Science Vs - Coronavirus: Will Chloroquine Save Us?

Episode Date: March 27, 2020

President Trump says an anti-malarial drug could be a “gift from god” for treating Covid-19. Does it really work? And is it dangerous? We talk to toxicologist Professor Daniel Brooks, infectious disease specialist Dr. Matthew Pullen, and microbiologist Professor Karla Satchell. Also: VAMPIRE BATS! We’ve set up a voicemail to collect all of your questions about Coronavirus. Or if you’re a healthcare worker with a personal story you want to share, please call ‪[phone]‬ and leave us a message. Here’s a link to our transcript: https://bit.ly/2xu4ER8 This episode was produced by Meryl Horn, Wendy Zukerman, Rose Rimler, Michelle Dang, Laura Morris, Meg Driscoll and Sinduja Srinivasan. We’re edited by Blythe Terrell and Caitlin Kenney. Fact checking by Eva Dasher. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Emma Munger, and Bobby Lord. Thanks to the NBC News Archives. A big thanks to all the researchers that we got in touch with for this episode, including Professor Thomas Doerner, Dr Hue, Professor David Boulware, Dr. Anne Melzer. And special thanks to the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman and you're listening to Science Versus from Gimlet. As this COVID-19 pandemic rages on, we at Science Versus have been keeping an eye on all the treatments that doctors are trying around the world. About a month ago, we told you about some promising research out of China into an anti-malarial drug. It was pretty obscure back then. But just this week, it felt like this drug had been upgraded to celebrity status. Thank you very much.

At my direction, the federal government is working to help obtain large quantities of chloroquine. Chloroquine. It's the drug that's making the headlines. And Trump is a big fan. In one press conference this week, he said that he'd heard the story of a man who took it and had a remarkable recovery. A gentleman, they thought he was not going to make it. He said goodbye to his family. They had given him the drug just a little while before, but he thought it was over.

His family thought he was going to die. And a number of hours later, he woke up, felt good. Then he woke up again, and he felt really good, and he's in good shape. And Trump said that this drug might be able to help lots of people. There's a real chance, I mean, again, we don't know, but there's a real chance that it could have a tremendous impact. It would be a gift from God if that worked.

It would be a big game-changer. And people all around the world have really latched onto this idea that this drug could help fight this coronavirus. Google searches for its sword. Some pharmacies are saying that demand for the drug has skyrocketed. And one company told us that at hospitals, orders were up 3,000%. But when some people went looking for chloroquine, it took a dark turn. They thought a drug could protect them from coronavirus, but he and his wife made a terrible mistake.

A couple ended up in this hospital after they each took a teaspoon of an old aquarium product they had. It contained chloroquine. So, is this drug a danger or a gift from God? Today on the show, what is going on with chloroquine? We speak to a scientist running a clinical trial into this very drug and coronavirus right now. And we'll find out, does it really have the chance to be a game changer in this pandemic? When it comes to this coronavirus, there is a lot of talk of... A gift from God.

But then there's science. Science versus the coronavirus part six, Return of the Jedi, is coming up just after the break. At Wealthsimple, we're built for whatever you're building. Built for Jane, who wants to break into the housing market. We're built for Ted, who's obsessed with what's happening in the global markets. And built for Celine, who just wants to retire and explore the world's flea markets. So take a moment and think about what you're building for. We've got the financial tools to help make it happen.

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to be automatically sent to your matches. Then sit back and let your matches start the chat. Download Bumble and try it for yourself. Welcome back. So chloroquine is making a lot of headlines right now. What is it? Well, it's a drug that's been on the market for decades. It's often used for malaria. And it's old. People have been taking it for around 70 years. And there's a few different kinds of this drug,

like hydroxychloroquine. That's used for diseases like lupus. So chloroquine has been hanging around for years, doing its thing. But this week, the story of this drug took a bizarre turn. Hello? Hi, can I please speak to Daniel? Yeah, this is Dan Brooks. Dan is a professor of toxicology and the medical director of the Banner Poison and Drug Information Centre in Phoenix, Arizona. People call his hotline when they're worried they've been exposed to something toxic.

So we take calls from people dealing with occupational exposures, rattlesnake animations. Wait, did you say rattlesnakes? Yeah, yep. That's the second one you said. Yeah, we get like about 80 or 85 rattlesnake patients a year. But recently, something else has been rattling Dan. As the coronavirus started to spread in the US,

Dan was getting worried that people would take matters into their own hands and start using homespun treatments and Dr. Google to cure all their coughs and fevers. We've seen it happen dozens of times before. I mean, you know, we just see, we've seen this with influenza when we've had bad years with influenza. And, you know, we've seen this over and over again. Yeah. Dan says for the flu, people will try all sorts of stuff. And in this pandemic, he says people were even calling

his poison center to see if they should take bleach to avoid getting sick with this coronavirus. And so we just knew when as more and more things were being promoted to heal or prevent COVID, so we just tried to get out and warn people. Last Friday, Dan's team reached out to some media to try to get the word out about this. Dan's poison center got a call from a couple in their 60s. This pair had heard all the excitement around chloroquine, including what Trump was saying about it. And then... They got concerned about some vague symptoms

that they interpreted may have been for coronavirus. Do you mean like a sore throat or a cough, something like that? Correct. So I understand that it was only the husband, but they became concerned about it and they decided that they may be able to prevent or treat coronavirus with a home product that contained chloroquine. The woman involved talked to NBC about what happened.

She said that she saw this stuff in her pantry that had chloroquine in it. It was something that she'd used to keep her fish healthy. And I just saw it sitting in the back shelf and said, hey, isn't that that stuff they're talking about on TV? And yeah, it was. They decided to take some. They mixed it with soda and pretty quickly started to feel sick. It happened so fast. It got so bad so fast.

Here's Dan Brooks again. And within 30 minutes of taking this powdered substance, both of them became sick. And the wife had significant vomiting, which may have saved her life because, you know, all this vomiting helped her not absorb this potentially deadly drug. But her husband took a turn for the worst. He had abnormal heart rhythm,

and the electrical activity in his heart was not normal. The paramedics and ER folks did as much as they could and did everything right, but he apparently had a very, very massive ingestion and he was not resuscitating. He died in the emergency department. He died from heart failure As the head of the poison centre

Dan was told about what happened Paramedics called us Via the poison centre on Sunday And what was going through your mind When you heard about that Given that you tried to get in front of this I don't know I've been doing this for 20 years,

so this happens to us almost every week. But you can't blame people for being afraid. It's sad. I think they were driven by understandable fear and worry. This is Matthew Pullen. He's a doctor and infectious disease specialist at the University of Minnesota. And I think fear in the situation is understandable. It's a very uncertain time with, you know, not a lot of good options in a lot of situations.

But yeah, as a clinician, all I can say is that I feel for them and I hate that it happened to them and I wish it hadn't. Matthew is part of a team in the US that's running a clinical trial into whether chloroquine can help people with coronavirus. And he says that we know when people take chloroquine at high doses, which is what this couple took, this chemical can be dangerous. They were taking, you know, many, many times more than the recommended amount. But Matt says that people take chloroquine at lower doses all the time for malaria. And then the main side effects are stomach troubles like nausea and also headaches. Some people also get itchy all over their body. But generally, at low doses, this drug is thought to be safe.

Matt has taken it to prevent malaria, and he's also given it to patients for autoimmune diseases. You know, it's a drug, I've personally prescribed it probably a hundred times. You know, it's very, very safe. I've never had anyone that had adverse effects from it. You can be taking it chronically. The upshot here is that dosage is super important. Chloroquine is not something that you want to be self-medicating with. But at the right dose and for short periods, it can be safe. The big question, though, is can it actually help people with coronavirus?

And that answer is coming up just after the break. Welcome back. We're talking about chloroquine. And although we've been talking about this for 10 minutes, I had to clear something up with Dr. Matthew Pullen. Is it chloroquine or chloroquine? I guess it depends on which side of the ocean you're from. I think it's an aluminum-aluminium type thing. Is this like the metric system all over again? We say chloroquine typically.

Isn't that weird? Why do we do this? Yeah. So in respect for you, I will call it chloroquine. Sure. Okay. Now that's settled, we want to know how could chloroquine, chloroquine, work for this coronavirus?

Okay. Chloroquine, work for this coronavirus. Okay, so first you have to know that a virus wants to copy its cells to make more tiny particles so that it can spread into more and more and more cells. And to do that, it first has to get into our cells. So it binds to what's called a receptor and that triggers this process. And then the cell ingests into a little pocket inside the cell. This process of getting ingested is called invagination, which is great. It's just a great word, invagination. But what's actually important here is that when a virus gets into that little pocket in our cells, the cell is like, whoop-a, you, you gotta go.

It tries to digest it. A lot like our stomach, you know, shoots acid into itself to digest food. That's kind of what the cell is doing. And so to get rid of this nasty virus, the cell will squeeze acid into that pocket. But it turns out this strategy backfires because the coronavirus, it actually wanted the cell to shoot that acid all along. You see, the virus needs acid to reproduce, to get more virus particles. Correct. Yeah, yeah.

So it's kind of taking advantage of a self-defense mechanism the cell has. That's very rude. Yeah, very rude. And here's where our old pal chloroquine comes into the mix. We think that it tells cells, stop it with that acid thing. It steps in to put the brakes on that process. Or as Matt says, right, it alkalizes or raises the pH. In this case, you want to be basic. Okay, so by slowing down this acid thing and keeping the virus from copying itself,

chloroquine could delay the spread of the virus in your body. Carla Satchell, a professor at Northwestern, described it to us like this. Anything that slows down this cycle of one virus makes 100, 100 makes 10,000, 10,000 makes a million, anything you can do to slow that down gives your body time to mount this immune response. Chloroquine is thought to do some other stuff too,

like dampen down inflammation, which is a big part of why this coronavirus makes some people so sick. Okay, so that's how researchers think chloroquine might stop this virus. But does it actually work? Well, there are a couple of studies done in Petri dishes where it looks like putting chloroquine onto cells protects them from getting infected with coronavirus. And we got a hold of some very early unpublished data

coming from a clinical trial in China. It had around 200 people in it and it found that those who got chloroquine, well, their fevers went away faster than those who didn't. But what might have kicked off a lot of this talk of chloroquine was a study out of France. It took 36 people with this coronavirus and gave 20 of them hydroxychloroquine.

Some of them got an antibiotic too. And the researchers said that this treatment eliminated the infection in some patients. The reason that Matt isn't that excited is because the study was basically a small grab bag of different patients and not all did well here. One died, three were sent to the ICU and just generally it's a pretty small study. It's definitely a good first step and it's definitely meaningful but there's still a question of how meaningful. On top of this another small study of 30 patients in China found that hydroxychloroquine didn't help their symptoms. So what to make of all this?

Well, we need more data. And there's actually more than a dozen clinical trials looking into this right now. And one of them is Matt's. In the last week, his team has started recruiting people from all across the country, and he's trying to see if hydroxychloroquine can help people who are sick. But also in a separate part of the trial,

they're giving it to people who have been exposed, like healthcare workers, to see if it can keep them from getting the virus. They've already enrolled around 500 people. Quite a few in a very short amount of time. Yeah. When do you think you'll get results? We're hoping in four to six weeks. Near the end of April, we'll have a preliminary sort of thumbs up,

thumbs down answer on whether this is working or not. Four to six weeks. And while we're living in self-isolation, this might feel like an eternity, in the land of science, it's the opposite. Many trials like this take years to recruit of science, it's the opposite. Many trials like this take years to recruit enough people and then analyse the results. Honestly, it's an insanely fast turnaround time in a clinical trial.

I mean, pardon me, it's not coronavirus, my cough at least. That's right, we're social distancing. Right, yeah, at least we're over the phone, so it's different. Yeah. And, you know, since we are in desperate times or we're heading into desperate times, for doctors on the front lines now, if they do have patients that aren't doing well at all, should they just give them this drug, you know,

even with this preliminary data we've got? Well, I mean, I think ethically it would be very questionable for me to, without any solid human data to give that kind of recommendation, unfortunately. But I guess, you know, we've got the French data, the Chinese data that's promising. I feel like we've tried things with less data in the desperate times. We don't know if it will work yet. We're optimistic that it will. But as a physician, I don't want to give anyone the impression

that this medication has been proven to work. Some academics that we reached out to agreed with Matt. Others said that for desperate doctors on the front line who are running out of options for their patients, well, chloroquine might be a good option now. But everyone agreed that for us at home, until there is more data, you should not be taking this stuff for coronavirus. Already, we're hearing that the demand is creating shortages. And remember, there are people who really need this drug for other stuff, like lupus. Meanwhile, Dan over at the Poison Centre in Phoenix has some wise words for us.

If you're seeing any exciting stuff online or Uncle Bill forwards you some cure-all, he says. There is no such thing as a miracle drug. And that's an important message for everyone to know. There are no miracle pills. That's science fiction. So, we don't know if chloroquine will save the day here. There's some promising research, but then there's some not so promising research. That's all part and parcel of living in a pandemic and doing science on the fly.

At least with this drug, though, the way science is moving, it looks like we won't have to wait too long until we get better data. Okay, and now for a little non-coronavirus content, because we need it. Today, bats. And we know bats feels like coronavirus content, but it's not. Here goes. Scientists carefully watched about 40 bats in captivity for 15 months, and they noticed that these bats built very cute relationships with friends. First, they would groom each other. Then they would scratch each other's backs. And ultimately, they became BFFs, Bat FFs. They even started sharing food. The researchers said that no one had seen this kind of behavior before. We just didn't know

that bats formed these kinds of friendships. So there you go. Bats, friends, and not just disease vectors. That's science versus. And one more thing, we have set up a voicemail to collect all of your questions about coronavirus. Or if you're a healthcare worker with a personal story you want to share with us, please call 774-481-1238. This is an American number, 774-481-1238, and leave us a message. Or you can always email us at sciencevs, sciencevs, at gimletmedia.com. Hello, this is Ben. Hey, Ben. This is Wendy calling from Science Versus.

Hi there, Wendy. How are you doing? I'm good. You had a gripe with our last episode. I did. Right. You want to school me? How do you do it? Waukesha is, is the correct pronunciation. Waukesha. Waukesha. Waukesha, Wisconsin.

Correct. Are you from Waukesha, Wisconsin? I am not from Waukesha, Wisconsin, uh, but I have lived in Wisconsin for about the last 20 years. You're right. So you're pretty well placed to know how to pronounce this city. Congratulations on having the world's oldest fossilized scorpion in your neck of the woods. Thank you. This episode was produced by Meryl Horne, me, Wendy Zuckerman, Rose Rimler, Michelle Dang, Laura Morris, Meg Driscoll and Sindhuja Srinivasan. We're edited by Blythe Terrell and Caitlin Kenny.

Backchecking by Eva Dasher. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Emma Munger and Bobby Lord. Thanks to the NBC News Archives. A big thanks to all the researchers we got in touch with for this episode, including Professor Thomas Dorner, Dr Kueh, Professor David Bulgare, Dr Anne Meltzer and a special thanks to the Zuckerman family and Joseph Lavelle Wilson. I'm Wendy Zuckerman. Back to you next time.