Coronavirus: Trump says he is taking unproven drug hydroxychloroquine

US President Donald Trump has said he is taking hydroxychloroquine to ward off coronavirus, despite public health officials warning it may be unsafe.

Speaking at the White House, he told reporters he started taking the malaria and lupus medication recently.

"I'm taking it for about a week and a half now and I'm still here, I'm still here," was his surprise announcement.

There is no evidence hydroxychloroquine can fight coronavirus, and regulators warn the drug may cause heart problems.

What did Trump say?

The 73-year-old president was hosting a meeting devoted to the struggling restaurant industry on Monday, when he caught reporters unawares by revealing he was taking the drug.

"You'd be surprised at how many people are taking it, especially the frontline workers before you catch it, the frontline workers, many, many are taking it," he told reporters. "I happen to be taking it."

Asked what was his evidence of hydroxychloroquine's positive benefits, Mr Trump said: "Here's my evidence: I get a lot of positive calls about it."

He added: "I've heard a lot of good stories [about hydroxychloroquine] and if it's not good, I'll tell you right I'm not going to get hurt by it."

Though some people in the White House have tested positive for coronavirus, the president said again on Monday he had "zero symptoms" and was being tested frequently.

He added that he had been taking a daily zinc supplement and received a single dose of azithromycin, an antibiotic meant to prevent infection.

When asked whether the White House physician had recommended he start taking the disputed remedy, Mr Trump said he himself had requested it.

Dr Sean Conley, physician to the president, said in a statement issued through the White House later on Monday that Mr Trump was in "very good health" and "symptom-free".

The US Navy officer added: "After numerous discussions he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risks."

What have US health officials said?

The US Food and Drug Administration (FDA) last month issued an advisory saying that hydroxychloroquine has "not been shown to be safe and effective".

It cited reports that the drug can cause serious heart rhythm problems in Covid-19 patients.

The FDA warned against use of the medication outside hospitals, where the agency has granted temporary authorisation for its use in some cases. Clinical trials of the drug are also under way.

The Centers for Disease Control (CDC) says there are no approved drugs or therapeutics to prevent or treat Covid-19, which is confirmed to have infected more than 1.5 million people in the US, killing more than 90,000 patients.

What else did Trump say?

Dismissing reports of severe side effects from hydroxychloroquine, the president said: "All I can tell you is, so far I seem to be OK."

He said the "only negative" he had heard was from a "very unscientific report" conducted by "people that aren't big Trump fans".

Mr Trump was apparently referring to a preliminary study from April of Covid-19 patients in US government-run hospitals for military veterans that suggested hydroxychloroquine had no benefit and may have even caused a greater rate of deaths.

"I get a lot of tremendously positive news on the hydroxy," the president told reporters, adding: "What do you have to lose?"

According to doctors, the drug has the potential to cause symptoms including heart failure, suicidal thoughts and signs of liver disease.

What's the reaction?

Mr Trump's most powerful elected antagonist, the Democratic Speaker of the US House of Representatives, Nancy Pelosi, could not resist taking a dig at his age and weight when asked on CNN about him taking the malaria medication.

"He's our president and I would rather he not be taking something that has not been approved by the scientists, especially in his age group and in his, shall we say, weight group - morbidly obese, they say," she said.

Last year, the White House physician noted in Mr Trump's annual medical exam that he weighed 243lb (110kg) and was 6ft 3in, which would score his body mass index at a technically obese 30.4.

Senate Democratic Minority Leader Chuck Schumer called Mr Trump's decision "reckless" but added: "Who knows if it's true?"

"He may not have been taking it for all we know. He just likes to make a splash," he told MSNBC.

"Maybe he's really not taking it," he continued, "because the president lies about things characteristically-like."

Is Trump misguided or a trailblazer?

Analysis by Michelle Roberts, Health Editor

I'll have what President Trump's having. No thanks - or rather, not yet.

Currently there is no convincing evidence that hydroxychloroquine helps fight the virus and it can cause unpleasant and harmful side effects in some people.

In theory, repurposing existing drugs to treat coronavirus is a very good and sound idea (unlike Mr Trump's previous ones about injecting disinfectant or hitting the body with "tremendous" UV light). It may be our only hope, at least in the short term, until a vaccine can be found.

The UK government has been stockpiling some medicines that might be useful against coronavirus. That includes 16m hydroxychloroquine tablets. Clinical trials are under way in the UK and the US to assess the drug's worth. The human guinea pigs taking part include frontline healthcare workers at high risk of exposure to the virus, as well as patients.

Experts agree that this work is worth doing, but they are concerned about advocating more general use of these experimental treatments before the proof is in.

Dr Stephen Griffin, associate professor at the School of Medicine at the University of Leeds, told me: "People that follow the president's example might not only endanger themselves but could also deprive patients with chronic autoimmune conditions of their much-needed medication."

(Source: BBC)

Resistant malaria spreading in South East Asia

Malaria parasites resistant to key drugs have spread rapidly in South East Asia, researchers from the UK and Thailand say.

The parasites have moved from Cambodia to Laos, Thailand and Vietnam, where half of patients are not being cured by first-choice drugs.

Researchers say the findings raise the "terrifying prospect" drug-resistance could spread to Africa.

However, experts said the implications may not be as severe as first thought.

What is happening?
Malaria is commonly treated with a combination of two drugs - artemisinin and piperaquine.

The drug combo was introduced in Cambodia in 2008.

But by 2013, the first cases of the parasite mutating and developing resistance to both drugs were detected, in western parts of the country.

The latest study, published in the Lancet Infectious Diseases, analysed blood samples from patients across South East Asia.

Inspecting the parasite's DNA showed resistance had spread across Cambodia and was also in Laos, Thailand and Vietnam.

It had also picked up further mutations, making it even more problematic.

In some regions, 80% of malaria parasites were drug resistant.

"This strain has spread and has become worse," Dr Roberto Amato, from the Wellcome Sanger Institute, told BBC News.

Does this mean the disease is becoming untreatable?
No.

A second study, published in the same journal, showed half of patients were not being cured with standard therapy.

However, there are alternative drugs that can be used instead.

"With the spread and intensification of resistance, our findings highlight the urgent need to adopt alternative first-line treatments", Prof Tran Tinh Hien, from the Oxford University Clinical Research Unit, in Vietnam, said.

That could include using different drugs alongside artemisinin or using a combination of three drugs to overcome resistance.

What's the concern?
Huge progress has been made towards eliminating malaria. However, the development of drug resistance threatens that progress.

The other issue is if the resistance spreads further and reaches Africa, where more than nine in 10 cases of the disease are.

"This highly successful resistant parasite strain is capable of invading new territories and acquiring new genetic properties, raising the terrifying prospect that it could spread to Africa, where most malaria cases occur, as resistance to chloroquine did in the 1980s, contributing to millions of deaths," Prof Olivo Miotto, from the Wellcome Sanger Institute and University of Oxford, said.

What does this change for people living there?
The findings will not change much in people's day-to-day life in the Greater Mekong Subregion, in South East Asia.

Tackling malaria is about more than just picking the right treatment after an infection.

All the efforts around controlling the mosquitoes that spread the disease will not change.

However, the researchers say the drugs people are given after an infection should change.

The studies also show genetic analysis of malaria parasites can help doctors keep one step ahead of emerging drug-resistance in order to give patients the right treatment.

Is this the whole picture?
The spread of resistance is set against the backdrop of falling cases in the region.

"These parasites are scary beasts, there's no doubt," Prof Colin Sutherland, from the London School of Hygiene and Tropical Medicine, said.

"However, I wonder if these parasites are not very fit because the population as a whole is crashing."

In Cambodia there were:

262,000 cases of malaria in 2008
36,900 cases of malaria in 2018
So, while the drug-resistant parasite has undoubtedly spread, it is not necessarily a global threat, according to Prof Sutherland.

"The implications are not as severe as we might think," he said.

How bad is malaria?
There are about 219 million cases of malaria around the world each year.

Symptoms include cycles of feeling cold and shivering followed by a high temperature with severe sweating.

Without treatment, the parasite can lead to breathing problems and organ failure.

The disease kills about 435,000 people every year - most of them are children under the age of five.

(Source: BBC)

The town that breeds resistance to Malaria drugs

As new waves of the disease threaten the globe, worried scientists want to conduct a mass inoculation in a Cambodian region where new vaccines always seem to stop being effective

Pailin is a small settlement nestling in tropical rainforest near Cambodia’s border with Thailand. It is an unassuming town that lies at the centre of one of the country’s main logging areas. Pailin harbours secrets, however. It was in this town, in the late 1970s, that the Khmer Rouge set up one of its main strongholds and ruled Cambodia with a ferocity that caused at least two million deaths. It is a grim legacy, by any standards.

But Pailin has another unwanted claim to fame, one that is also associated with widespread death. The town, it transpires, lies at the heart of a region that has seen successive waves of resistance to malaria drugs arise in local people and then spread across the globe. The resulting death tolls can be measured in millions of lives, say scientists.

Just why malarial drug resistance has arisen here is not clear. Nevertheless scientists are emphatic: the region has seen the creation of several mutations in malaria parasites that have allowed them to shrug off medicines that once protected humans. Even worse, they have discovered that a new wave of malarial drug resistance has recently appeared in this tiny area and has already spread into Thailand, Laos, and Vietnam, and begun to move into Myanmar and travel towards India and Bangladesh.

The prospect has so alarmed scientists and politicians that the issue is to be raised as an emergency topic to be debated at the heads of Commonwealth meeting in London next week (16-20 April). There are 19 Commonwealth member states in Africa, the continent that is the most vulnerable to malaria. According to World Health Organisation statistics, about 90% of all malaria deaths occur in Africa. Hence the concern of many Commonwealth heads of state who believe their homelands are most at risk of a spreading malarial resistance.

“The problem is that we are pussyfooting around,” said Professor Sir Nicholas White, of the Mahidol Oxford Tropical Medicine Research Unit. “The World Health Organisation has not provided the necessary leadership. We need very firm direct action and at present we are not getting that.”

Resistance to major malaria drugs first appeared in the late 1950s when chloroquine -– then a highly effective successful treatment for the disease -– began to lose its efficacy. Crucially, this resistance first appeared in Pailin on the Cambodian-Thai border and then spread to Africa by the early 1980s. Several million deaths were added to the already grim toll of lives lost to the disease as a result.

A new set of drugs, known as sulfadoxine-pyrimethamines, was then developed and used to treat malaria. But once more resistance to the drugs appeared and again it first manifested itself around Pailin before spreading westwards. Again the disease’s death toll soared.

Then, at beginning of this century, a new set of malarial medicines was developed. Known as artemisinins, they were discovered in 1972 by Tu Youyou, a Chinese scientist who was awarded the 2015 Nobel prize in medicine for her work. Administered with a slower-acting second drug, artemisinins have become the medicine of choice for dealing with malaria across the globe, leading to improvements in malarial statistics with deaths and case numbers declining globally.

But now scientists have recently discovered once more that resistance to key malarial drugs has evolved -– and in exactly the same place as before: the farms and village that surround around Pailin. “That resistance has emerged in exactly the same place that resistance to chloroquine and then pyrimethamines emerged. The same very place. Around Pailin,” said White.

Just why this tiny region of south-east Asia has proved to be such a fertile zone for the emergence of deadly resistance to malarial medicine is not clear, a point stressed by Dominic Kwiatkowski, director of the centre for genomics and global health at Oxford University.

“We would love to know the answer, but it is not obvious,” Kwiatkowski told the Observer.

“One idea is that resistance keeps arising here for historical reasons. Maybe it has something to do with the way that malarial medicines are administered here. But how exactly?” In fact, the This theory is just one of a great many other suggestions that have been put forward to explain why this resistance is appearing here first.

A mosquito takes blood from a human host. Resistance to the latest anti-malarial drugs poses a major problem for scientists. Photograph: James Gathany/AP

The local strain of malaria parasites may have some special properties, or the ecology of the region may have features that boost the rise of resistance. “The crucial point is that we need to do something about it and once we have, we need to monitor the situation very, very carefully,” said Kwiatkowski.

One factor that has recently become clear is that malarial drug resistance appeared very quickly in the region. Writing in Lancet Infectious Diseasescorrect in February, researchers from the Wellcome Sanger Institut and collaborators reported that resistance to combination therapies that included artemisinins arose almost as soon as the treatment was introduced as a first-line malarial drug. However, that this loss of efficacy was not spotted, for a variety of reasons, until several years had passed.

The implications of this failure were stressed by Ben Rolfe, head of the Asia Pacific Leaders Malaria Alliance. “On our watch, drug resistant strains have spread almost unnoticed,” he told the BMJ recently (pdf). “As a result, we now risk a global resurgence of the disease.”

Khmer families are screened for malaria in Pailin province in 2010. Photograph: Paula Bronstein/Getty Images

The question facing scientists -– and heads of state and health leaders -– is straightforward: what can be done? White -– who is scheduled to speak at the Commonwealth heads of state meeting -– is emphatic. “We have a window of opportunity but it is closing rapidly,” he told the Observer.

What is needed is a campaign, run with military efficiency, to use current drugs -– while they still have some efficacy -– not only on people who already have malaria but on those individuals who have been infected but who have not succumbed or shown symptoms of the disease.

“These individuals carry small numbers of parasites and although they don’t get ill they are sources of new infections,” said White. “Mosquitos bite them, take their blood and spread it to others. They are the source of new infections.”

The plan, proposed by White and other scientists, is that everyone in a village in a malaria hotspot should be treated with anti-malarial drugs -– regardless of their symptoms. “It is called mass drug administration. It is very controversial but it works -– if it is done as part of a concerted strategy. If you do it badly you will only make the problem of resistance worse. So this has to be done right. But if we don’t do it we won’t be able to eliminate malaria quickly enough, and if resistance worsens it may become untreatable,” says White.

In addition, it is proposed that a third anti-malarial drug be added to the combination therapy currently used to treat those who have actually succumbed to malaria: a triple whammy instead of a double. Next week, Britain’s Department for International Development is expected to announce support for trials using triple combination drugs.

For its part, WHO officials say that the dangers posed by the new malaria superbug are exaggerated and that better prevention efforts, monitoring and treatments will limit its spread from the Mekong region. Others are not so sure, however. The Malaria summit -– organised by the Ready to Beat Malaria campaign is to be held in London on 18 April at next week’s Commonwealth summit and will be attended by scientists and business leaders, including Bill and Melinda Gates. They are pressing for urgent commitments from all world leaders to battle the disease.

“We are currently on a cliff edge,” said a spokesman for Ready to Beat Malaria. “We can continue to battle the disease or risk an acute and deadly resurgence.”

This view is backed by White. “We are running out of time and unless we act rapidly, people will suffer and the people who will suffer most will be the children of Africa.”

(Source: The Guardian)

Asima Chatterjee: Google honours Indian chemist on 100th birthday

Throughout her career, her research contributed to the development of drugs that treated epilepsy and malaria, says Mirror. Read on: 

When Dr. Asima Chatterjee was growing up in Calcutta in the 1920s and 1930s, it was almost unheard of for a woman to study chemistry.

But that didn't stop the determined young woman - she not only completed her undergraduate degree in organic chemistry, but she also went on to receive a Doctorate of Science, the first woman to do so in India.

Dr. Chatterjee primarily studied the medicinal properties of plants native to India.

Throughout her career, her research contributed to the development of drugs that treated epilepsy and malaria.

Dr. Chatterjee's most noted contribution to the field, however, was her work on vinca alkaloids. Alkaloids are compounds made from plants, often to treat medical ailments.

Vinca alkaloids, which come from the Madagascar periwinkle plant, are used today in chemotherapy treatment because they help slow down or stall the multiplying of cancer cells.

Dr. Chatterjee's groundbreaking contributions to medicine were recognized by universities all over the world.

She received numerous accolades from the Indian government, including some of the highest awards (like the Padma Bhushan) and an appointment to the upper house of Parliament!

A firm believer in collaboration and teaching, Dr. Chatterjee also founded and led the department of chemistry at Lady Brabourne College.

She started a research institute and mentored many of India's rising chemistry scholars.

Today's Doodle pays homage to this trailblazer and her great accomplishments in the name of science.