Unprecedented Times

It’s official.

Jersey Medicine is dead.

It’s physicians, sheep.

By a unanimous vote, the Saint Barnabas Pharmacy and Therapeutic Committee voted this week to ban HCQ…only for Covid pts I mean.

As the motivation for banning HCQ for Covid pts, the Committee wrote

“The safety concern is that the risks of this medication outweigh the reported clinical outcome data for COVID 19 treatment.”

I have requested information on the Committee’s safety concerns. To date, I haven’t received any and I am not aware of any.

Doctors don’t have to use HCQ for Covid, of course.

So, why would doctors vote to ban HCQ for Covid pts?

I cover the ID doc on the Committee and used HCQ on many of his pts Covid pts.

He never raised any concerns of my treatment of his pts.

After this process started, he still asked to take his call and see pts which would have been assigned to him.

My ID group is…or was the only group at Saint Barnabas still using HCQ for Covid. No one from the Committee or Saint Barnabas’ pharmacy ever contacted me about HCQ and its side effects. When the Pharmacy announced they were considering this HCQ, I called for a meeting of the ID docs and Pharmacy to review the data on all Covid therapies. I was rebuffed. BTW, the Pharmacy did tell me that we monitored HCQ pts very well. I said "Yeah, I know."

HCQ is the drug of choice for Lupus and is commonly used in rheumatoid arthritis as well. The doses and duration for either disease are much higher or longer than any HCQ-Covid regimen. So, a Saint Barnabas pt can be treated with HCQ at higher doses for longer periods of time for essentially anything EXCEPT Covid. If I order HCQ for any other reason, say for a migraine headache, Saint Barnabas will still allow it.

Barnabas doctors still use other drugs, which are not recommended by any of the three recognized guidelines, those of the WHO, NIH and IDSA

The only drug recommended by all 3 guidelines is dexamethasone 6 mg per day for up to 10 days in hypoxic (meaning those needing oxygen therapy), hospitalized Covid pts.

No antiviral therapy is recommended by all 3 guidelines.

Remdesivir isn't recommended by the WHO. A recent clinical trial, called Solidarity, showed that Remdesivir did not improve mortality.

Barnabas physicians continue to use tocilizumab to treat Covid.

Certainly, tocilizumab, a rheumatoid arthritis drug, has well documented, serious side effects.

Tocilizumab isn't recommended by any of the guidelines and has been shown to not improve Covid mortality.

Bamlanivimab (known as BAM, the antibody from Lilly) also isn't recommended by any of these guidelines and commonly used in the ER Covid pts.

The Committee has not explained why tocilizumab and bamlanivimab are not restricted and HCQ is.

This restriction is unprecedented. Hospitals have never, until now, restricted FDA-approved drugs by indication, meaning the disease or condition the drug is being used to treat.

I asked Saint Barnabas if they had done any outcomes analyses on Covid pts treated with or without HCQ.

They should.

Regarding future Covid pts, my hands are now tied. You don't need me anymore, because I can't treat you the best way. Yes, giving HCQ was tedious, because we did watch those pts like hawks. We did that only because of the hostile environment. So, now we can what other ID docs do for Covid pts, virtually nothing.

SMS