Joe Rogan: (
16:44)
That’s great. Now let’s talk about treatments that are being considered. We know that Z-Pak’s are one of them, and chloroquine. Can you explain that and what went horribly wrong with the couple that took the wrong kind of chloroquine and it turned out to be a koi pond cleaner?
Dr. Hotez: (
17:04)
Okay. So let me give you the framework for that so it makes some sense. When we talk about all the interventions, you have things that are going to be ready down the line, things are going to be ready a little closer and things ready now. So and then we can talk about one and then I’ll … let me give you the framework then I’ll answer your chloroquine question.
Dr. Hotez: (
17:25)
So the highest bar there is in terms of financial investment required, and time to show safety, is a vaccine. So that’s what we’re doing and other groups are doing. Next tier down, that’s going to be a year, 18 months away, according to Dr. Fauci, could be longer than that. Next tier down are what we call small molecule drugs, new drugs that have never been discovered before. Still takes a while, maybe not as high a bar as vaccine in terms of time. The next tier down is re-purposing existing medicines that we already know are relatively safe and then showing-
Dr. Hotez: (
18:03)
Now are relatively safe and then showing that those drugs also work against the Coronavirus and that’s going to be the [inaudible 00:18:08] category, and I’ll get to your question and then the nearest ones, the one that we could do now is what’s called this convalescent antibody therapy, which I’ve been pushing very hard on because I think we can actually have it going right now. So let’s do the chloroquine hydroxychloroquine. This is, and that’s one of the repurposed ones. That’s not the lowest hanging fruit, but the next lowest hanging fruit. This is a medicine that’s used for malaria. It’s an anti-malarial drug. It’s been around for decades. In fact, the World Health Organization was going to had in the 1960s proposed an elimination strategy for malaria to treat everybody with chloroquine until we had chloroquine resistance and that derailed that.
Dr. Hotez: (
18:53)
But in some parts of the world, it’s still works as an anti-malarial drug. It’s also used as an antiinflammatory drug for the tree treatment of lupus and other autoimmune diseases. You can make a bucket of it. It’s cheap. We know the safety profile. We know it can cause arrhythmias in some patient and other toxicities, but it generally has a pretty good safety profile. We know that this drug can block the replication of the virus in the test tube, so it inhibits the virus in what we call it, in vitro in the test tube. Second, we know this drug reduces inflammation and that’s nice because one of the things you get with COVID-19 pneumonia is you not only get the virus infection in the lung, you got a lot of inflammation, so it checks a couple of boxes in terms of why it’s attractive to look at it.
Dr. Hotez: (
19:43)
And then the Chinese did a small study and then a colleague of mine is a fascinating guy. I really appreciate his work as a scientist. He’s a very serious scientist in Marsay in France named [inaudible 00:19:59] and he’s, I don’t know, must’ve published at least two or three dozen papers in the journal that I founded call Plus Neglected Tropical Diseases. He’s a serious scientist, works on all sorts of intracellular bacteria and that kind of thing. Tick borne diseases, did a small study showing that it worked in COVID patients. And what he did was he combined hydroxychloroquine with the Z-Pak, the Zithromycin drug and found that there’s an effect. The problem was that it was a very tiny study and so people put those three things together and all of a sudden said we’ve got the miracle cure. I’m not sure that’s going to turn out to be the case.
Dr. Hotez: (
20:36)
I mean we really need to do large studies to show that it really works. And the reason I’m holding back is nothing to do with Dr. Professor O is a really important scientists, but it’s a small study. We were there about a decade ago with influenza that this hydroxychloroquine also inhibited the influenza virus in the test tube. But then it didn’t pan out in larger clinical studies. So I think we have to be really careful and don’t be too quick to say, “Okay, this is going to be it.” We’re not even close to that yet, but we’ll know in the next few weeks because we’re working hard to scale up clinical trials looking at that medicine.