President Trump is so worried about the health of Prime Minister Boris Johnson — currently in intensive care with Chinese Coronavirus — that he has offered U.S. medical support.
Anyone who considers this to be overreach by Trump — doesn’t the UK have a perfectly good National Health Service already? Isn’t it known domestically as ‘the Envy of the World’? — might consider a letter that appeared over the weekend in the Sunday Telegraph, written by Dr Steven R Hopkins of Scunthorpe, Lincolnshire.
It says:
The chief medical officer, Professor Chris Whitty, has banned doctors from treating Covid-19 with anything other than paracetamol and in severe cases, oxygen.
Colleagues have rightly condemned this response, which ignores the experience of doctors overseas. Professor Whitty’s position is that British doctors may not use therapies that have not undergone double blind controlled trials here. This could condemn many thousands to avoidable death through a failure to recognise that different rules should apply when patients are dying at such a rate.
The drug hydroxychloroquine is well-known, with a well-understood side-effect profile. It is safe. It also has a recognised mode of action in preventing replication of the virus. Comparison of the death rates in South Korea and Italy strongly suggests that it works to dramatically reduce the death rate. Evidence from India is similarly encouraging.
What the letter appears to indicate is that the hidebound, overcautious, unimaginative approach of the NHS bureaucracy to the coronavirus may actually be jeopardising lives.
Though President Trump didn’t mention any specific drugs when he offered support from the U.S. it seems likely that one of the ones he had in mind was the anti-malarial drug chloroquine.
According to the Guardian, President Trump said shortly after PM Johnson was moved to intensive care:
“I’ve asked two of the leading companies … They’ve come with the solutions and just have done incredible jobs – and I’ve asked him to contact London immediately,” Trump said. “They’ve really advanced therapeutics … and they have arrived in London already. The London office has whatever they need. We’ll see if we can be of help. We’ve contacted all of Boris’s doctors, and we’ll see what is going to take place, but they are ready to go.”
“They’ve had meetings with the doctors, and we’ll see whether or not they want to go that route,” Trump added. “But when you’re in intensive care it’s a big deal. So they’re there and they’re ready.”
It’s true that the jury is still out on hydroxychloroquine’s efficacy in treating Covid-19. But it appears to have fared well in a number of small scale studies and an increasing number of doctors around the world have made it a key part of their treatment protocols.
Hydroxychloroquine — originally designed as an anti-malarial treatment – is often used in conjunction with zinc.
This is because chloroquine is a zinc ionophore – see this 2014 study by Jing Xue et al – which means it enables the body’s cells to absorb zinc. Zinc — as well as being effective in boosting the immune system — is thought to disrupt the most deadly phase of coronavirus, the cytokine storm, when the body’s immune system attacks its own healthy tissue.
I asked a senior NHS consultant if it were really true that only paracetamol and oxygen had been permitted for use in Coronavirus treatment in the UK.
He told me: “No one I know is using chloroquine but at this rate it seems likely that we’ll be trying it on spec, without the trials. Whitty is a good doctor, for sure, and if the anecdotal/cohort study evidence mounts from elsewhere, then it will come on. The Boris situation is a test, if he does deteriorate…”
This isn’t exactly reassuring, is it? In the U.S., when President Trump heard about the potential of chloroquine as a treatment for coronavirus, he successfully called for the drug to be fast-tracked through the regulatory system. (It has been permitted as a treatment for malaria — and other conditions such as lupus — for 75 years, but obviously not for Covid-19, which didn’t exist till last year).
Britain, on the other hand, remains in thrall to its stolid, sclerotic, overcautious, unimaginative, rules-bound public health bureaucracy. In normal times, this bureaucracy was merely inefficient, wasteful, and a massive drain on the taxpayer. But in extraordinary times like these, this public health bureaucracy has become a positive menace.
When all this is over, a serious investigation needs to be conducted into the performance of the National Health Service, Public Health England, and the rest of the public health bureaucracy in this crisis. If it turns out that because of its dogged obsession with procedure and correct form it denied to dying patients basic medicine that could have saved their lives, then I hope that heads will roll and that root and branch form will be instituted.