FEMA ships out nearly 20 million hydroxychloroquine tablets

The Strategic National Stockpile has sent out 19.1 million tablets of hydroxychloroquine, the malaria drug that some doctors have prescribed to Covid-19 patients, a spokesperson for the Federal Emergency Management Agency confirmed. The tablets, sent out in two shipments, are heading to cities around the country.

About 10.1 million are going to the Departments of Defense and Veterans Affairs, as well as Washington, D.C.; Baton Rouge; St. Louis; Philadelphia; Baltimore; Miami; Milwaukee; Indianapolis; Houston and Pittsburgh.

Another shipment, of 9 million tablets, is headed for Detroit, New Orleans, New York City and Chicago, according to the spokesperson.

Those last four cities — particularly New York — have been hit hard by the pandemic. Others slated to receive the medication have fewer cases but may face upticks. Allegheny County, where Pittsburgh is located, has fewer than 900 cases, according to the Pennsylvania Department of Health. And Milwaukee County has fewer than 2,000, per its county government. Miami-Dade County, meanwhile, has 7,555 confirmed cases of the illness, according to the Miami Herald. And Cook County in Illinois has had more than 15,000 cases, per the county’s Department of Public Health.

Erin Fox, senior director of Drug Information and Support Services at the University of Utah College of Pharmacy, said most courses of hydroxychloroquine treatment for Covid-19 take 12 to 14 tablets. So the shipments will cover treatment for about 1.4 million patients.

“It’s a lot,” she said.

Fox added that the data on the drug’s efficacy for coronavirus patients is anecdotal, as there have been no clinical trials showing that hydroxychloroquine is effective in treating Covid-19.

“It doesn’t seem like it’s the miracle cure that some folks have talked about it being in the press,” she said. “It’s hard to know.”

President Donald Trump has touted the drug on Twitter and at White House briefings on the pandemic — even musing at one point that he might take hydroxychloroquine himself. He announced last week that the stockpile had amassed some 29 million doses, after reports of furious infighting within the coronavirus task force over whether to recommend the drug’s use.

The national debate over hydroxychloroquine has at times taken on the flavor of a culture-war issue: Some of Trump's closest allies, including Fox News host Sean Hannity and attorney Rudy Giuliani, have highlighted it as a potential remedy, while Democrats and the scientific community have generally urged caution.

Hydroxychloroquine has been in use for decades, primarily to treat malaria. In late March, however, the Food and Drug Administration granted emergency approval of the drug’s use to treat the illness caused by the novel coronavirus. Thus far, there isn’t reliable data on whether it works.

Administration officials have stressed that the choice of using hydroxychloroquine, which is often combined with other drugs such as azithromycin, is a matter between doctors and their patients.

But some medical experts have raised concerns about widespread use of the drug, which can have dangerous side effects under some circumstances. It could also lead to shortages for proven uses of hydroxychloroquine — for lupus and rheumatoid arthritis, for instance.

Dr. Irwin Redlener, who heads Columbia University’s Center for Disaster Preparedness and studies pandemics, told POLITICO he worries the move will put some patients at risk.

“There’s at this moment no conclusive evidence that it is safe or appropriate to use that medication for Covid-19,” he said. “This has become some kind of weird pet obsession with Donald Trump that has somehow been absorbed by governors and others around the country, although I think you’d be hard pressed to find any physician or public health expert who could say that it is safe to use.”

His concerns are not universal. Dr. Michael Ganio, senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists, said he is not particularly concerned about hospitals using the drug for inpatient treatment. He said he worries more about reports that medical doctors have prescribed the medication for their friends and family to take at home.

“The role of hydroxychloroquine has not been clearly established, so prescribing it for anyone to have on hand in case they get sick or to take daily to prevent the infection — we have no idea what the role is,” he said.