The dangerous illusion of alternative anti-COVID remedies

Antimalarials, deworming, Ayurvedic remedies and other ineffective solutions, often touted by politicians.

Agnese Codignola has a degree in chemistry and pharmaceutical technologies. After years in the field of research, she has devoted herself entirely to journalism. Today he collaborates with the main Italian publishing groups (RCS, Espresso-Repubblica, Il Sole 24 Ore, Focus-Mondadori and others) dealing with health, nutrition, environmental sustainability and science in general. His latest book is “The fate of food. So we will eat to save the world “(Feltrinelli, 2020).

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L’last, in chronological order, is ivermectin, an anthelmintic – that is a dewormer – used in veterinary medicine and sometimes also on humans, which is becoming popular in Latin America. To the point that Peru, Argentina, Bolivia and Guatemala are producing and distributing hundreds of thousands of doses. But the over-the-counter anti-worms is not alone: ​​it comes after the Madagascar Covid-Organic syrup, sold to at least two dozen African countries by the enterprising Malagasy president. After Ayush-64, one of the Ayurvedic remedies touted by the special Indian ministry, whose budget has tripled for this purpose. After the Xuebijing, passed with full marks (on trust) by the Chinese Ministry of Health along with other traditional medicine medicines, because if they cure colds they don’t hurt. After the African agencies have drawn up protocols with the WHO to try to start studying dozens of traditional treatments that are circulating without any rules on the continent. And after many Western countries have unashamedly and without scientific basis embraced the use of the antimalarial hydroxychloroquine, only to then make a sensational reverse and trim tons of drug now useless to more defenseless countries.

There is a parallel story to that of the gigantic effort underway by official research, which is painstakingly verifying dozens of anti-COVID drugs, gradually excluding almost all of them, and trying to understand if, beyond the amazing ads, there is getting really close to a satisfactory and safe vaccine. A story that takes on very evident political-anthropological veins: those of the remedies provided they are, those of the answers that many rulers, especially (but not exclusively) populists, want to offer their citizens at all costs, to reassure them and play saviors. And it doesn’t matter if they are dangerous falsehoods that leverage on despair, on the impossibility of access to health care, on the misplaced trust in traditional medicines, concretized in “drugs” which, at best, either do nothing or they are active in vaguely (sometimes very, very vaguely) similar pathologies – and the analogy often means nothing in this field -, remedies that in addition expose those who are willing to believe in them to two types of risks: those of not resorting to treatment really effective (and there are some such as heparins, cortisones and, to a small extent, the antiviral remdesivir,

While waiting to understand if we are really approaching a satisfactory and safe vaccine, “creative” and ineffective solutions, often touted by politicians and heads of state, are depopulating.

The WHO is worried, and is making continuous appeals for governments to avoid, the sick do not listen, doctors do not lend themselves. But the results are practically nil, especially when governments are the first sponsors. And the story of ivermectin, from this point of view, is exemplary.

Clandestine Pharmacology As told by Nature , which like other scientific journals continues to follow this “clandestine” pharmacology, anthelmintic, which costs very little, has been used for decades in animals, and sometimes in people, but has become even more popular last May, when Bolivia, through its health workers, distributed 350,000 doses to some populations in the north of the country. A few weeks later the Peruvian police seized 20,000 doses of the veterinary version sold on the black market for humans, but in July the government of the same country announced plans to produce 30,000 doses, to meet domestic demand.

All this without there being any demonstration of an anti Sars-CoV 2 effect, except in a few studies on cell cultures. In April an Australian study, which came out unrevised, actually suggested that high doses of ivermectin reduced viral replication in vitro. Immediately after another, always uncontrolled, hypothesized a lowering of mortality in patients, but was soon withdrawn, because it was based not on real data, but on virtual data, purchased by a company at the center of a scam, the Surgisphere. A few more were started later (on very few people), and there seems to be some positive clue, but there is no verifiable data for now. They would like to conduct them on larger populations, but all researchers run up against a huge obstacle: In the meantime, already in 2018 an investigation pointed out all the risks: from tremor to lethargy, from disorientation to coma, especially at high doses.

Even more serious consequences could have the spread of Covid-Organic , the Malagasy syrup advertised by none other than President Andry Rajoelina , which according to Science could lead to the annihilation of one of the last weapons that still have some effect against malaria, especially in Africa.

The use of artemisin against COVID-19 in Africa could lead, in a dramatic chain reaction, to millions of new victims of malaria.

The debut was with a bang: in April the same Rajoelina announced that the mixture, made by the Malagasy Institute of Applied Research or IMRA, but whose exact composition is unknown, would cure two patients. The National Academy of Medicine of Madagascar has taken just position, calling for caution, but it did not help: Tanzania and Democratic Republic of Congo immediately announced by the mouth of presidents, of wanting, of the syrup, and a lot. And later other African countries bought it up.

The problem is that in that syrup there is artemisin, the active ingredient of a plant, Artemisia annua , which is among the very few antimalarials still effective in some parts of the world. To the point that it is never given, for this purpose, alone, precisely to avert or at least delay the development of resistance. It is easy to imagine what could happen if it were taken by millions of people across Africa: a disaster that would leave millions of new malaria victims behind.

The idea of ​​proposing it as an anti Sars-CoV 2 stems from a 2005 Chinese research on SARS, in which, in vitro, something was seen, but nothing more. In fact, artemisin has never been studied in animals or in humans for any coronavirus. And it is not clear why, if it works a little on a protozoan like that of malaria, it should act against a virus: they are two very distant entities, from a biological point of view. The African Union, as well as the African CDCs (Centers for Disease Control) have asked for numbers, data, facts, but have so far received no answers.

India and China
Another alarm comes from India, where Health Minister Harsh Vardhan himself began recommending Ayurvedic medicine for the lighter forms of COVID in spring, supported by colleagues from the Ministry for Ayurveda , yoga and naturopathy, Unani (medicine of Arab-Muslim ancestry), Siddha (medicine from Tamil Nadhu) and homeopathy or AIYSH, created by the Modi government in 2014, to which the funds were tripled, passed to 290 million dollars. Again, the Indian Medical Association (IMA) immediately asked for evidence, openly speaking of fraud to the nation, but it didn’t help. Patients must trust and hope that mixtures of hot pepper, ginseng and other herbs will work the miracle, along with the 4-herb blend called Ayush64, which has been patented since the 1980s. According to the secretary of AIYUS Vaidya Rajesh Kotecha , there are dozens of studies of all kinds on it: in vitro, on animals and in humans. Too bad that these are studies conducted with methodologies not recognized by any scientific community and, above all, data extrapolated from studies conducted on other diseases, not on COVID. For example, reports Science, Ayush 64 would be tested in 38 people with flu symptoms, who were already taking acetaminophen and other medications. Even if it had worked, it is by no means certain that an anti-flu can act against Sars-CoV2, and it is indeed unlikely, because they are very, very different viruses.

Nature also spoke about the situation in India , which in recent days published a dramatic article in which it denounced the approval, by the local agency for medicines, of drugs used for other purposes (with the so-called repurposing). Among them is the antiviral favipiravir, which has already proved to be bankrupt and excluded in many countries, which has instead been given a green light for use in an emergency, without however anywhere explaining what is meant by emergency in India. Now it will be produced by three companies that offer 3 different dosages (200, 400 or 800 mg), and even in this case the reason, nor the possible differences in use, has not been disclosed, but in the meantime the drug has also been approved in Russia and China. And then there is the monoclonal antibody used for psoriasis itolizumab, also approved in Cuba, for which there are the data of about thirty patients, never disclosed to the international scientific community.

In recent months, Chinese government agencies have advertised everything: two dozen types of pills, decoctions, herbal teas, powders and injectable substances.

In this scenario, China also sent its traditional remedies to Italy last spring, together with doctors and nurses who came to the aid of the Lombard health system, and which recommends them, also in this case, through the Ministry. of health and the Administration of traditional medicine. In recent months, reports Nature , government agencies have touted everything: at least two dozen types of pills, decoctions, herbal teas, powders and even injectable substances, stating that at least three of them were of proven effectiveness.

Effectiveness emerged, according to China Daily, in studies such as the one on Jinhua Qinggan, herbal granules developed against avian flu in 2009, which would negativize the tampon in 2 days, or the one on Xuebijing, a mix of 5 herbs that would act by detoxifying and moving the stasis of the body fluids and, when given together with less traditional drugs, would reduce mortality by 8%. The details are not known, of course: you have to believe it, and that’s it. But it is known that many decoctions contain ephedrine, a stimulant and anorectic substance obtained from Ephedra, a plant, which was banned in Europe and the United States as early as the nineties due to numerous deaths with which it was associated, and a toxicity relevant to the heart and other organs. The WHO, which warned in the first months that these therapies were not effective and could be dangerous,

The infatuation of Europe and the USA with hydroxychloroquine
If in poorer countries and where access to medicine is more complicated, politicians rely more on less than anything and reach unattainable heights, such as that of North Korea – where the ‘official media outlet Rodong Sinmun invited people to stay at home not for lack of personal protection devices, but because the Sars-CoV 2, officially absent from the country, could arrive with the wind directly from the Chinese Gobi Desert, carried from the yellow grains of sand for over 1,900 km -, even in the most developed ones, excesses have been seen and still are seen that would be spectacular, if they did not have dramatic consequences.

For months, former President Donald Trump has advertised the use of the antimalarial hydroxychloroquine, a drug whose heavy side effects have been known for decades and which had never shown antiviral activity, despite having been tested on Zika over the years. chikungunya, Ebola, Epstein-Barr, swine fever and more, as recalled by a comprehensive review published in April in the Canadian Journal of Medical Association. On the contrary, it has sometimes made the situation worse. But several heads of state including Emanuel Macron – who for a few weeks was fascinated by Didier Raoult, a much discussed doctor from Marseille (who denies Darwinian evolution and climate change, to stick to his most imaginative claims), convinced advocate of the antimalarial -, and Jair Bolsonaro, at some point, decided that that was the solution. And also Italy has reconverted the production of the military pharmaceutical plant in Florence to increase its synthesis, since those who used it for some rheumatic diseases and lupus were in danger of being left without. All before there was evidence. Which, however, soon arrived in abundance, and brought all of themWestern regulatory agencies (FDA, EMA and, subsequently, national ones) to speak out against  hydroxychloroquine, which does nothing to Sars-CoV 2 and is harmful.

None of this has anything to do with medicine and science: it’s politicization and consensus-seeking in the anti-COVID drug race.

As Science pointed out in an article devoted to the politicization of the anti-COVID drug race, none of this has anything to do with medicine and science. And with hydroxychloroquine there was an epilogue that makes it clear that there are no great distinctions between countries, when it is decided to please the electorate, and not to follow science itself, taking on the burden of telling the truth.

The Bayer pharmaceutical company had donated 200 kg to the United States, equivalent to 3 million doses. The Reuters , with exclusive investigation, he discovered that it was the Resochin, a product not approved in the US for serious deficiencies in the synthesis process in two plants in India and Pakistan, never certified nor authorized. At that point, since, in the meantime, the first doubts about efficacy also began to emerge, Trump found himself very generous, with a friendly country: he sent two million doses of hydroxychloroquine to the Brazil of the king of deniers Bolsonaro (without specifying , at least officially, where it came from). It remains to be seen what happened to the missing million, since it did not appear on the list of drugs that saved the former president.

The same dynamics, unfortunately, are being seen with the vaccine rush: governments that believe in the press releases of companies, launched by financial press organs, without waiting for the publication of the complete numbers in the appropriate forums. Government agencies that trust those – very smoky and opaque – about a few dozen volunteers chosen from tens of thousands of participants without a clear criterion. Ministries that decide to buy millions of doses without waiting for safety data, and so on. But the show, you know, must always go on. Even and especially in times of pandemics.

 

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