(EDITOR’S NOTE: The following is a July 11 letter Fareed penned to Congressman Juan Vargas and others in the federal government, including President Donald Trump. Fareed submitted it as an op-ed to be run in its entirety.)
My name is Dr. George Fareed. I am a physician in Imperial County, California, that has been hit hard by the COVID-19 pandemic. I take care of patients on both an outpatient and inpatient basis, as well as nursing home patients, the most vulnerable among us.
In this letter, I am proposing a medical strategy that can help us not only through this current crisis, but also that will enable us to approach outbreaks of COVID-19 that may occur in the future.
In my attempts to keep people alive, I have had an opportunity to use many different types of treatments — remdesivir, dexamethasone, convalescent plasma replacement, etc. Yet, by far the best tool beyond supportive care with oxygen has been the combination of hydroxychloroquine (HCQ), with either azithromycin or doxycycline, and zinc. This “HCQ cocktail” (that costs less than $100) has enabled me to prevent patients from being admitted to the hospital, as well as help those patients that are hospitalized. The key is giving the HCQ cocktail early, within the first five days of the disease.
Not only have I seen outstanding results with this approach, I have not seen any patient exhibit serious side effects. To be clear — this drug has been used as an anti-malarial and to treat systemic lupus erythematosus as well as rheumatoid arthritis and has over a 50-year track record for safety. It is shocking that it only now is being characterized as a dangerous drug.
Moreover, I am in my 70s, and I (as well as some other older physicians in the hospital) use hydroxychloroquine and zinc as prophylaxis. None of us have contracted the disease despite our high exposure to COVID patients nor have we experienced any side effects.
Despite the characterization in the mainstream media as the drug being “ineffective” and “dangerous,” the evidence in the literature tells a different story. I am not only an “MD,” but a former Harvard Medical School assistant professor and UCLA School of Medicine associate professor as well and am very competent at evaluating studies. There is ample evidence now that the HCQ cocktail is effective, and there is no good evidence that there are significant side effects.
Yet, like many of my colleagues in the trenches treating COVID, I find myself being obstructed on different levels from treating my patients with hydroxychloroquine. The next option is remdesivir, which in my opinion is inferior and very expensive. Moreover, that drug is not readily available, and is rationed by hospitals. Despite the representations by Dr. (Anthony) Fauci and others, there is less evidence supporting the use of remdesivir than hydroxychloroquine.
To be clear — hydroxychloroquine is normally not helpful when given to very ill patients. Unfortunately, most of the studies have evaluated this drug only in that context. The HCQ cocktail is best used to prevent patients from getting to that dire stage.
This is all so tragic because the use of HCQ cocktail would solve some of the very basic problems we are now facing:
#1 The HCQ cocktail can be used for outpatients to prevent hospitalizations and thus keep our hospitals and ICUs from being overrun with COVID patients.
#2 The HCQ cocktail can be used early on in hospitalization to prevent patients from requiring mechanical ventilation and reducing the length of hospital stay.
#3 HCQ/zinc can be used for prophylaxis for high risk individuals including front line health providers, first responders, and even teachers who are at high risk for COVID.
As a physician, I am committed to my patients as well as doing my part to solve the COVID crisis. It has been deflating to see how the “science” has been corrupted and manipulated in an effort to disparage hydroxychloroquine. The fact that both Lancet and the New England Journal of Medicine had to retract articles relevant to hydroxychloroquine due to gross manipulation and mischaracterization of data goes to the heart of what is best characterized as a smear campaign.
As an example of the faulty science — one study (University of Minnesota) was cited in the mainstream media as disproving the effectiveness of hydroxychloroquine as “prophylaxis.” Yet the patients received the drug one to four days AFTER exposure. That is not prophylaxis at all — the drug must be taken PRIOR to exposure. This is just one example of the non-scientific way the drug has been evaluated and the subsequent mainstream media mischaracterizations.
I am writing to you out of the frustration of knowing that there is a solution but watching as our country flounders in dealing with COVID-19. In my opinion, tens of thousands are dying unnecessarily. Our current approach of waiting for these high-risk patients to become ill and then hospitalizing them is failing. The answer is early diagnosis of the high-risk individuals, and then treating them as outpatients with the HCQ cocktail to prevent hospitalization.
So, what I am proposing is a drastic shift from our current approach: we need to ramp up our outpatient efforts of treating COVID-19 to decrease the burden on hospitals and save lives. Such an approach requires an effective outpatient treatment — we have that in the HCQ cocktail.
How do we get there? I propose a Congressional hearing in which our elected representatives could listen to clinicians like myself and researchers specifically regarding the HCQ cocktail (as well as the HCQ/zinc prophylaxis treatment), and how it can help us change to a model focused on outpatient treatment and prevention as opposed to a hospital-based approach only treating patients when they become ill. The FDA and CDC should be there as well given that they are the agencies that formulate the drug policies.
We need a medical strategy, not only for now while we are in a crisis, but for the future. There is no guarantee that a vaccine will rid us of COVID-19. If we had a strategy, we would not have to shut down American life, especially schools, every time there is an outbreak.
We should be seeking a solution that will save as many lives as possible, and the outpatient-based approach that I and some other doctors have been advocating will best accomplish that goal.
I hope you consider my proposal, and I look forward to hearing from you.
Sincerely yours, George C. Fareed, M.D.
CMA Rural Physician of the Year 2015 Brawley, CA 92227