On Friday, Prof. Didier Raoult posted another study of azithromycin and hydroxychloroquine used against COVID-19. It is a single arm observational study of patients with mostly mild (or even asymptomatic) disease that is painfully uninformative with respect to the question of this treatment’s effectiveness. That didn’t stop America’s Quack Dr. Oz and other grifters from touting Raoult’s study, as well as a handful of “miracle cure” testimonials, to promote the treatment as a cure and attack the FDA.

Last week, I wrote about an experimental treatment for COVID-19 that repurposes old drugs. One version of the treatment uses chloroquine (which is sold under the trade name Aralen and others), an anti-malaria drug that’s also used to treat autoimmune diseases. Another version, the one that at the time was getting the most press, claimed that the combination of hydroxychloroquine (trade name Plaquenil, and it’s a drug which is very similar to chloroquine) and the antibiotic azithromycin (often prescribed in the famous “Z-Pak”) could completely render SARS-CoV-2, the virus that causes COVID-19, undetectable in patients. As I described, it was a horrible, horrible study about which I later found out things that make me suspect that its awfulness could have been due to more than mere incompetence and instead might have been scientific fraud. Meanwhile, the only existing randomized trial of chloroquine in COVID-19 was negative. As I said at the time, that doesn’t mean that the drug doesn’t work, but it does strongly suggest that its effects are probably not dramatic, although it is also possible that the dose used was too low.

Professor Didier Raoult releases another COVID-19 study
With that background in mind, as I was thinking about what to write this week, I wasn’t planning on writing about this particular issue again, but then I observed two developments. First, Professor Didier Raoult, who published the hydroxychloroquine/azithromycin study, published another trial that’s being flogged as evidence that his combination works. Second, in the conspiracy fever swamps on social media and even on traditional media an emerging narrative was being promoted late last week. It came in the form of articles like this one by a local Pacific Legal Foundation member named Kathy Hoekstra, “Michigan’s doctors fight coronavirus, and governor’s office“. First, let’s discuss the new study of azithromycin and hydroxychloroquine, because I know that’s what will likely most interest people. Again, it’s from Raoult’s group and is entitled “Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study“.

Unsurprisingly, the first thing I noticed about the study is that it is a single arm, unrandomized trial with no control group. Right there that tells you it’s not going to produce good evidence for the efficacy of azithromycin and hydroxychloroquine against COVID-19.