Nursing home patients test coronavirus drug

Thirty residents of a Texas City, Texas nursing home are being treated for the coronavirus with hydroxychloroquine. The nursing home houses one of the largest outbreaks in the Houston area.

Out of more than 100 coronavirus tests that were administered to residents and staff at the Resort at Texas City, a nursing home, 83 tested positive for COVID-19. There are 135 beds in this facility in Galveston County. A staff member became ill with the coronavirus and that prompted the mass testing. Now 30 residents are being given hydroxychloroquine as treatment. On Monday, Governor Greg Abbott said that the drug began being administered to the residents Saturday. He said there are no conclusions yet but he will do updates as warranted.

Nana and Pop-Pop are human guinea pigs, essentially, as the medical experts try to get a handle on treatment for the coronavirus. President Trump says, “What have you got to lose?” while Dr. Fauci cautions about the inconclusive test results to date. Those who are testing positive are caught somewhere in the middle of that. Hydroxychloroquine has been used for years against malaria and is prescribed to those with lupus and arthritis. My husband has taken it because his work frequently has taken him overseas to places where exposure to malaria is a concern. He says it makes him feel sick but he never contracted malaria.

In this case, Dr. Robin Armstrong is conducting the treatment of these 30 patients. He is the nursing home’s medical director. Armstrong is also a Republican activist and serves as a surrogate for the Trump campaign. He serves on the advisory board of the Black Voices for Trump coalition and is one of Texas’ two Republican National Committee members. I give this information about Dr. Armstrong because apparently his political activity is important to the Texas Tribune, as they included it in the piece about the drug’s use. Perhaps he has been inspired by President Trump’s advisers who are looking to hydroxychloroquine as a viable drug treatment. Armstrong says it is still too early to tell if the treatment is working. Some patients have experienced improved oxygen saturation but it is too soon to know if that was caused by hydroxychloroquine.

The hydroxychloroquine was donated by Amneal Pharmaceuticals, a donation of 1 million tablets the New Jersey-based company made directly to Texas. The process of securing that donation began a couple of weeks ago.

The donation from Amneal Pharmaceuticals went to the Department of State Health Services pharmacy, which has been distributing the drugs to hospitals upon request, according to a department spokesman, Chris Van Deusen. The department has given 10 bottles to the University of Texas Medical Branch at Galveston.

Hughes said the donation began coming together at least a couple of weeks ago through a colleague at his law firm who knows an Amneal board member. The board member said the company was following reports of shortages of the drug and wanted to give it away to people who needed it, Hughes said. The senator then got in touch with state officials like Nim Kidd, chief of the Texas Division of Emergency Management, who Hughes said helped him navigate the bureaucracy of getting the donation into the state’s supply.

“We want to make sure that docs have every possible tool to fight this virus,” Hughes said. “Hydroxychloroquine is not a silver bullet, but many doctors say it’s helping their patients, so let’s make sure they have access to that.”

New York doctors are also using hydroxychloroquine now though initially, Governor Cuomo was hesitant to do so. The Food and Drug Administration began sending thousands of doses of hydroxychloroquine last month.

The FDA is approving the use of the drug on an emergency basis. Dr. Fauci continues to express caution. He says the drug’s success has only been shown anecdotally.

“It was not done in a controlled clinical trial, so you really can’t make any definitive statement about it,” Fauci said at the time. “If you really want to definitively know if something works, you’ve got to do the kind of trial where you get the good information.”

Guidance has been given by the Texas Pharmacy Board to pharmacists and it is clear that hydroxychloroquine can only be given with a prescription from a doctor. This is something advocates have said from the beginning – the drug is only available through a prescribing doctor.

The Texas Pharmacy Board on March 20 issued a guidance to pharmacists saying they would only be allowed to dispense the drug as well as other antimalarial medications to COVID-19 patients with a “written diagnosis from the prescriber consistent with the evidence for its use.”

The guidance also limited new prescriptions to no more than a 14-day supply and required a new prescription for refills so as to “prevent the stockpiling of the drugs and to ensure that reasonable quantities are available for all patients that require therapy with the drugs, including patients with a COVID-19 diagnosis.”

The rule did not stop doctors from prescribing the drug for an off-label use, and it did not apply to patients already established on the medication.

“This drug is widely being used to treat COVID-19 although its effectiveness is unclear,” said Dr. Philip Keiser, the Galveston County Local Health Authority. “This drug is licensed by the FDA and doctors have the ability to use it in their best judgment.”

The experiments with hydroxychloroquine in Texas and New York are on the cutting edge of treating this coronavirus. They will provide valuable information going forward. We can thank Nana and Pop-Pop for being our guinea pigs now in order to treat the virus in future pandemics.