Opinion

A safe, effective outpatient treatment plan for COVID-19 exists. Why aren’t more doctors using it?

Americans want to know if any outpatient treatment can protect their health and prevent hospitalization.
Mon Jul 6, 2020 - 1:10 pm EST
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July 6, 2020 (LifeSiteNews) – Professor of Epidemiology, Dr. Harvey Risch, at the Yale School of Medicine, has written that more than 1.6 million American have been infected with COVID-19. High-risk patients realize that the likely course of hospital treatment has a high mortality rate. Dr. Risch stated that an outpatient treatment that prevents hospitalization is desperately needed.  

Americans want to know if any outpatient treatment can protect their health and prevent hospitalization. They are eager for any treatment that can help them to keep their jobs, businesses and income to provide themselves and their families. Many feel highly fearful of waiting for endless months for the hope of an unproven vaccine.  However, an internist colleague has found that his immediate medication treatment of over 60 patients with COVID-19 symptoms or who tested positive was highly effective and safe.  None of his patients have needed hospitalization.

Readers may be surprised to learn that this successful treatment protocol used in outpatients was also employed in the Detroit Henry Ford Health System double blind study of 2,541 patients with COVID-19. It  showed that hydroxychloroquine-azithromycin (HCQ-AZ) initiated immediately on hospitalization lowered the death rate of COVID-19 patients by 50%. Roughly 82% of the patients began receiving hydroxychloroquine within 24 hours and 91% within 48 hours, a factor Dr. Marcus Zervos identified as a potential key to the medication’s success.  In addition, there were no heart-related side effects from the drug. 

The recent French COVID-19 study reported the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ was associated with a case fatality rate was 0.9%.  This remarkable effectiveness of outpatient treatment was also associated with a decreased risk of hospitalization and no cases of a severe cardiac arrhythmias or sudden death. This retrospective analysis suggests that early diagnosis, early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ lead to a significantly better clinical outcome. 

Unfortunately, an unscientific bias against hydroxychloroquine and criticism of the use of HCQ-AZ has been based largely on reports of failures of this treatment that was reserved for patients who were hospitalized in severe crisis and often in ICU units.  However, antivirals, like Tamiflu or HCQ, need to be used immediately in order to be effective.  To expect a serious case of COVID-19 to benefit from a late intervention with HCQ is unreasonable. 

On July 1, 2020 the FDA update on a summary of safety issues reports similar use of HCQ to treat hospitalized patients with COVID-19 and claimed serious heart rhythm problems and other safety issues. Such reports contribute to mistrust among physicians and the American populace.  Hopefully, the FDA will report the newer research on its immediate use, effectiveness and safety in outpatient treatment and especially in early hospital treatment.

In his recent paper, Dr. Harvey Risch, at the Yale School of Medicine, cited five studies, including two controlled clinical trials, that have demonstrated significant major outpatient treatment efficacy and safety of hydroxychloroquine/azithromycin. He recommends these medications be made widely available and promoted immediately for physicians to prescribe to treat the pandemic.

Obstacles to Treatment

In many states physicians are forbidden to initiate this effective treatment for their patients by mandates of the Governor of the state which only permits prescribing HCQ in the hospital setting.  Such protocols ignore or deliberately reject the outpatient and early inpatient studies of its effectiveness in containing the pandemic.

One frustrated physician wrote of the Detroit study, “The key is that 82% of patients received hydroxychloroquine within 24 hours of being admitted. In my hospital the patients usually only received it when they landed up in the ICU or their breathing worsened: therefore it obviously did not help. But then politics in the minds of many physicians overrides their willingness to help patients as best they can. It is obvious that any treatment has to be started right away, like Tamiflu in treating the flu or hydroxychloroquine in this case. Meanwhile, Americans are not being let into the European Union because the CDC directors are bundling everyone, whether they have a positive viral test or positive antibody test, as COVID infected patients, artificially raising the amount of supposedly sick patients.” 

Another physician reported his frustrations in being able to provide the most effective treatment to his COVID-19 patients.  He called his licensing board to ask if he could use HCQ-AZ in those who test positive or who have symptoms of COVID-19.  He was informed that he would be in violation of state regulations which only permitted its use in a hospital and would be risking sanctions against his medical license. These restrictions on the scientific practice of outpatient medicine by states need to be removed as soon as possible as they have contributed to needless deaths in the past and will continue to do so.

The livelihood and health of Americans needs to be protected by permitting Americans to return to work with the protection of HCQ-AZ as has occurred in a number of countries.  Unless this occurs immediately, as a psychiatrist who is seeing a marked increase in despair in patients, we may soon be facing a major mental health crisis of severe depression and suicide.  Also, the spike in those who test positive without a rise in mortality from a weakened virus is not a solid scientific basis to prohibit a return to full employment.

Dr. Risch, professor of epidemiology, at Yale School of Public Health and School of Medicine should be immediately consulted on a national level to coordinate a safe and effective outpatient treatment protocol as occurs with most infectious diseases. The medical evidence is in. COVID-19 can be contained by proper outpatient care in addition to the continued use of proper public health measures. A disease that can be treated with a mortality rate of 0.9% does not need to wait for a vaccine.

Dr. Rick Fitzgibbons is a psychiatrist who directs the Institute for Marital Healing outside Philadelphia in Conshohocken, PA.  He has an expertise in the nature and the treatment of excessive anger.  Forgiveness Therapy: An Empirical Guide for Resolving Anger and Restoring Hope (APA Books), which he co-authored with Robert Enright, Ph.D, U-W, Madison, received in 2019 the Benedict XVI Foundation Award for Expanded Reason in Research in association with University Francisco de Victoria in Madrid. In 2019 he authored the best-selling Ignatius Press book, Habits for a Healthy Marriage: A Handbook for Catholic Couples.


  coronavirus, hydroxychloroquine

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