Yale New Haven stops using hydroxychloroquine for virus.

Hospital calls hydroxychloroquine ‘not-recommended’ COVID-19 med

NEW HAVEN — While President Donald Trump may be taking hydroxychloroquine as a preventative measure, doctors from Yale New Haven Health not only don’t recommend it, they’ve taken it off the list of drugs used for COVID-19 patients.

Dr. Thomas Balcezak, chief clinical officer for the health system, said Tuesday that, as of Monday, “we have moved it from a possible drug to a not-recommended drug.”

Hydroxychloroquine has been used to treat malaria, but it comes with significant side effects, including heart arrythmias, and “has significant toxicities associated with it,” according to Dr. Richard Martinello, medical director of epidemiology and infection prevention.

Martinello said “a small number of patients” have developed complications. “And because we haven’t seen any clear benefit either in the care that we’ve provided, in the medical research that’s been performed to date, and because we are very aware of these potential risks that this drug has … it’s been removed from our recommendations for treatment for patients.”

Trump told reporters on Monday that he’s been taking the drug for about 10 days, along with zinc, after being in close contact with staff members who have tested positive for COVID-19.

Balcezak, asked about Trump’s use of the drug, said he would not respond directly about the president’s taking it.

“My personal recommendation is I think it’s a mistake,” he said. “We’ve used hydroxychloroquine, but we’ve used it in a setting where the patient has been in the hospital, on a heart monitor and monitored. But this drug does have side effects, and those side effects can be dangerous in certain patients. And if it’s not effective against the virus, which the scientific consensus now is that it is not effective against the virus in humans, then we shouldn’t be using it.”

Balcezak said the health system has been using remdesivir, a drug originally developed to treat hepatitis C and Ebola and which has shown some effectiveness against other coronaviruses, such as SARS and MERS.

“We have an adequate supply now to treat all patients who qualify for remdesivir within our health system,” Balcezak said. “The efficacy of that drug, how it changes the natural history and the course of this disease, is relatively modest. It shortens length of stay by a couple of days and hasn’t yet been proven to change the risk of mortality. And I think it’s important for all of us to remember that we are searching for a magic bullet, whether it’s a virus or a drug, and yet right now we have none of those things.”

He said the more important treatments are oxygenation of patients with diminished lung capacity, “proning” — lying patients face down to avoid using a ventilator and supportive care.

“Our treatment has demonstrated that we are at least as good if not better at treating these patients, as evidenced by our mortality rate, than virtually anyplace else that has seen the volume of patients that we’ve seen,” Balcezak said.

Also Tuesday, Yale New Haven Health CEO Marna Borgstrom reported that the total number of COVID-19 patients was down to 388, a decrease from 487 last week: 248 at Yale New Haven Hospital, 99 at Bridgeport Hospital, 20 each at Greenwich and Lawrence and Memorial hospitals and one at Westerly Hospital in Rhode Island.

Balcezak said the number of COVID-positive patients who have been treated with pediatric multisystem inflammatory syndrome is five, now that the Centers for Disease Control and Prevention has defined the syndrome. Previously, Yale New Haven had reported 10 confirmed or suspected cases. He said there have been about 100 cases nationwide.

“One has been successfully discharged to home,” Balcezak said. “One is currently in our ICU and recovering,” while three others have been moved from the intensive-care unit to a medical floor.

Balcezak said the health system is looking toward opening five more coronavirus testing sites to add to the seven now open across the state, with two of them likely in New Haven, and that the goal is 5,000 tests per day.

Martinello said, “We are now testing nearly a thousand patients a day for COVID and that includes all of our patients that are being hospitalized.” He also said Yale New Haven has held “close to 120,000 telehealth visits” since January, when the service was “relatively modest” in scope.

Martinello also said 887 staff members have tested positive for COVID-19, out of more than 20,000 staff statewide. “While 887 sounds like a very large number, and it is, is this is a rather small part of our staff overall,” he said.