Brazilian Researchers Warn Against High Dosages Of Chloroquine To Treat Coronavirus Patients; Urgent Push To Address Racial Disparity In Covid-19 Cases.
JOHN KING, CNN HOST: A new study warns against using high doses of chloroquine to treat coronavirus patients. Chloroquine is closely related to the more widely used drug hydroxychloroquine, which President Trump repeatedly pushes, as a quote, game changer in the fight against COVID-19. CNN chief medical correspondent, Dr. Sanjay Gupta is here with details on the study. So, Sanjay, this is a study in Brazil that was called off abruptly because what they were seeing was startling and scary.</s>DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, it was. And, you know, I should preface this by saying, it is a small study. It did not -- it wasn't randomized, meaning it didn't have a placebo control arm to this. So it's not the kind of study, John, that we would typically be reporting on because it is so early and so small. But there's a lot of studies out there because of all the interest in hydroxychloroquine and chloroquine studies. Some studies have shown benefit. This one did not show benefit, did show some harm within the people who had the highest doses. Let's take a look at specifically what they showed. Again, a small study 81 people, they basically divided them into two groups. One group got a lower dose, one group got a higher dose, which was 600 milligrams for people who follow this, 600 milligrams twice a day for 10 days. And what they found in that group were that -- there were patients who died, 11 patients who died. There were also people who develop these heart arrhythmias, John, something that we've talked about before. Now, again, the problem with these small studies is we don't know for certain that the medication caused those deaths. There has been this link to heart arrhythmias. But that's why you have to do larger studies on this. I think we are starting to get a sense that certain doses of this medication may just be too toxic. We don't know what the right doses if there is a right dose at all. I should add as well on Friday, just before the before the weekend, John, in Sweden, now where they've been studying this as well, they've now made a -- given out guidance for all the hospitals in Sweden to stop giving the hydroxychloroquine because, and this is their words, they're not seeing any effect so far in the studies, and they also can't rule out serious side effects. So, again, small studies, there's going to be a lot of these, John. But, you know, we're waiting for the more definitive study to see if this actually has any benefit at all.</s>KING: But that's the importance of the science here. Have patience. Look at the studies waited out for the right ones. Sanjay Gupta, really appreciate your insights there. Moving on to another big issue, health experts tell us the comprehensive coronavirus testing is the only way to effectively get life back to normal or at least close to normal. Despite that, President Trump says, testing everyone is not necessary. According to Johns Hopkins, 2.8 million Americans have been tested. Our country of course has almost 320 million people. In addition to comprehensive testing, public health experts say, contact tracing is also imperative to understanding the virus and how it might spread. Here's what the CDC director said this morning.</s>DR. ROBERT REDFIELD, DIRECTOR, CENTER FOR DISEASE CONTROL & PREVENTION: The things that need to happen for the reopening is that what's happening with the numbers of new cases. We've got substantially augment our public health capacity to do early case identification, isolation, and contact tracing.</s>KING: With me now Dr. Joia Mukherjee, she's the chief medical officer at Partners in Health and is working with the State of Massachusetts to ramp up contact tracing. Doctor, thank you so much for being with us. I want to get into how this works just so you can lay it out for people so they can understand this since it may be coming to their lives in the near future. But let me start with the threshold question about the infrastructure, 2.8 million Americans have been tested for the coronavirus so far, 462,000 in New York, 190,000 in California, 185,000 in Florida, 117,000 where you are in the State of Massachusetts, which rakes number three right now state by state, I believe, in the number of cases. Is the infrastructure in place both manpower, technology, whatever else you would need to have contact tracing at the level at which you believe it would be effective and helpful?</s>DR. JOIA MUKHERJEE, CHIEF MEDICAL OFFICER, PARTNERS IN HEALTH: It's not in place yet, but we are in the process of rapidly building it and scaling it up. John, thank you so much for having us on. Partners in Health has been talking about the need for this basic public health approach of testing and contact tracing and isolation. For months now, we've been supporting countries all over the world to get in early in this preventive approach. And yet, day after day, people are focusing on the hospitalization, which is very important but part of comprehensive public health approaches, demand, treatment, as well as care and prevention. And so the infrastructures are there in every state to do contact tracing. That's what the purpose of public health do, and they do it generally quite well. But they are outmanned and outnumbered by the scale of this epidemic. So we have stepped in to really massively expand the ability of the State of Massachusetts to trace every contact.</s>KING: So walk me through, walk me through so people understand how this would work. And I'm going to give you a personal example. My youngest brother lives where you are in Massachusetts. He has tested positive. He is recovering. He is doing OK. He says this was the nastiest thing he's ever had to deal with. So if you were contact tracing him, walk through how it works.</s>MUKHERJEE: OK. So if a person is positive, normally public health demands that we do first a case investigation. So we would call your brother and say, you have been tested positive, hopefully, he's already been called by a clinician or the testing center. And then we would investigate who have his close contacts been within the time that he's been symptomatic and also for two days before that. So assuming that he may have been before developing symptoms, also able to transmit the virus. Then we would enumerate those contacts, some of them would be people in his family, some of them might have been, let's say, a running buddy, one might have been maybe he was driving a friend to the grocery store. So a contact would be anyone who's been within six feet for more than 15 minutes of your brother for that period that he's been ill and for the two days prior to that. Then the second stage is that information goes to a contact tracing team that would call each and every one of those people that meets that definition of a contact in that six foot radius and said, you have been a contact of someone with COVID. These are the things you need to know. One, are you OK? Are you feeling OK? And if not connecting people rapidly the care, testing? Second, are you able to quarantine yourself until we figure out if you are -- have COVID or not? And if not, then we would refer that person into social support. So that's the third piece of the strategy is really assuring that there's enough social support for people that might be food, that might be housing, that might be sanitation, so that people can properly isolate and not spread the disease within families or close circles because all epidemics are quite local. And so we have to address those local contacts to really stop transmission of this virus. And so what we have been concerned about all over the world is that a lot of focuses on the top of a pyramid, about 20 percent of people with COVID will need to go on to oxygen, need a ventilator, and that's very important to take care of them. But the bottom 80 percent are people who may be spreading this with just mild symptoms or even before they develop symptoms. And there's very little being done to control community spread. And if we want to not only flatten the curve which we're doing through social isolation, but shrink the curve actually end up making fewer infections. We have to do contact tracing and isolation.</s>KING: I wish you the best of luck as you try to roll this out of Massachusetts. Hopefully, it set an example that people can watch Dr. Mukherjee very much appreciate your time and expertise today.</s>MUKHERJEE: All right.</s>KING: Coming up for us, deadly tornadoes ripped through the southeast and the severe weather threat, is not over yet.