Doctor Remington,
Nevin and occupational and preventive
medicine physician and former U.S.
Army Public health officer
and now executive director
of the Quinn ISM Foundation,
a nonprofit that raises
awareness of the dangers.
Medications as
we talked about last night,
core Queen and Hydroxychloroquine
aren't new molecules.
They aren't new medications.
They've been around for awhile.
Can you briefly talk about
what we know about them?
You know up to this point.
Sure, so both drugs were developed
around the time of World War 2.
Towards the end of World War Two
and 1950 peso hydroxychloroquine,
both designed as replacements for a group
called at agreement or or clinic remains,
is quite toxic and it was thought that
these two drugs did not share the same
neuro psychiatric adverse effect profile
that plagued clinic printer Anna Britain.
But we know that both drugs.
You caused adverse effects,
including changes in mood, sleep,
cognition as well as neurologic
problems such as dizziness, Vertigo,
tinnitus, and hearing period.
Sure.
One of the things you said last night,
well, OK, so the primary use of chloroquine
and hydroxychloroquine around the world
is treatment of malaria. However,
there's no malaria in the United States,
so can you talk about what it is?
Now typically used for here in the US.
Right so soon after Hydroxychloroquine
or Plaquenil was developed,
it became widely used for
rheumatologic disease,
and that's been the primary
use of the drug ever since.
No, it is primarily at antimalarial drug.
We have experience with the drug,
typically in older persons who
are treating their rheumatologic.
You know one of the things that
struck me that we talked about
last night was you basically said.
It was kind of a yes, but like yes,
this probably will work.
We know it has antiviral properties,
but can you maybe go into that
a little bit more detail on
what your concerns are here.
So these drugs belong to
a class called Quinnell.
Andrew is such that it rendered
them useful as antimalarial,
but the same property also
likely underlies their toxicity
and this property that's of
interest in use of these drugs has antivirus.
The fact that they can accumulate in
certain areas of the cell alter the
function of the cell and and in so doing
he think if you're with viral replication,
but that same property may underlie
the drugs. Chicken tenders.
So the same thing that makes it
effective makes it potentially toxic.
That's right.
The FDA right now has just said.
These drugs are approved
for compassionate use.
Your concern is expressed to me was that the.
Because of the urgency behind this,
it will get approved for or
it'll it'll start being used
for general prophylaxis.
Can you talk about?
Why you're concerned about that?
So.
The use of these drugs outside of the post
medical supervision is very problematic
because of the potential for these
drugs could cause neuro psychiatric.
Unrecognized. Find the patient.
I'm very concerned as possibility that
members of the public will attempt
to obtain one of these of these drugs
without a doctors prescription over got
any medical or public health oversight
that possibility trouble us all?
Additionally, I'm very concerned
draft guidance that I've reviewed
today from the FDA suggesting that
in the midst of this pandemic,
the FDA will accept the delay of up
to six months in the reporting of
adverse effects for licensed drugs,
and the possibility can't be excluded
based on this guidance that a newly
licensed version of chloroquine
and Roxie chloroquine for COVID-19
that is resulting in many serious.
Adverse reactions wouldn't result in
the companies behind these drugs
licensing reporting this to the FDA,
that's I think something very problematic.
That should prompt a
revision in this draft items.
Yep. Two questions left.
I think that will actually put
a 6 total. It's not like I'm
the data import or anything.
What were they? What were they?
So you had talked about.
People take these.
People have already started reaching
out to you about the possibility of
access these drugs and using them.
What you know what?
What have you heard just right now?
Or what are people asking you right now?
So I have been inundated by phone calls,
tweets and emails from individuals
who heard the possibility that
these drugs may be effective.
Wanting to acquire supplies outside of the
traditional medical or pharmacy channels,
and this is, I think, very dangerous.
And while these studies are underway,
and while the drugs are being considered.
To be licensed for this new indication
I I think it's important that public
health officials emphasize these
drugs should not be used by members
of the public without supervision.
Great thank you last question.
People people are going to, you know,
the reason as we I asked you last night.
The reason that these extreme and
potentially toxic drugs are used because
malaria is also a very dangerous disease.
Do you think or people are going to ask?
I think, is coronavirus not at
that same level where the risk of
these drugs makes it worthwhile to.
Is it not worth taking the
risk to deal with coronavirus?
So there are two
very different uses being
considered for these drugs.
The first is in treatment of
serious life threatening illness.
When someone's in the hospital,
potentially in need of a respirator, right?
I don't think there is any
concern with exploring the use
of the drug for that indication.
The real concern is that these
drugs may become widely available
for use by members of the public
in an attempt to prevent or
prophylaxis disease or possibly
treat mild cases of infection.
We simply don't have enough evidence
at the moment to know whether the
risks of doing that would outweigh
whatever potentially minimal
benefits would come from that use.
Doctor Norman, thanks so much.