Developed countries reject chloroquine against Covid; Venezuela maintains recommendation

In contrast to the Federal Council of Medicine (CFM) in Brazil, which does not see problems in prescribing chloroquine against Covid, medical associations in several developed countries have undertaken initiatives to combat the use of these drugs, which are ineffective against the coronavirus.

Associations from the United States, France, Portugal, Argentina, Uruguay and Chile, among other countries, are at the opposite pole to the CFM. In Venezuela, on the other hand, the defense of chloroquine and hydroxychloroquine is still a reality.

The American Medical Association (AMA), for example, went to social media to fight misinformation. The entity that represents the country’s doctors publishes videos almost every day on its YouTube channel to bring updates on changes, advances and results of new studies on Covid-19.

The AMA advocates the use of US government guidelines and FDA-approved treatments. One of the channel’s programs interviewed John Farley, the agency’s director, about the use of ivermectin.

“People need to know that there are clinical studies that show there is no benefit from using ivermectin and that studies that have shown some benefit have been done in other countries without any FDA oversight, so we can’t confirm that the results are real or not,” Farley said.

The AMA, together with the APhA (Association of Pharmacists of the USA), is unhesitatingly opposed to the use of the drug to fight the coronavirus.

The entity also advocates mandatory vaccination of health professionals. “The path to ending the pandemic must be based on science, and vaccination is an indispensable part of the solution,” said Gerald E. Harmon, president of the AMA, in a statement.

Other US government measures, such as booster shots and vaccinating children, were also endorsed.

The US Government Treatment Guide recommends not using chloroquine and azithromycin. So far, only remdesivir has been approved for the treatment.

Despite federal guidelines, there are groups that defend ivermectin and even publish a list of doctors willing to prescribe the drug, despite the lack of scientific evidence.

Physicians in the US are empowered to treat patients, but they can be held responsible if their actions are deemed inept or unethical.

“The vast majority of doctors work in hospitals or institutions linked to universities or health plan operators. Most of them follow the requirements of the CDC [Centro de Controle e Prevenção de Doenças dos EUA]”, says Maricella MacKenzie, professor of medicine at the University of Michigan.

The AMA code of ethics also includes the obligation for professionals to report cases of colleagues who act in an unethical or incompetent manner.

“The groups that defend alternative treatments are very active on social networks, and a lot of people only get information there. Many out there say they don’t believe in Covid or in vaccines. There is a political component, especially in red states [de maioria republicana], to challenge vaccines in favor of alternative treatments,” says MacKenzie.

Former Republican President Donald Trump, who stepped down in January, made many statements downplaying the pandemic. He even advocated the use of chloroquine as a treatment, as did President Jair Bolsonaro (non-party).

Europe

Doctors spreading false information about Covid vaccines or pseudo-treatments are also a concern in Europe, although the action of professional councils varies widely from region to region and there are few public cases of punishment.

One of the most recent took place in Ireland at the end of September. After a decision by the Independent Medical Practice Court (MPTS), Anne McCloskey was banned from acting for 18 months for spreading anti-vaccination comments on the Internet.

McCloskey posted a video in August saying there was not enough evidence that immunization was safe for young people and calling the vaccine an “experimental gene therapy.”

When allegations arose, she was provisionally suspended by the Health and Social Welfare Council, “as a precautionary measure while carrying out a thorough investigation.” It will now be investigated by the General Medical Council (GMC) of Ireland.

In France, the Order of Doctors released in February this year a warning against doctors who prescribe hydroxychloroquine or essential oils as a way to prevent Covid.

Among these professionals is psychiatrist and congresswoman Martine Wonner, who was expelled from her party for “regularly transmitting false information about the coronavirus”.

On his website, Wonner also advertised zinc, vitamins C and D, ivermectin, homeopathy and sophrology (relaxation technique) as a treatment against the coronavirus.

German medical associations and regional courts have also recently launched a series of investigations because of the increased presence of doctors in denial protests.

Last month, the German Medical Association announced that it will take legal action against doctors who, by participating in actions against the Covid pandemic, have damaged the reputation of their colleagues.

In addition to state medical associations, district courts have also taken action against health professionals who disseminate false information.

In Spain, audios with false information about the coronavirus, denying its seriousness and fighting isolation, are disseminated by doctors who founded the Doctors for Truth group.

In July, they held an event to deny the pandemic and combat the use of masks and vaccination, which led to the opening of investigations in Spanish medical organizations.

According to the advice, in addition to being very serious for individual and collective health, misinformation disseminated by doctors compromises the credibility of other professionals.

In Portugal, similar cases have been punished with fines, and since last year law professors have discussed the possibility of criminalizing those who contribute to the spread of the pandemic.

The thesis defended in articles in specialized journals is that these professionals can be framed in the “crime of spreading a contagious disease”, for which a prison sentence of 1 to 8 years is foreseen.

In Belgium, a doctor was suspended indefinitely for providing patients, without their asking, with medical certificates exempting them from covering their face.

He had previously been suspended by the local council for refusing to wear masks on duty and claimed the pandemic was a conspiracy. His license was withdrawn for “putting patients and public health in danger”.

Central and South America

Hydroxychloroquine and chloroquine were included in treatment protocols against the coronavirus, with the approval of local medical councils, in Colombia, El Salvador, Venezuela, Peru and Bolivia – the latter two countries also prescribed ivermectin.

In Argentina, Uruguay, Paraguay and Chile, medical councils have taken a stand for the ban on both.

The last country to abandon the recommendation was Peru, in March of this year. Venezuela still maintains. In all of them, it was established that medications should only be administered with a medical prescription.

“In the first months of the pandemic, people arrived feeling sick, they had coronaviruses, but they had several symptoms that were due to a reaction to these medications. It was difficult to differentiate and treat,” says sanitarian Patricia García, former health minister of the Peru .

“It wasn’t just not approving, we should have been more emphatic in publicizing the risks of indiscriminate use of these medications.”

“Self-medication caused serious damage to the fight against the pandemic. It was not possible to put the police at the doors of pharmacies, and people were desperate,” said Mexican infectious disease specialist Uri Torruco.