Texas City doctor claims victory with malaria drug
Physician asserts win even after 3 die in nursing home
TEXAS CITY — When 83 residents and staff at a Texas City nursing home tested positive for the novel coronavirus in April, Dr. Robin Armstrong rolled the dice.
Armstrong, a politically connected physician and medical director at The Resort at Texas City, obtained supplies of hydroxychloroquine, a drug not approved for treating COVID-19, from the state and immediately began providing the tablets to 38 residents who had tested positive but not yet shown symptoms.
More than a month later, Armstrong is touting his gamble as a success story. While three patients that he treated have died, he said 35 are no longer showing COVID-19 symptoms and have in essence “recovered,” though some still test positive for the virus itself.
Although he can’t say for certain that the drug helped the patients survive the potentially deadly disease, he added, “It seems like the evidence is at least suggestive that some of that made a difference in the patients that we saw and were able to treat.”
In the absence of a proven cure, public health experts and scientists continue to debate the efficacy of drugs such as hydroxychloroquine — an antimalarial pill commonly known as Plaquenil — to alleviate virus symptoms. While President Donald Trump has promoted the drug’s benefits, the Food and Drug Administration and National Institutes of Health have issued warnings about treating coronavirus patients with it, and recent studies have cast doubt about its effectiveness.
And this week, Rick Bright, a top vaccine expert with the federal government, filed a whistleblower complaint alleging that he was removed and given a lesser role after he pushed back against efforts to promote hydroxychloroquine “as a panacea.” He told a congressional committee on Thursday that he considered the drug to be a “potentially harmful” treatment.
“The whole hydroxychloroquine question is still up in the air,” said Dr. Philip Keiser, the local health
authority for Galveston County who helped test 146 residents and employees at The Resort after the initial outbreak there in late March. “This is what in medical science we call anecdotal data — ‘I did this and it’s a story’— but what we really need are trials that will tell us, compared to (another drug), how did people do?”
Neither The Resort nor the Galveston County Health District has verified Armstrong’s claim that only three patients in his care died. Through a spokeswoman, The Resort released a statement saying 11 residents who tested positive for the new coronavirus have died but did not specify how many were treated by Armstrong with hydroxychloroquine.
Some relatives of nursing home residents treated by Armstrong have questioned his claim that 35 patients have recovered, primarily because the facility remains on lockdown with active coronavirus cases. County health officials say the facility recently retested 40 of the 56 residents who were infected and found 19 still tested positive; there were five new cases.
“I suspect that the virus is still (at The Resort) in at least some of these folks and that’s what’s responsible for this low-level growth in the nursing homes that already have it,” Keiser said.
At the center of the debate is Armstrong, a Texas City native and married father of four who holds a medical degree from the University of Texas Medical Branch in Galveston and is also a national committeeman for the Republican Party of Texas.
Armstrong has been eager to share his story with news outlets across the state, from doing a Dallas radio interview to inviting an Austin Fox News affiliate to bring cameras into the nursing home. He claimed administering hydroxychloroquine to residents of The Resort was a matter of life and death — “We could potentially lose 15 to 20 percent of the residents, which was not an option,” Armstrong told Fox — and their subsequent improvement rewarded any risk.
Long-term care facilities across Texas continue to bear the brunt of the coronavirus’s impact. As of Wednesday, nearly half of the state’s coronavirus-related deaths were from nursing homes or assisted living facilities, according to a Houston Chronicle analysis.
Gov. Greg Abbott on Monday announced that Texas will begin testing all nursing home residents and staff for the new coronavirus, following public pleas and a directive from the White House.
Armstrong believes his treatment regimen can be a beacon of hope in stemming infections among high-risk populations.
He said he was a skeptic before reading a study by a French doctor who provided hydroxychloroquine and the antibiotic azithromycin — also known as a Z-Pak — to 20 patients and wrote that those patients were “virologically cured.” Armstrong is now so convinced of the drug cocktail’s effectiveness that he hopes to present data on The Resort’s patients to a scientific journal.
The physician also argues the FDA should rescind its regulation that the drug can be used only under strict medical supervision or as part of a clinical trial. The FDA initially authorized hydroxychloroquine for emergency use in coronavirus patients, then issued warnings about it following reports of “serious heart rhythm problems” in patients who had taken the drug combination.
“I’m morally obligated to put out what we’ve seen, what we’ve experienced because it can be helpful to the conversation,” said Armstrong, adding that he can “pretty definitively” say the drug combination didn’t cause abnormal heart rhythms in Resort residents he treated.
Larry Edrozo is not so convinced the treatment doesn’t have harmful side effects.
His mother, Helen Edrozo, 87, was living at The Resort when she tested positive for the coronavirus. She was not displaying COVID-19
symptoms, making her a potentially ideal candidate for Armstrong’s treatment.
She received the medications but nevertheless her oxygen saturation levels began to drop and she stopped eating. Eventually, she was transferred to Mainland Medical Center for treatment of a neck infection.
“I do know that when they sent her to the hospital finally, when she woke up that morning there was a large what they called ‘goiterlike’ swelling on her throat,” Larry Edrozo said.
Her condition quickly worsened and she died in hospice care on April 23. Edrozo laments not getting the chance to say goodbye to his mother, and speculates whether the neck infection was an adverse reaction to the drug. He said he was surprised to recently read an article in which Armstrong implied that patients he had treated at The Resort were
cured.
“I saw that article and said, ‘I don’t think (my mother) was cured.’ ”
Armstrong said the growth on Helen Edrozo’s neck was “unusual” but couldn’t say what caused it without reviewing hospital records.
“She was treated and she had recovered from the COVID-19 and had a lot of other medical problems in addition to that,” Armstrong said.
The doctor also treated Kristi Doss’ mother, Janet Thomas, another Resort resident who had tested positive for the virus.
Doss, who is Thomas’ medical power of attorney, was initially wary when she heard Armstrong was using an unproven medication on her mother without her consent. Thomas gets regular dialysis treatment and has congestive heart failure, two conditions that the FDA highlights as worth telling your medical provider about before taking hydroxychloroquine.
One month after Thomas’ initial treatment, she continues not to show any symptoms and has had no adverse side effects from the medication. But Thomas is still testing positive for the virus, so Doss is hesitant to echo Armstrong’s assertion that she has recovered and says nurses there need to “keep up the precautions.”
Armstrong believes using the term “recovered” to refer to patients who are no longer showing COVID-19 symptoms is largely a matter of semantics. He said the diagnostic test that The Resort is using on its infected residents is particularly sensitive, which is why he believes residents without symptoms continue to test positive.
Keiser, the local health authority, is puzzled by the stubborn persistence of the coronavirus at The Resort, though he is more assured about treating infected patients with hydroxychloroquine. He’s spoken with rheumatologists who use the drug to treat inflammation and speculates that it could be effective in calming the “cytokine storms” in COVID-19 patients — where the body starts to attack its own cells and tissues rather than just fighting off the virus. To truly gauge the drug’s efficacy against the virus, he would like to see it tested in a clinical study in comparison to other drugs or placebos.
“The one thing we can say pretty clearly, this ain’t penicillin,” Keiser said, referring to the breakthrough antibiotic. “That’s why we need to do the arduous work of critically analyzing it.”