Medical entities advise against medicine that Bolsonaro presents as a panacea

Three of the main medical entities in Brazil discouraged the use of chloroquine to treat patients with COVID-19 on Tuesday despite the fact that President Jair Bolsonaro ordered an increase in the production of this medicine and wants to force its use for all those infected in the country.

The veto on chloroquine, an antimalarial drug, was stated in a joint statement by the Brazilian Intensive Medicine Association, the Brazilian Society of Infectious Diseases and the Brazilian Society of Pneumology.

According to a report prepared by 27 specialists from the entities, the evidence on the efficacy of chloroquine and its derivatives to treat COVID-19 is "weak" and the medicine, on the other hand, has serious side effects, such as cardiac arrhythmia.

Although there is no scientific evidence on the efficacy of this medicine, which is being tested in several countries to treat COVID-19, Bolsonaro ordered the Army Laboratory to increase the production of this drug so that it can be distributed throughout the country.

He also asked the Ministry of Health to publish a protocol for the treatment of COVID-19 that establishes chloroquine as a medicine for the treatment of the disease even among patients without severity and who present the first symptoms.

The current protocol only foresees the provision of chloroquine on an experimental basis for patients in serious condition and with special monitoring in case it is necessary to suspend treatment.

Bolsonaro's insistence that the Ministry publish the new protocol on Friday caused the resignation of the Health Minister, oncologist Nelson Teich, who only held the position vacated by Luiz Henrique Mandetta for 28 days, who was also dismissed in April due to his disagreements with the head of state regarding strategies to combat COVID-19.

"The available evidence does not suggest a clinically significant benefit from treatment with hydroxychloroquine or chloroquine. The same is true for the use of the combination of chloroquine with azithromycin," according to the scientific report.

The specialists also said that if the results so far have not been effective in treating seriously ill patients admitted to intensive care, there is no basis to recommend it also for those who are still in the outpatient setting.

According to Mandetta, Bolsonaro's insistence on forcing the use of chloroquine to treat all patients with COVID-19 can lead to many deaths because it is a medicine whose efficacy has not been proven and with serious side effects.

"We began to experiment with serious patients who are already in hospitals. From what I know of those studies, which have not yet been concluded, 33% of patients had to stop using chloroquine because they had arrhythmia, something that can lead to arrest (cardiac), "said the former minister in an interview published Monday by the Folha de Sao Paulo newspaper.

Mandetta stated that Bolsonaro's intention with his commitment to chloroquine is for people to think that they can return to work because a remedy already exists.

"It is something to reassure, to regain normality without so much weight on consciousness. If it had logic of assistance, the idea would have come from specialized societies. So there is no one serious who defends a medicine as a panacea," he said.

The far-right leader is one of the most skeptical rulers about the severity of the pandemic, has come to call COVID-19 a "flu" and insists on criticizing the social distancing measures adopted by regional governments to curb the pandemic and calling for standardization of activities.

For Bolsonaro, more concerned with the paralysis of the country, the already predicted historical recession and the millions of jobs destroyed by the health crisis, COVID-19 "will infect 70% of the population sooner or later" and "it will kill many people "regardless of the distancing measures adopted.

Brazil, with 254,220 confirmed cases of the disease until Monday, became the third country most affected by COVID-19, after surpassing the United Kingdom, and the trend is that the numbers of infected and dead (16,792) continue to grow from exponentially until July, when the peak of the incidence curve is expected.

The forecast is that in a few days Brazil will rise to second place as the figures tend to rise in the country, with 210 million inhabitants, serious inequalities and a poor health system, while in most European countries the curves they are already descending.


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