Opinion: Michigan’s doctors fight coronavirus, and governor's office

Kathy Hoekstra

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The coronavirus is unquestionably a significant threat to the health and safety of people throughout the world. The infection’s worldwide death toll is more than 23,000 and counting, 1,163 in the United States and 60 here in Michigan.

There is a silver lining however, in the numbers of people who are recovering from COVID-19 — more than 122,000 at this writing.

Michigan Governor Gretchen Whitmer speaks during a press conference Thursday in Lansing.

Even greater hope lies in a promising new treatment using a combination of old drugs: Plaquenil (hydroxychloroquine) and a Z-Pak (azithromycin).

These well-known drugs have very favorable safety profiles. Several small studies have shown significant reduction in viral loads and symptom improvement when combining these medications in COVID-19 patients. Though these studies are small and do not prove efficacy, the results were so promising that the authors of the most famous study concluded:

“We therefore recommend that COVID-19 patients be treated with hydroxychloroquine and azithromycin to cure their infection and to limit the transmission of the virus to other people in order to curb the spread of COVID-19 in the world.”

Based on these and other results physicians and governments around the world are now using these medications to claimed great effect. Even in the state of Michigan, prominent hospitals such as the Henry Ford Hospital and the University of Michigan have added hydroxychloroquine to their treatment protocols for hospitalized patients with COVID-19.

By doing so, physicians are using these medications “off-label,” that is, without the costly and time-consuming process of Food and Drug Administration approval. The federal agency’s approval process performs the good task of helping to ensure medications safely do what they claim to do. However, lack of FDA approval does not mean lack of efficacy. It means lack of governmental confirmation of efficacy.

“Off-label” use of medications is legal and common. It may even account for as many as 1 in 5 prescriptions in the United States. This practice is even accepted by the FDA. Furthermore, given the severity of the COVID-19 pandemic and the promise of these medications the FDA has avoided condemning the “off-label” use of hydroxychloroquine for COVID-19.

But if you live in Michigan, and you or a loved one is infected with this potentially lethal disease, you’re out of luck.

Gov. Gretchen Whitmer’s Department of Licensing and Regulatory Affairs literally threatened all doctors and pharmacists in the state who prescribe or dispense hydroxychloroquine to treat COVID-19.

The agency’s March 24 letter warns physicians and pharmacists of professional consequences for the prescribing of hydroxychloroquine (and chloroquine). Beyond the rational recommendation against hoarding as production of this medication needs to be ramped up, the letter deviates into open threats of “administrative action” against the licenses of doctors that prescribe hydroxychloroquine.

The letter also instructs pharmacists to ignore physician orders for this medication. Due to the debate over a pharmacist’s right to refuse to fill medications that go against their religious beliefs, this could place pharmacists in the unprecedented position of being told that they must fill prescriptions that violate their “conscience (religious belief)” but must not fill prescriptions to treat COVID-19.

Even worse, the letter indicates health care providers are “required to report” their fellow physicians who are prescribing these medications. This draconian measure carries ominous Gestapo-like overtones of neighbor reporting neighbor to “authorities.”

During a time of crisis, in which physicians continue to see patients despite not having enough protective gear, this threatening, authoritarian stance from our governor is counterproductive at best.

What makes this directive more of a head-scratcher is that the same day the state issued its threatening nastygram to Michigan’s health care providers, Whitmer’s counterpart in New York started clinical trials of the very same drugs.

With his state now the nation’s pandemic epicenter, and with the blessing and help of the president and FDA, New York Gov. Andrew Cuomo brought in 70,000 doses of hydroxychloroquine, 10,000 doses of Zithromax and 750,000 doses of chloroquine.

The implications of Whitmer and her administration’s knee-jerk scare tactics should terrify all Michigan residents. Not only is our state’s top leader threatening the selfless health care workers who are on the frontline trying to save lives, but she’s denying possible life-saving medications to actual COVID-19 victims.

Kathy Hoekstra is a Michigan-based communications writer.