Miracle drugs not best way to defeat COVID-19 outbreak

The COVID-19 pandemic is no different than any other outbreak where we do not have a treatment or a vaccine for a disease, in that we depend on proven public health strategies.

Let us be clear about what public health does and what it does not do. Public health protects and improves the health of all people and communities.

Life expectancy has more than doubled in the last two centuries, but not from any miracle drug. The vast majority of improvement has come from the public health playbook: clean air and water, sanitation, control of infectious diseases, immunizations, reduction of infant mortality, and early detection of cancer.

More recently, the challenge has shifted to tackling chronic diseases like heart disease, diabetes and chronic lung disease, which cause three quarters of healthcare costs and deaths and are often caused by modifiable behaviors.

To control the spread of COVID-19, good hygiene and sanitation practices include handwashing and proper use of masks and protective equipment. Testing, disease investigation and contact tracing, as well as isolation and quarantine, have been key strategies in countries that have effectively controlled outbreaks.

Early data show that our state’s community mitigation strategies to decrease spread — cancellation of public gatherings, stay-at-home orders, school closures, social distancing—are helping us flatten the curve.

Unproven treatments risk more harm than good

What public health does not do is endorse treatments that are unproven or may cause more harm than good.

The annals of medical history include examples of highly touted but failed treatments.

Thalidomide was marketed for morning sickness in pregnancy but discovered to produce devastating birth defects. Isotretinoin, used to treat severe acne, is also linked to birth defects and now includes that caution and safety measures when prescribed.

Today there is a lot of attention on a drug called hydroxychloroquine (approved to treat malaria and lupus) based on anecdotal reports that it may help patients with COVID-19.

Conflicting reports already show it does not help. Concerns exist about the known side effects such as heart rhythm problems (especially when combined with the antibiotic azithromycin) or interaction with a commonly used diabetes medicine metformin.

Controlled studies are under way, and we await their results.

Let us rely on what works

On the other hand, immunization is a proven strategy to stop infectious diseases.

In my lifetime, I have seen it almost eliminate polio and markedly reduce meningitis, measles, and mumps.

When we have a safe and effective vaccine against this coronavirus, the local public health department will be working with our healthcare partners to get our community immunized. Just like we did with the H1N1 pandemic eleven years ago.

Until there is a cure or a vaccine, public health will continue to use proven strategies from the public health playbook.

I want to thank everyone for being patient and helping by observing good hygiene behaviors and social distancing.

Dr. Anthony L-T Chen is director of health for the Tacoma-Pierce County Health Department.

MORE INFORMATION ONLINE

Learn more at www.tpchd.org/coronavirus

This story was originally published April 11, 2020 at 12:00 PM.