Brazil’s health ministry recommended Wednesday using chloroquine and hydroxychloroquine to treat even mild cases of COVID-19, treatments President Jair Bolsonaro has pushed for despite a lack of conclusive evidence of their effectiveness.
New federal guidelines released by the ministry recommend doctors prescribe the anti-malarial drugs from the onset of symptoms of coronavirus infection, together with the antibiotic azithromycin.
Patients will be required to sign a waiver acknowledging they have been informed of potential side effects, including heart and liver dysfunction, retina damage “and even death.”
The guidelines, which apply to the public health system, leave the final decision on using the drugs up to doctors and their patients.
The two medications have been swept up in a politically charged debate amid the pandemic.
Bolsonaro and his US counterpart Donald Trump, to whom he is often compared, tout them as potential wonder drugs against COVID-19.
Trump even revealed Monday he has been taking hydroxychloroquine daily as a preventive measure.
But some studies have cast doubt on the drugs’ safety and effectiveness against coronavirus.
The health ministry acknowledged that “there are still no meta-analyses of randomized, controlled, blind, large-scale clinical trials of these medications in the treatment of COVID-19.”
However, it said the government had a responsibility to issue guidelines using the information currently available.
Medicine and politics
Chloroquine and hydroxychloroquine, a less toxic derivative, are typically used as anti-malaria drugs and to treat certain auto-immune diseases.
They are both synthetic forms of quinine, which comes from the cinchona tree and has been used to treat malaria for centuries.
Preliminary studies of the drugs in China and France showed promising results against COVID-19, though other studies have raised doubts.
Most countries have not authorized their use against coronavirus, except in clinical trials or severe cases.
Brazil’s former health minister Nelson Teich resigned last week after less than a month on the job, reportedly after clashing with Bolsonaro over the far-right president’s insistence on recommending chloroquine against COVID-19.
The interim minister is an active duty army general, Eduardo Pazuello.
Bolsonaro has compared the new coronavirus to a “little flu” and condemned the “hysteria” around it, arguing lockdown measures would trigger an economic crisis that could cause more death and suffering than the virus itself.
Brazil has emerged as the latest flashpoint in the coronavirus pandemic, and infections are only expected to peak in June.
The country registered more than 1,000 COVID-19 deaths Tuesday, its highest yet, bringing its total death toll to 17,971.
The country now has the third-highest number of infections in the world, with more than 270,000, behind only the United States and Russia.
Experts say under-testing means the real figures are probably much higher.