NOT REQUIRED: THE RESORT AND HYDROXYCHLOROQUINE COVID-19 TREATMENT

In April 2020, at the beginning of the COVID-19 pandemic, nursing homes were a vulnerable population for the virus to spread. As scientists and healthcare providers worked tirelessly to further understand the evolving virus and how to treat it, the medication hydroxychloroquine was proposed to be a potentially effective drug that inhibited the virus. Since studies surrounding the drug for COVID-19 treatment were more recent, many health professionals were hesitant to prescribe the drug to their patients. The Resort, a nursing home located in Texas City, Texas, did not share this hesitation. When residents at The Resort had contracted COVID-19 and received treatment, they were given doses of hydroxychloroquine, an unapproved FDA COVID-19 treatment. 

​

The primary use of hydroxychloroquine is to treat malaria and autoimmune diseases such as lupus. Its introduction to the COVID-19 virus was a result of early laboratory studies suggesting that it had capabilities to inhibit the virus. During the pandemic, the drug gained traction in political circles as it was endorsed by President Trump to be a “cure” for the virus. There were "substantial increases in purchases and searches for previously unpurchased and unsearched therapies by the general public,” such as hydroxychloroquine, which was advocated by President Trump previously through Twitter posts and television broadcasts. 

​

Dr. Robin Armstrong, medical director of the Resort administered hydroxychloroquine to 39 of his elderly patients diagnosed with COVID-19 for treatment as well as to conduct an “observational study”. After an outbreak of the virus at the nursing home, Dr. Armstrong received tablets of the medication through a political connection in the Republican party. Since the virus was spreading, residents were quarantined and unable to see their loved ones, and the families were not notified of what the residents were receiving in their treatment. After further studies on the drug and its use of COVID-19, it was determined that hydroxychloroquine increased mortality rates for COVID-19 patients and was not beneficial for treatment. 

​

This case created interesting situations for the residents and their family members, such as Larry Edrozo, whose mother, Helen Edrozo, was a dementia patient at the Resort receiving hydroxychloroquine for her COVID-19 diagnosis. As his mother’s power of attorney, Larry was supposed to be informed of her updated treatment plan, and was not given his legal responsibility to give consent. This lack of information given by the providers at the Resort, especially with a vulnerable community, presents the idea of the residents being exploited to participate in this study.  "It's not required," said Dr. Armstrong, explaining that “it is common for physicians to prescribe new medications to patients without explicit consent from the patient or family members,”. Some patients like Helen Parrish, were just thankful to have recovered, “​​I'm so glad that I've got the paper that I'm not positive anymore.” Whether residents recovered or not, were grateful or grieving, the question that remains doesn’t rest with the drug, but if the people who received it were ever given the chance to say no.

​

References:
Axfors, C., Schmitt, A. M., Janiaud, P., van’t Hooft, J., Abd-Elsalam, S., Abdo, E. F., Abella, B. S., Akram, J., Amaravadi, R. K., Angus, D. C., Arabi, Y. M., Azhar, S., Baden, L. R., Baker, A. W., Belkhir, L., Benfield, T., Berrevoets, M. A. H., Chen, C.-P., Chen, T.-C., & Cheng, S.-H. (2021). Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nature Communications, 12(1). https://doi.org/10.1038/s41467-021-22446-z

InsuranceNewsNet.com. (2020, August 28). Sens. Casey, Wyden, Warren: Reports Reveal Nursing Homes Gave Residents Hydroxychloroquine to Treat COVID-19 Without Consent. Insurance News | InsuranceNewsNet. https://insurancenewsnet.com/oarticle/sens-casey-wyden-warren-reports-reveal-nursing-homes-gave-residents-hydroxychloroquine-to-treat-covid-19-without-consent

Niburski, K., & Niburski, O. (2020). The Media Landscape of COVID-19 treatments: an Observation of Influence (Preprint). Journal of Medical Internet Research, 22(11). https://doi.org/10.2196/20044

Pathak, D. S. K., Salunke, D. A. A., Thivari, D. P., Pandey, A., Nandy, D. K., Harish V K Ratna, D., Pandey, D. S., Chawla, D. J., Mujawar, D. J., Dhanwate, D. A., & Menon, D. V. (2020). No benefit of hydroxychloroquine in COVID-19: Results of Systematic Review and Meta-Analysis of Randomized Controlled Trials”. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(6), 1673–1680. https://doi.org/10.1016/j.dsx.2020.08.033

Platoff, E., & Svitek, P. (2020, April 6). Texas City nursing home residents with coronavirus being treated with unproven hydroxychloroquine drug. The Texas Tribune. https://www.texastribune.org/2020/04/06/texas-city-coronavirus-patients-get-unproven-hydroxychloroquine-drug/

Powell, N., & Goldenstein, T. (2020, April 10). Treatment of COVID-19 patients at Texas City nursing home draws ethical questions. Houston Chronicle. https://www.houstonchronicle.com/news/houston-texas/houston/article/Treatment-of-https://www.houstonchronicle.com/news/houston-texas/houston/article/Treatment-of-COVID-19-patients-at-Texas-City-15194710.phpCOVID-19-patients-at-Texas-City-15194710.php

Romo, V. (2020, April 10). COVID-19 Patients Given Unproven Drug In Texas Nursing Home In “Disconcerting” Move. NPR. https://www.npr.org/2020/04/10/830348837/covid-19-patients-given-unproven-drug-in-texas-nursing-home-garnering-criticism

Wallace, R. (2020a, April 28). FOX 26 gets unprecedented access to Texas’ 1st nursing home to treat COVID-19 with Hydroxychloroquine. FOX 26 Houston. https://www.fox26houston.com/news/fox-26-gets-unprecedented-access-to-texas-1st-nursing-home-to-treat-covid-19-with-hydroxychloroquine