While speaking with Laura Ingraham on Fox News on Monday, July 20, Yale epidemiology professor Dr. Harvey Risch said hydroxychloroquine (HCQ), if used properly, could save between 75,000 and 100,000 lives and can also be taken safely as a preventative.  His findings were published in the May 27 American Journal of Epidemiology to no effect.  A similar French study in early March reported similar evidence of success using HCQ to combat COVID-19.  The French report was dismissed as anecdotal. 

Dr. Risch insisted that HCQ is effective and safe, but he has become the victim of a "propaganda war" ever since President Trump recommended it back in March.  The Lancet even published a study claiming that HCQ is ineffective and increases the risk of death.  By June the journal's false claim was retracted, but lasting damage was done. 

Dr. Risch summed up the problem with HCQ: "It's a political drug now, not a medical drug.  I think we are basically fighting a propaganda war against the medical facts, and that colors not just population people, how they think about it, but doctors as well.”

He also said state medical boards have threatened doctors daring to use HCQ.  Locally, Virginia’s health commissioner published updated COVID-19 guidance in late March directing health practitioners to restrict prescriptions for HCQ and continuation of existing medication therapy.

Surprisingly, no mention was found in either the Risch or the French study to explain why HCQ works.  HCQ has no known properties as an anti-viral drug.  Its primary use is for malaria, lupus, and arthritis.  Answering this question required more research.

First, the initial worldwide spike in deaths was likely a result of the lack of information and faulty early treatment protocols coming from China and the World Health Organization.  The early guidance advised against the use of anti-inflammatory drugs and pushed aggressive use of ventilators.  Until April 2020, these early treatment protocols were widely used (and ventilators remain in high demand even now).  However, this early guidance was not only wrong; it was a virtual death sentence and likely inspired the grossly inflated estimates of deaths and requirements for critical care/ICU beds and expensive ventilators. 

An article at The Daily Signal noted that Dr. Thomas Yadegar, the director of an ICU in California, had been using these early guidelines but by April realized that the primary cause of COVID-19 deaths was the internal inflammation resulting from a sepsis-type overreaction by the body’s auto-immune system (AKA a cytokine storm).  Apparently, COVID-19 has exceptionally strong cytokine storm–triggering properties, and that susceptibility is greatest for the elderly.  Yadegar immediately broke with the early guidance and achieved remarkable success using the anti-inflammatory steroid tocilizumab, a fairly new drug.  He also avoided using invasive respirators, which often resulted in more inflammation.  Instead, he found that readily available CPAP-type oxygen masks were as effective and reduced the risk of triggering more inflammation.  As a result, deaths in his unit immediately dropped from 40%–70% to single digits.  Once this realization reached the worldwide medical community, the global death rates began to decline. 

Dr. Yadegar was also early to recommend testing for an overabundance of interleukin, a chemical found in white blood cells that stimulates them to fight infection.  If elevated levels are detected early during hospital triage, it is a sign that the patient has a high risk of experiencing a potentially lethal cytokine storm and should be hospitalized while others can be safely sent home to preserve critical care beds and scarce PPE resources.

Anti-inflammatory drugs work by calming the cytokine storm so the auto-immune system can attack the virus rather than attacking the body.  HCQ is an inexpensive, powerful anti-inflammatory drug, and this explains why it works for COVID-19.  HCQ appears most effective when administered early in the progression of the disease.

There are a variety of other readily available anti-inflammatory drugs, including dexamethasone.  This drug has been safely used since 1957 at only $1 per dose.  It has proven effective for reducing inflammation in more advanced COVID-19 cases.  Remdesivir is another promising new drug, but its limited availability makes it suited for only the most severe cases. 

Had the leftist media and anti-Trumpers not ridiculed the use of HCQ when first proposed, it is likely that many thousands of U.S. deaths could have been easily prevented as Dr. Risch proposed.  The deadly consequences of blocking the use of HCQ (and the hesitancy by U.S. physicians to deviate from prescribed treatments) is illustrated in the following chart from OurWorldinData.com (updates daily) showing the daily average daily death rates per million for a few key countries.

Note that the U.S. peak came after that of Italy and the U.K. due to Trump’s immediate lockdowns and travel bans from these early hot spots, so it did not reach nearly as high or peak as early.  However, the decline in the U.S. death rate was not as steep.  Of more concern, the U.S. death trend is now showing a slight increase.  Meanwhile, deaths in worst-case Italy and the U.K. continue to drop and are now approaching zero.  The medical practitioners in these other countries were far less risk-averse in trying drugs having anecdotal evidence of success, including HCQ.

The consequence of HCQ fear-mongering fomented by leftists has likely resulted in thousands of preventable deaths, and that trend will likely lead to the extension of economically devastating lockdowns.  I can only hope that is not the intent, but it will help justify using fraud-prone mail-in voting.

Lifting restrictions on the use of HCQ and discouraging the overzealous use of ventilators (that earn a much higher reimbursement rate for hospitals than CPAP-type oxygen masks) would likely bring the U.S. death rate back down rapidly so this crisis can pass.