Covid Cures

Today, just shy of two months since the World Health Organization declared COVID-19 a pandemic, the media are once again flooded with cures, patients such as Michigan State Representative Karen Whitsett are being quoted with claims that hydroxychloroquine “saved my life,” and doctors are prescribing drugs that have not been shown to be effective. Only this time, it’s the twenty-first century, the age of “evidence-based medicine.” Or so it might seem. But instead of no science to back up treatments, we now have bad studies being reported uncritically in the press, and Twitter storms of doctors, journalists, and researchers arguing about the ethics of withholding drugs from dying patients, even though we have no idea if those drugs do more harm than good.

If there is a silver lining to all the confusion, it is that this pandemic is exposing three persistent fault lines in medicine. First is the willingness on the part of clinicians to abandon the prime dictum of medicine, to do no harm, and rush into treatments that not only may not work but may well cause serious harm. The fact is, most physicians are not trained to recognize good science from bad. Nor do they have the time to analyze every study, and too many are willing to ignore the need for reliable evidence when fear sets in. Even in non-pandemic times, doctors often favor treatments that have long been in use, seem biologically plausible, are highly remunerative, or have been heavily marketed by manufacturers. In the case of two drugs now being used against COVID-19, hydroxychloroquine and remdesivir, there is a very real possibility that patients who might have recovered from the virus without them will be harmed or even killed by the treatment.