Contested effects and chaotic policies: the 2020 story of (hydroxy) chloroquine for treating COVID‐19

During the past 12 months chloroquine and hydroxychloroquine have been touted as miracle cures for COVID‐19 and introduced into COVID‐19 treatment protocols in Asia, Africa, and North and South America (see Figure 1). This has led to massive increases in demand such that patients with rheumatoid arthritis and lupus have been deprived of effective treatments.

A Cochrane Review by Bhagteshwar Singh and colleagues definitively concludes that hydroxychloroquine has no clinical benefit in treating COVID‐19 in hospitalized patients.[1] The dissemination of information on these drugs in the scientific press and other media has been rapid and tumultuous with strong and polarized opinions among scientists, politicians, and the general public, building a climate of mistrust. Potential resulting harms included wasted resources (including research capacity) and drug shortages for evidence‐based indications. The false hope instilled may have also led to unsupervised use of potentially harmful medications. While most national and health system‐level guidance is evidence based, how did we get into such a chaotic and confusing situation with the assessment of chloroquine and hydroxychloroquine efficacy?