hydroxychloroquine and patients who use it to treat other ailments are having a hard time accessing the drug. Meanwhile the clinical trial avoids this issue by pulling from a separate procurement method.
"Whatever anyone might say about this drug, this question has not yet been answered, and we are trying to answer it," MacKenzie said.
Health-care workers can find more information on the trial at CovidPrepTrial.ca.
Sarah Lawrynuik reports on climate change for the Winnipeg Free Press. Funding for the Free Press climate change reporter comes from the Government of Canada through the Local Journalism Initiative.
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