President Donald Trump’s push to put hydroxychloroquine at the forefront of his administration’s coronavirus strategy may be quieting down, but one of his biggest proxies in New Jersey is keeping up the fight.
“Not only do I read the stories, I read the studies,” state Sen. Joseph Pennacchio, who is co-chairman of Trump’s 2020 campaign in New Jersey, told POLITICO on Wednesday.
“The internet is a wonderful place,” he added, saying he’s discussed the issue with physicians.Pennacchio, a retired dentist, has spent the better part of the last month advocating for state officials to open the floodgates on the use of hydroxychloroquine, citing controversial studies from French physician Dr. Didier Raoult and the support of hundreds of physicians through the New Jersey Doctor-Patient Alliance as questions continue to emerge about the drug.
On Tuesday, a government panel at the National Institutes of Health issued guidelines that hydroxychloroquine should not be used outside clinical trials when paired with antibiotics. The same day, a study of 368 men infected with coronavirus at Veterans Health Administration hospitals found that 28 percent who received hydroxychloroquine plus treatment died, compared to just 11 percent of those who received standard treatment alone.
The latter study has been submitted to the the New England Journal of Medicine and has not been reviewed by other scientists.
While many have cited anecdotal reports and studies suggesting hydroxychloroquine is an effective tool in fighting Covid-19, there’s still no concrete clinical evidence to support the claims.
New York is running a large ongoing clinical trial — one of several underway worldwide. The first batch of data from the New York trial was sent to federal agencies earlier this week.Pennacchio (R-Morris) downplayed the veterans study, saying hydroxychloroquine would have limited effect on any patients who required a ventilator or were “on their last leg.” He also took issue with the NIH, which noted in its “living document” guidance that the drug could lead to heart problems.
“What is their choice then? Nothing. That’s the only choice,” Pennacchio said, adding he didn’t believe the NIH was offering any alternatives to hydroxychloroquine. “This is the same group of people that told you don’t wear masks. … I mean, I’m not totally discounting them, but the first thing they’re discounting is hope."
“The people on the front line, they seem to want this drug a lot more than the bureaucrats who are telling you what you should or shouldn’t be doing without offering any alternatives,” he said.
The rapid emergence of Covid-19 as a once-in-a-century public health crisis has forced elected officials and health systems to scramble for potential treatments.
In March, as case totals climbed in New Jersey — the state has recorded more than 95,000 cases and 5,063 deaths as of Wednesday — Trump began promoting anecdotal evidence and limited studies showing the drug had promise as a prophylactic, meaning it is most effective before Covid-19 patients begin exhibiting major symptoms.
The drug’s promotion, both by Trump and conservative media figures, led to widespread reports of hoarding — potentially jeopardizing patients and physicians‘ ability to access the drugs for approved usages as an antimalarial and treatment for lupus and rheumatoid arthritis.
On March 30, New Jersey Attorney General Gurbir Grewal issued a directive to preserve supplies of the drug, limiting prescriptions in a Covid-19 setting to those who had tested positive for virus.
Delays in the testing process have forced many New Jersey patients to wait days or weeks before receiving results, which means even if reports of the drug’s effectiveness were eventually affirmed by a clinical trial, it would be too late for patients requiring hospitalization.
“Assessing the impact of using HCQ in the sickest patient population is the equivalent of assessing the effectiveness of a bullet proof vest with someone who has already been shot,” said Dr. Stavros Christoudias, chairman of the NJDPA board, in a statement. “It should be left to the clinical judgment of our physician community to weigh the risks and benefits of this medication on a case by case basis, as well as keeping up to date on the latest evidence for the medication’s efficacy. Regulations should not be making that judgement for us.”
That perspective is hardly shared by every physician.
Dr. Anthony Fauci, America’s top infectious disease expert, went so far as to dismiss early reports on the drug as “anecdotal evidence” and said more clinical trials would be needed to say anything conclusive about its efficacy.
“People are using these medicines with little rhyme or reason and very little evidence,” said Dr. Raymond Panettierri, the vice chancellor of clinical and translational Science at Rutgers Institute for Translational Medicine, in an interview.
“We need firm evidence. If the drugs were absolutely innocuous, the only downside would be cost,” he said, noting HCQ’s potential heart-related side effects. “I think the prudent use of studies driven by evidence is the way to go.”
Panettierri is among the physicians leading a clinical trial at the Rutgers Cancer Institute, Robert Wood Johnson University Hospital in New Brunswick and University Hospital in Newark to determine if coronavirus infections can be decreased faster with hydroxychloroquine or with the combination of hydroxychloroquine and azithromycin (better known by its common brand name Z-Pak).
The study is one of several being conducted throughout New Jersey into possible Covid-19 treatments, which include HCQ as well as Gilead’s experimental drug remdesivir and convalescent plasma.
“We obviously don't have those results yet, because they're trials, but New Jersey and particularly the larger organizations in New Jersey, are pretty active in treating patients with Covid-19 and I think having better results than we even imagined a month ago,” state Health Commissioner Judith Persichilli said at a daily coronavirus press briefing earlier this week.
Pennacchio, on the other hand, doesn’t want to wait, going so far as to call for a select oversight committee to investigate the response by Gov. Phil Murphy‘s administration to the Covid-19 pandemic, largely based on his allegation the state has withheld hydroxychloroquine at Grewal’s directive.
By the same token, should a vaccine for coronavirus reach trial stages, Pennacchio — a vocal opponent of mandatory childhood vaccinations — said he didn’t believe those drugs should be tested on New Jersey residents en masse.
“Should we explore vaccinations? Absolutely,” he said, commenting on New York Gov. Andrew Cuomo’s offer for the federal government to use New York as a laboratory for future coronavirus vaccines. “He’s willing to give people an untried vaccine versus a drug that’s safe, OK? That’s going to be administered by a doctor, OK? What am I not getting here?”