Coronavirus: To use malaria drug hydroxychloroquine, or not to

  • Is Hydroxychloroquine efficient in treating COVID 19?

  • What is the national protocol on the use of hydroxychloroquine in the COVID-19 outbreak?

  • How are Maharashtra and Rajasthan, two of the states with the highest COVID-19 counts decided to use this drug?

  • What are the concerns in using the hydroxychloroquine?

UPSC can list these Questions under

GS paper 2 (Issues related to health, education and Human Resources.)

What is the context about?

  • Hydroxychloroquine is an oral prescription drug that is used for the treatment of some forms of malaria, as well as autoimmune disorders such as rheumatoid arthritis and lupus.
  • A combination of anti-malarial drug chloroquine and hydroxychloroquine, which is a derivative of chloroquine, is among the four lines of possible COVID-19 treatment that are being investigated by the global Solidarity trials.

Is Hydroxychloroquine efficient in treating COVID 19?

  • The efficacy of the chloroquine and hydroxychloroquine combination is still being researched, a study in The Lancet Rheumatology has found that hydroxychloroquine decreases the acidity in compartments in the cell membrane.
  • Since many viruses use the acidity of these compartments to breach the membrane and set off the process of replicating copies of itself, the reduction of acidity can potentially inhibit viral replication.
  • In 2005, the drug was used to treat SARS, but it failed to decrease the viral load in mice.

What is the national protocol on the use of hydroxychloroquine in the COVID-19 outbreak?

  • In the context of COVID-19, the Indian Council of Medical Research (ICMR) has recommended hydroxychloroquine in very specific cases .
  • It is to be used as a post-exposure prophylactic (preventive medicine) by asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19, and by asymptomatic household contacts of laboratory-confirmed cases.

How are Maharashtra and Rajasthan, two of the states with the highest COVID-19 counts decided to use this drug?

  • Maharashtra and Rajasthan, two of the states with the highest COVID-19 counts, have independently decided to allow use of the drug beyond healthcare workers.
  • The Rajasthan Health Department has issued an advisory on administering hydroxychloroquine to policemen in COVID-19 hotspots.

What are the concerns in using the hydroxychloroquine?

  • Besides the fact that hydroxychloroquine’s efficacy as a COVID-19 cure or preventive is not yet established, there are concerns about its side effects.
  • Hydroxychloroquine is “not a treatment for everyone”. The drug has it owns side effects, one of them is cardiac toxicity leading to irregular heartbeat.
  • The drug is known to cause “drug-induced” prolongation of QTc of some patients (QTc is a measure related to heat rates on an ECG).