Fear and Misguided Praise

"Given the media hype around hydroxychloroqnine, given messaging coming out of the White House and out of President Trump, there are a lot of people that are wanting to believe that hydroxychloroquine is that panacea, that magical drug that will protect us against COVID-19."
"It's understandable, because people are looking for that solution that's going to protect them. And I think the numbers have moved as a result of that hype."
Allan Malek, Chief Pharmacy Officer, Ontario Pharmacists Association

"Health Canada recently warned Canadians of the serious side effects associated with chloroquine and hydroxychloroquine, including heart rhythm problems, liver or kidney problems, low blood sugar [hypoglycemia], and nervous system problems."
Health Canada spokesperson

Hydroxychloroquine   Courtesy Mint Pharmaceuticals

"This is a product that has historically appeared in the drug-shortage database in Canada."
"So we believe that some patients [who suffer autoimmune diseases] might have been proactive, and wanted to get ahead of this when they realized that this was being touted by the leader of the free world as the cure-all for COVID-19."
Jaiveer Singh, CEO, Mint Pharmaceuticals, Mississauga

Various preliminary reports augmented by U.S.President Donald Trump's praise for hydroxychloroquine, an anti-malaria drug commonly prescribed for people with autoimmune diseases, saw a situation where sales of the drug doubled in March in Canada, leaving people suffering from lupus or rheumatoid arthritis discovering that they were unable to renew their prescriptions caused by the resulting drug shortage.

The surge in sales, according to pharmacists and manufacturers, was responsible for the shortage encountered by the people who needed the drug. The anti-malaria drug saw sales in that month of 9.5-million doses in Canada, according to IQVIA -- a clinical research company -- representing over double the volume distributed the month before and close to double the average monthly volume since January 2019.

A French researcher had claimed that he had seen a 100 percent cure rate for COVID-19, with the use of the drug in a small clinical trial. Critics of the experiment pointed out its small sample size and lack of peer review. But the praise heaped on the drug for its assumed efficacy by President Trump as a "game-changer" in the battle against COVID-19 on March 21 convinced many that their fears would be alleviated if they were in possession of the drug.

If ordinary people, vulnerable through fear of contracting the disease, were gullible enough to seek out the unproven drug, what can one say of evidence that doctors had been acquiring supplies of the drug for themselves or for others for which they were prescribing unusual amounts labelling their acquisition as "office use". In response, a number of professional organizations warned physicians of the drug's unproven status.

Irrespective of which, globally demand to access hydroxychloroquine was magnified in the belief that it held the answer to the question, how to defend against the global pandemic of SARS-CoV[-2. No evidence has yet been found of a convincing nature for the anti-malaria drug's usefulness in the treatment of COVID-19, a drug capable of a litany of collateral health issues.

India, one of the largest producers of hydroxychloroquine in the world, halted exports of the drug (along with others they export) to ensure an adequate supply of drugs internally, as a response to the spread of COVID-19 throughout the country.  A shipment of five million capsules of the drug dating back to a November order has since been received in Canada, by Mint Pharmaceuticals. Even so, its CEO which explains his company, which supplies some 60 percent of all orders in Canada, sees them dwindling.

HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains – Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents)…..

— Donald J. Trump (@realDonaldTrump) March 21, 2020

He is convinced that legitimate patients for whom the drug is prescribed to treat their autoimmune disorders could very well have taken self-protective action by stockpiling the drug, fearing a shortage since publicity surrounding the possible use of the drug for COVID-19 began growing in the international community. His company, assures Mr. Singh, despite that, is positioned to avoid major issues of medication supply in Canada.

Over the past few weeks, he pointed out, demand for the drug has significantly decreased, and he posits that might be as a result of mounting evidence against the use of hydroxychloroquine in the treatment of COVID. Federal and provincial public health groups ordered pharmacists to release only 30-day doses of all drugs to patients, a practise that may well have aided in reducing the strain on pharmaceutical supply chains.

A World Health Organization spokesperson pointed out several days back that multiple treatments in the fight against the virus were indicating promise. "We do have some treatments that seem to be in very early studies limiting the severity or the length of the illness, but we do not have anything that can kill or stop the virus", Margaret Harris advised, in a late briefing.

Pharmacist Jim Giontsis, who runs a pharmacy in Toronto’s Moss Park neighbourhood, warns against using drugs like hydroxychloroquinine to treat COVID-19. (Evan Mitsui/CBC)