Chloroquine May Fight Covid-19—and Silicon Valley’s Into It

(Johns Hopkins did not return a request for comment; a spokesperson for Stanford Medical School emails: “Stanford Medicine, including SPARK, wasn’t involved in the creation of the Google document, and we’ve requested that the author remove all references to us. In addition, Gregory Rigano is not an advisor with Stanford School of Medicine and no one at Stanford was involved in the study.“)

It turns out that people have been pitching chloroquine as an antiviral for years. In the early 1990s researchers proposed it as an adjunct to early protease inhibitor drugs to help treat HIV/AIDS. A team led by Stuart Nichol, the head of the Special Pathogens Unit at the Centers for Disease Control and Prevention, published a paper in 2005 saying that the drug was effective against primate cells infected with SARS, the first big respiratory coronavirus to affect humans. That’s an in vitro test, not live animals—just cells.

Nichol didn’t respond to a request for comment, but a CDC spokesperson emailed this: “CDC is aware of reports of various medications being administered for either treatment or prophylaxis for COVID-19, including those demonstrating in vitro activity against SARS-CoV- 2. At this time, it is important to ensure robust clinical data, gathered from clinical trials, are obtained quickly in order to make informed clinical decisions regarding the management of patients with COVID-19.”

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At a World Health Organization press conference in February, a reporter from the fact-checking group Africa Check asked whether chloroquine was an option. Janet Diaz, head of clinical care for the World Health Organization Emergencies Program, answered that WHO was prioritizing a couple of other drugs in testing along with remdesivir, and acknowledged that Chinese researchers were working on even more. “For chloroquine, there is no proof that that is an effective treatment at this time,” Diaz said. “We recommend that therapeutics be tested under ethically approved clinical trials to show efficacy and safety.”

Chloroquine and an alternative version called hydroxychloroquine seem to work on viruses by inhibiting a process called glycosylation, a chemical transformation of the proteins in the virus’s outer shell that’s part of the infection process. Chinese researchers have initiated perhaps a half-dozen randomized trials of the two versions in humans and gotten at least some promising initial data.

With that data in mind, a French infectious disease researcher named Didier Raoult published a fast review of existing in vitro studies of chloroquine and hydroxychloroquine, and (along with some other researchers) has recommended not only spinning up research in humans but also starting to use the drugs clinically. (Raoult didn’t return a request for comment, but a publicist at the hospital where he works sent a link to a video in which Raoult presents data he says shows efficacy in a small group of actual humans. That data hasn’t been published or peer reviewed.)

Except for that video, which hadn’t come out yet, Rigano put all that together and got in touch with Todaro. “I essentially wrote the publication based on my interface with various Stanford researchers and others, and we developed this body of evidence and hardcore science,” Rigano says. “James, Dr. Todaro, was doing the best job, I thought, of anyone in the media, any doctor, any news outlet, anyone on Twitter, of covering coronavirus. I’d been following his research on other items, like decentralized computing, for several years.”

Todaro, who got an MD from Columbia and is now a bitcoin investor, was interested enough to collaborate on the document. “I added stuff that pertained more to the medical side of things, and gave a more, I guess, clinical feel to it,” Todaro says. “Something that Big Pharma is not going to like—it’s widely available, it’s pretty cheap, and it’s something that at least a million people are already on. It’s really got a lot of the aspects of something that can be rolled out quickly if the right clinical data is there.”

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