Dr. Harvey Risch is a distinguished cancer epidemiologist who has opined on the topic of hydroxychloroquine (HCQ) and COVID-19 out-patient therapy. He has written a review article in the American Journal of Epidemiology that cites evidence that he believes supports HCQ use for out-patient infection with SARS-CoV-2. Studies that indicate no effect or harmful effects, Dr. Risch believes, enrolled patients too sick to benefit from HCQ.
Yale-affiliated physicians used HCQ early in the response to COVID-19, but it is only used rarely at present due to evidence that it is ineffective and potentially risky. The Food and Drug Administration of the U.S. Public Health Service issued the following statement (in part):
June 15, 2020 Update: Based on ongoing analysis and emerging scientific data, FDA has revoked the emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19 in certain hospitalized patients when a clinical trial is unavailable or participation is not feasible. We made this determination based on recent results from a large, randomized clinical trial in hospitalized patients that found these medicines showed no benefit for decreasing the likelihood of death or speeding recovery. This outcome was consistent with other new data, including those showing the suggested dosing for these medicines are unlikely to kill or inhibit the virus that causes COVID-19. As a result, we determined that the legal criteria for the EUA are no longer met.
As Dean of the Yale School of Public Health where Dr. Risch is employed, I have championed maintaining open academic discourse, including what some may view as unpopular voices. The tradition of academia is that faculty may do research, interpret their work, and disseminate their findings. If persons disagree with Dr. Risch’s review of the literature, it would be advisable to disseminate the alternative scientific interpretations, perhaps through letters or other publications with alternative viewpoints to the American Journal of Epidemiology, Newsweek, or other outlets. My role as Dean is not to suppress the work of the faculty, but rather, to support the academic freedom of our faculty, whether it is in the mainstream of thinking or is contrarian.
- Sten H. Vermund, MD, PhD
Dean and Anna M.R. Lauder Professor of Public Health; Professor of Pediatrics, Yale School of Medicine