'I'm not surprised' FDA revoked hydroxychloroquine COVID-19 use: Expert

Senior scholar at Johns Hopkins Center for Health Security Dr. Amesh Adalja joins Yahoo Finance’s Melody Hahm to discuss the FDA pulling its emergency use authorization for hydroxychloroquine and chloroquine to treat the coronavirus.

Video Transcript

MELODY HAHM: And for more on the coronavirus and the latest developments on increasing outbreaks, several states, including Arizona, Arkansas, California, Florida, North Carolina, South Carolina, Utah, experiencing record or near record one-day increases in new cases over the weekend. Texas and North Carolina reported record numbers of COVID-related hospitalizations on Saturday.

And we want to dig into this with Dr. Amesh Adalja, who is the Senior Scholar at Johns Hopkins Center for Health Security. Thanks so much for joining us today.

AMESH ADALJA: Thanks for having me.

MELODY HAHM: So you published a really interesting op-ed this morning in the "Washington Post" with the headline "Protest? Visit grandma? The pandemics next phase means weighing risks and values." And you really show how nuanced this conversation is right now as we grapple with COVID and civil unrest. Can you kind of give us a sense of you sort of representing the medical community and how you view these protests during this time?

AMESH ADALJA: You have to remember that nothing in the era of the pandemic is going to be risk free, that everything is going to carry the risk of transmitting or contracting the virus until there is a vaccine. But people are going to go about their lives, and there are going to be values that they want to pursue such as protesting police brutality, such as protesting racism that are going to outweigh that risk.

And I think it's important as public-health professionals, as infectious-disease physicians, we give people the ability to do that and also do it safely by giving them recommendations for how they can do these activities, whatever they might be, in a way that minimizes the risk but knowing that you're not going to get the risk down to zero. And we have to go forward in this new phase of the pandemic and try to find a middle way where the virus is controlled to the extent that it can be controlled and people are able to go about their lives and pursue their values.

MELODY HAHM: And sort of like investors, right, thinking about risk and weighing the cost/benefit analysis as they try to determine whether they want to invest in a stock, your op-ed rightfully points out that everyone's risk appetite is different. When you think about the protests that have happening-- and I've seen so many folks who are doctors and nurses wearing signs, wearing posters that say white coats for black lives, right? When you see this sort of confusion, perhaps, as people are being told to stay home but then there are medical experts who are really championing this cause, what do you say to kind of the average American who's trying to figure out am I allowed to go out? Should I be staying home? You know, what's the calculus there?

AMESH ADALJA: You have to remember that the stay-at-home orders and the enforced social distancing was about hospital capacity. And in many parts of the country right now, hospital capacity is OK. There is not a strain on hospitals. We have a little bit of difference in Arizona where there is some strain, but most places it's not.

So when you think about an activity, you really have to think what is my risk-- what are my risk factors for severe disease? How important is this activity for me? And can I do it in a safe manner? And what is my risk tolerance? Am I somebody that's really, really afraid of getting this virus, or am I somebody that's a little bit more risk tolerant?

And I think that's going to be different for each person. So as a physician, you kind of have to meet people where they are and talk about their concerns, address their concerns, and try to find a way to reduce the harm that the virus causes them knowing that there are going to be activities that are going to carry some risk with this virus.

And it's not going to be easy. It's not going to be black or white. It's not going to be one size fits all, and it's going to be something that we have to incorporate into our risk-- our risk profiles as we step out the door-- every time we step out the door, just like we do with other risks. And I think we have to get to that place in this pandemic, at the same time trying to control it with contact tracing, diagnostic testing, antiviral and vaccine development. But we have to find a middle way to go through this.

MELODY HAHM: And, of course, one area that has actually been shut down as not really effective in helping COVID is the use of chloroquine and hydroxychloroquine to really treat these potential COVID cases. Of course, it's used for malaria, lupus, and other things, but the FDA did revoke the emergency-use authorization of those drugs.

What is your reaction to this? Even in the early aughts in March when Trump announced that this would be useful, what was your initial response? And then now are you surprised that those have been revoked?

AMESH ADALJA: No, I'm not surprised that they've been revoked. This is a politicized decision regarding hydroxychloroquine when it was given the emergency-use authorization. So this wasn't something that was actually supported by the science.

We know that there is an effort to try and understand if hydroxychloroquine has some benefit and treatment or prophylaxis against this coronavirus, and the data that's emerging is showing that it really does not have that effectiveness and it's not something that should be routinely used by doctors. We still have some more clinical-trial data that's going to come in, but it's not looking like this is going to be a promising treatment or prophylactic. And the side-effect profile is something that is dangerous, and you don't want to actually ignore that and just give it to everybody the way that some people have advocated.

So I do think this was an expected move by the FDA, and it really reflects the fact that the growing evidence of clinical data does not support the effectiveness of hydroxychloroquine.

MELODY HAHM: I mean, I know it's 2020, right, so everything seems to be political to a certain extent, but even your sort of one-line response of saying, yes, this was more of a political move for the FDA to approve this, isn't that deeply problematic in trying to really inform the average American of what kind of information and what sources they should be listening to? Because if the FDA did approve this early on, I think there is a little bit of whiplash, right, that folks must be experiencing.

AMESH ADALJA: Definitely. When you're in a public-health emergency, what you really need are trusted sources of information. That means public-health authorities, physicians, scientists that are speaking directly to the public about what's known, what's not known, what the questions are that are being answered, and trying to understand how this is going to evolve.

And what you don't want is politics being injected into that where what drug you take or what drug you recommend reflects more your party affiliation than actual science. And that's what's happened throughout this whole pandemic, and it's been very hard to navigate because any type of position you take automatically is seen in the light of a political party or a political position, and that's not how we want to manage an infectious-disease emergency. We want it to be science and medicine guiding policy and not allowing politics and politicians to inject themselves into something that they don't know anything about and actually create more harm by involving themselves in.

MELODY HAHM: Thank you so much. Dr. Amesh Adalja, the senior scholar at Johns Hopkins Center for Health Security, really appreciate your insights.

AMESH ADALJA: Thank you.