A Cure for Covid?
Testing the Effectiveness of… say it with us… hydroxychloroquine
First, a note about the title. When dealing with data, numbers matter. When dealing with language, words matter. It can be important to be precise! Data can help cut through misinformation, but only if we are careful with our language and our numbers. Many are talking about Hydroxychloroquine as a “cure” for COVID-19, when in fact it is only being tested to help stop the spread of the virus after a known exposure. Thankfully, data can help us answer whether or not it is actually doing this.
Scientists at the University of Minnesota conducted a study to assess the effectiveness of hydroxychloroquine in preventing the spread of coronavirus and published the results in The New England Journal of Medicine. Hydroxychloroquine is most commonly used to treat and prevent malaria, and based on its activity in vitro (outside a living organism) interacting with the coronavirus, the medical community decided it was worth examining whether or not the drug could help prevent the infection of individuals who’ve been exposed to the virus. Interestingly, hydroxychloroquine was observed binding glycoproteins (the little spiky things on the outside of the virus that can be seen with a powerful microscope) and thus possibly inhibiting the ability of the virus to inject its genetic material into another human cell. This is what motivated scientists to test the effectiveness of hydroxychloroquine at preventing the spread of COVID-19.
To do this they enrolled 821 people from the US and Canada in their study. Over 87% of the study participants reported a high-risk exposure to a confirmed Covid-19 patient. Roughly half of the participants (414 people) received hydroxychloroquine within 4 days of their Covid-19 exposure, while the other group (407 people) received a placebo. The researchers then recorded whether the people in the two groups developed Covid-19 within 19 days and whether they developed any side effects. The side effects reported in the study included upset stomach, nausea, and stomach pain.
Activity:
1) Use the “Make a graph” feature to make a Categorical Bubble chart to show the difference between the rate of post-exposure infection in the group who received the drug versus the group who received the placebo. Choose the graph icon that looks like a scatter plot and then Show “Treatment” on the X-axis and “Incidence of Illness” on the Y-axis. The size of the bubbles will show how many people ended up being counted in each of the four possible combinations of treatment and outcome.
2) Based on the graph you just created, can hydroxychloroquine be considered an effective prophylaxis (preventative treatment)?
3) The effectiveness of a drug must always be balanced with the likelihood of side effects. Make another graph, but this time use a bar graph to compare the incidence of side effects in the two groups. Choose the Histogram/Frequency icon, place “Treatment” on X and show “Side effect reported” on Z. Do you see a noticeable difference in side effects between the treatment groups?
4) Pretend that you are the governor of your state or the mayor of your city. Based on the data here, would you use your platform to recommend that citizens take hydroxychloroquine to help stop the spread of a pandemic? Why or why not? What are some of the challenges in using data to inform your decision? What are some of the risks in making your recommendation?
For more information…
The data were derived by using the sample size and proportions reported in the New England Journal of Medicine. As with the testing of all drugs, the implications of the finding can be enormous. For more information on how the study was conducted, check out this article for the many considerations researchers had to make while designing and carrying out the study.
The CDC website continues to be an excellent resource for up to date information on the outbreak.