“If I’m out in the community and I’ve got somebody who’s dying of course I would do whatever I could to try and help them,” said Dr. Tim Schacker, the vice dean for research and an infectious disease specialist at the University of Minnesota medical school.
A number of hospitals were giving coronavirus patients hydroxychloroquine, an old, inexpensive and relatively safe malaria drug that lab studies indicated might keep the coronavirus from invading human cells. Reports of its use in patients in China and in France have suggested that it may help, but there is not enough data to be sure.
Nonetheless, the idea is catching on, so much so that shortages of the drug are being reported.
In Seattle, many hospitals have signed up to enroll patients in a clinical trial of Gilead’s experimental antiviral drug remdesivir. The trial is a controlled study, meaning that some patients will be picked at random to receive placebos rather than the drug — the gold-standard type of study to determine whether a drug really works.
Dr. James Town, director of the medical intensive care unit at Harborview Medical Center in Seattle, said that the first choice for most patients would be the remdesivir study. Those not eligible for the study could apply to the Food and Drug Administration for “compassionate use,” special permission sometimes given to receive an experimental drug outside of a study.
After remdesivir, Dr. Town said, the next choice would be hydroxychloroquine, as long as the patient did not have abnormalities in heart rhythm, which would make the drug unsafe.
For critically ill patients suffering from intense inflammatory reactions, called a cytokine storm, some centers are trying a drug called tocilizumab.
“That’s the creative juice we need right now, as we try and take care of these patients literally on the run,” Dr. Schacker, from the University of Minnesota, said.