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Issue #1917      June 1, 2020

“HE WHO MUST BE BLINDLY OBEYED”

President Trump trumpeted that chloroquine has shown “very encouraging early results.” He also said “it may work, it may not work. I feel good about it. That’s all it is. Just a feeling.”

Australia has always been fully compliant. “Why?” is the big question.

Politicians, with no expertise in science, medicine, or public health (with the help of some media outlets), have been spruiking the use of antimalarial medication as the magic pill for COVID-19.

However, the US Food and Drug Administration has warned about the potentially severe side-effects with the use of the malaria drug hydroxychloroquine in treating patients with COVID-19.

This is a medical disaster waiting to happen, and it leaves us wondering: just how far will our political leaders go salaaming to the American Alliance?

Doctors prescribe hydroxychloroquine not just for malaria but also rheumatoid arthritis and lupus. The side effects of this drug are well documented in medical journals around the world.

AUSTRALIA JUMPS ON BOARD

The first clinical trial to determine whether the drug can help prevent COVID-19 is now taking place, with calls for frontline staff to volunteer. Professor Ian Wicks hopes to recruit approximately 2,250 to take part. The duration of the trial is expected to be four months, half will be given hydroxychloroquine, and the others (probably the lucky ones) will receive a placebo. Any volunteer who has had a heart rhythm disturbance or retinal disease of any kind will be excluded because the drug is commonly known to worsen such conditions.

All this aside, the Australian government is well informed on the horrors of the side effects.

On 24th March, the Department of Health, Therapeutic Goods Administration published a document which lists the effects of hydroxychloroquine and chloroquine, which include:

  • Cardiac toxicity including fatal cardiomyopathy;
  • Severe hypoglycaemia (low blood sugar) with loss of consciousness;
  • QT interval prolongation;
  • Blurred vision, irreversible retinal damage;
  • Skin reactions including rash/itch;
  • GI disturbances including nausea/vomiting/abdominal cramps/ diarrhoea;
  • Muscle weakness;
  • Headache;
  • Alopecia;
  • Blood dyscrasias, monitoring required for long-term treatment.

President Donald Trump has made clear that he thinks two old malaria drugs should be deployed quickly against the coronavirus. However, the US Food and Drug Administration and the National Institute of Allergy and Infectious Diseases have been hesitant for very good reasons. While the chemical trials have shown promise from infected cells in the laboratory, a small and preliminary clinical trial of hydroxychloroquine in France was hardly definitive about whether the drug would benefit coronavirus patients.

However, politicians are desperate to use any possible drug for the treatment of COVID-19. In the case of President Trump, hydroxychloroquine, the unproven and probably harmful drug, has been his medicine of choice, as he is supposedly currently taking it for post-exposure prophylaxis.

Coronavirus continues to spread around the world and has affected different countries in different ways; how early the pandemic hit the countries has been dictating how health care systems and their government are responding. The US has recorded over 1.5 million cases, and this tally climbs daily. Deaths have risen to over 94,000 and also continue to grow. Russia introduced a lockdown on the 28th March and has now recorded over 300,000 cases and 3,000 deaths.

Outside of hydroxychloroquine, systematic trials aimed at identifying safe and effective drugs for early infection with coronavirus are needed now. Drugs such as antibiotic prophylaxis (used for people with artificial heart valves), cefazolin and cefuroxime (most commonly used before surgeries), and prophylactic antibiotics (used after a bout of rheumatic fever or the subsequent development of Sydenham’s chorea) are also being trialled.

The British Medical Journal reported on a hydroxychloroquine study in China. The study of 150 patients hospitalised with confirmed cases of COVID-19 were treated with 1,200 mg of hydroxychloroquine daily for three days, followed by a maintenance dose of 800 mg for the remaining days (total treatment duration was two or three weeks for mild/moderate or severe patients, respectively). The conclusions were that hydroxychloroquine did not result in a significantly higher negative conversion and adverse events were higher in hydroxychloroquine recipients than non-recipients. The most common adverse event in hydroxychloroquine recipients was diarrhea in ten per cent of patients and two hydroxychloroquine recipients reported serious adverse events. This published BMJ article has not been peer-reviewed.

SAFER ACE INHIBITORS ARE AVAILABLE

ACE inhibitors are a group of antihypertensive drugs that relax arteries and promote renal excretion of salt and water by inhibiting the activity of an angiotensin-converting enzyme.

A trial of an old TB vaccine to help combat the severity of COVID-19 was safely given to millions of babies a year. Frontline health workers are lining up – such as thoracic medicine nurses, Women’s and Children’s Hospital staff in Adelaide and are co-ordinated by the SA Health and Medical Research Institute. The Melbourne base trial is to see if the vaccine turbocharges the immune system. SA study leader Dr Simone Barry said “about 10,000 health care workers (about 700 SA workers) would be involved in Australia, Spain and the Netherlands.”

Health authorities have known about safe ACE inhibitors for years; the question needs to be answered – why wasn’t the TB drug used on older seriously ill patients who were predicted to most probably die when they had nothing to lose, but may have had a chance of survival if given the TB drug?

Next article – LEAVE NO ONE BEHIND!

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