Chloroquine and other drugs

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By MOMTCHILO RUSSO*

The current policy of the Ministry of Health to insist on chloroquine and to be against social isolation is, respectively, a quackery and an excrescence when compared to what is advocated by the WHO and in most countries.

The worst of the current viral pandemic (Covid-19) is the ignorance of not following the recommendations of the World Health Organization (WHO) and what other European countries have done to avoid the catastrophe that is now taking place in Brazil, with the high number of deaths. .

Chloroquine and hydroxychloroquine are drugs used in the prevention and treatment of malaria, a disease caused by a protozoan and transmitted by mosquito bites.

These synthetic drugs were based on the active principle of quinine, a natural bitter substance extracted from the bark of a tree found in Peru.

An anecdotal fact that I use to illustrate the malaria class relates to the three main problems that British colonists had in India: mosquitoes, heat, and malaria.

So they invented a drink that solved all three problems at once.

Gin to stop worrying about mosquito bites; tonic water on the rocks to quench thirst and beat the heat; and quinine to kill the parasite that causes malaria.

That is, a perfect solution to the three problems.

In 1918, the use of quinine was recommended to combat the influenza virus responsible for the Spanish flu epidemic and later chloroquine, in episodic outbreaks of influenza, without having its effectiveness proven.

The use of hydroxychloroquine in Covid-19 came from an observation by the French doctor Didier Rault, from Marseille, who noticed improvement in some patients.

Based on this observation, Dr. Rault published a work on the beneficial effect of the treatment of hydroxychloroquine combined with the antibiotic azithromycin in Covid-19, but the work was done with a small number of patients and with problems in the statistical analysis due to the withdrawal of some patients in the data analysis, suffering criticism of the scientific community which resulted, at the request of the authors themselves, in the withdrawal of publication of this work.

One of the initial problems with the use of chloroquine is that there was a lack of concrete reports about its efficiency in Covid-19.

As most patients, nearly 90% recover from the infection, it is difficult to determine the effect of chloroquine.

This type of situation, when you are not sure what really works in a certain disease, opens the field to quackery.

Today there are several studies, which have concluded that treatment with chloroquine or hydroxychloroquine is not beneficial in Covid-19, on the contrary, it can even have a deleterious effect.

Therefore, recommending its use, as the Ministry of Health currently does, violates a basic principle of medicine, which is primum non nocere, that is, not inflicting unnecessary harm on the patient.

There is a saying in medicine that says “the patient can be healed with, without and in spite of the doctor”.

Although the doctor refers to the possible iatrogenic action, which are complications resulting from medical treatment.

Because of this, today's clinicians follow evidence-based protocols.

The recommendation for the use of chloroquine by three presidents who share ignorance regarding chloroquine's mechanism of action is illustrative.

In common, the three do not have any professional training or scientific knowledge to give an opinion as they do not understand viruses or therapy.

The president of Brazil follows President Trump, who advocated and took chloroquine.

On the other hand, President Maduro of Venezuela also defends its use, indicating that the defense of chloroquine is not a primacy of a type of government.

The defense of chloroquine is reminiscent of the case of Lysenko, Minister of Agriculture at the time of Josef Stalin. Lysenko was convinced that Mendel's genetics (laws based on plant crossing that determine genetic inheritance from parents to offspring) was a bourgeois theory and dismissed all the scientists who supported it.

The consequence of this was felt in the agriculture of the Soviet Union, which collapsed.

Similarly, the Ministers of Health in Brazil who refused to indicate chloroquine and/or the end of social distancing were removed and have not yet been replaced, which resulted in an exponential increase in the number of hospital admissions in some cities, leading to the collapse the Unified Health System.

The use of chloroquine in Brazil has become an ideological problem even among professors and researchers.

A few months ago, a document was written, addressed to the Minister of Health and signed by 31 researchers asking for urgency in the application of chloroquine.

It is noteworthy that the signatories of this letter belong to an organization called Docentes pela Liberdade (DPL) — as if there were professors and researchers opposed to this cause.

On a visit to the DPL website, it appears that the group defines itself as: non-partisan, made up of teachers and professionals from any area, whose interest is to recover the quality of education in Brazil, break with the hegemony of the left and fight ideological persecution.

This document was published on the website “Brasil Sem Medo”, which has on its editorial board Olavo de Carvalho, guru of the president and his children.

It is no coincidence that part of the DPL board was hired to work in different government positions.

That is, contrary to what it says on its website, DPL is a party group identified with the current government.

Regrettably, the Brazilian government ignored an important finding made by physician Elnara Marcia Negri, from the Hospital Sírio Libanês and the University of São Paulo, showing the beneficial effect of heparin, an anticoagulant drug, on Covid-19.

Equally relegated was the advancement of knowledge on Covid-19 made by Brazilian researchers from the Department of Pathology of the Faculty of Medicine of the University of São Paulo (FMUSP) coordinated by Prof. Marisa Dolhnikoff, showing that thromboembolism (exaggerated blood clotting) is associated with the pathology of Covid-19.

Even the current orientation of doctors — who also deserve to be highlighted — at the Hospital das Clínicas of FMUSP is to use heparin.

It is worth remembering that a type of heparin for Covid-19 was also developed in Brazil by Dr. Helena Nader from UNIFESP.

Nor was a test that identifies the presence of the virus from the first day of infection, developed at Albert Einstein Hospital, highlighted by the government.

In addition to these, numerous innovative initiatives by Brazilian universities were ignored, including initiatives by my Institute (ICB – USP), which established an ultra-sensitive serological test for Covid-19.

Finally, the Brazilian president made a mistake and a failure when he stated that — those who are on the right take Chloroquine, those on the left take Tubaína – because the left does not take Tubaína, it is the people who take Tubaína.

Tubaína have popular appeal due to their low cost.

By associating Tubaína with what he hates the most, which is the left, the president reveals his class bias, that is, his contempt for the Brazilian people by referring to Tubaína in a pejorative way.

The current policy of the Ministry of Health to insist on chloroquine and to be against social isolation is, respectively, a quackery and an excrescence when compared to what is advocated by the WHO and in most countries.

This guidance led by the president will soon take Brazil to the top of deaths.

Someone must be blamed for this catastrophe.

Who is responsible? Who will judge the chloroquine quackery? When will the culprits be judged for necropolitical acts? Which court will judge them? What do we need to do to reverse this announced tragedy?

* Russian Momtchilo He is a professor at the Department of Immunology at the Institute of Biological Sciences at USP and at the Department of Infectious Diseases at the Faculty of Medicine at USP.

Originally published on the Viomundo website.

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