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Nursing Home Residents as Guinea Pigs?

Published on April 14th, 2020

Donald Trump has touted the drug chloroquine as wonder cure for COVID-19. Over and over, despite being aware that his claims were unproven, and dangerous.  He has been told that people had died from taking the drug; despite being warned that his false hope was resulting in a shortage for people who actually needed the drug to treat rheumatoid arthritis, lupus, and malaria, Trump keeps telling the American people he has a “hunch” that chloroquine and the closely related hydroxychloroquine are a “game changer” in the fight against COVID-19. He is truly dangerous.  His vanity requires his supporters to try to prove him right.  That’s where Texas comes in where nursing home residents are being turned into experimental subjects sometimes without their knowledge or consent.  According to the FDA and medical ethics, all clinical trials must follow strict guidelines such as informed consent to protect human rights and prevent abuse. And studies on human subjects must also be approved by institutional review boards to ensure safety and ethics.

As NPR reports, a doctor working at a nursing home in Texas has been doing what too many others have—giving hydroxychloroquine to patients, even though this represents an off-label use of the product which, despite Trump’s many blessings, has still not been cleared by the FDA. Dr. Robin Armstrong, the medical director of an extended care facility called “The Resort” at Texas City, Texas, has made the drug a routine part of his care for patients. And he now has a lot of patients. 87 people at The Resort have tested positive, making it one of the largest outbreaks in the state.  Armstrong is a prominent player in Texas Republican politics. He’s served in a series of roles, including as the Vice Chairman of the Republican Party of Texas.

Armstrong states that hydroxychloroquine has “virtually no side effects” which is definitively, absolutely not true. Both hydroxychloroquine and chloroquine can both worsen existing heart conditions and cause new heart conditions — the kind of problem exactly likely to worsen the outcome of COVID-19. In fact, these drugs have a long list of side effects from digestive issues to retinal damage. Researchers looking into the use of these drugs against COVID-19 have actually found more serious side effects than expected.  Those side effects are being imposed on residents even though no evidence exists that chloroquine is effective in helping against COVID-19.

And he’s even giving that drug to patients with dementia who are unable to consent to being part of this experiment. The doctor also said that “for the most part,” he has made residents aware that they are receiving the tablets but added that physicians are “not required” to get explicit consent from the patient or family members and that some residents at the nursing home suffer from the middle stages of dementia.

“This is really disconcerting,” Katherine Seley-Radtke, a medicinal chemist at the University of Maryland, Baltimore County told NPR.

“The problem with this is that it’s not being conducted in a proper scientific manner,” Seley-Radtke said. “It’s not being carried out with controls. It’s not being carried out under strict testing protocols and using appropriate guidelines.”   Some patients and their families are not aware that they are being given the unproven drug that has been heavily-endorsed by President Trump. “I just find it amazing that everybody, including the president, thinks that this is just no big deal to go ahead and take this,” Seley-Radtke added.

Even with Dr. Anthony Fauci, and other medical experts consistently warning against the acceptance of anecdotal evidence of the drug’s effectiveness, Trump continues to pitch for the drug.

As for Armstrong and his nursing home, NPR also looked into the facility itself and the results were anything but reassuring. In July of 2019, the last time the facility was inspected, it was cited for 14 violations, including the building’s design not meeting safety standards as well as cleanliness issues in food areas and other parts of the building. Additionally, the report stated, “The facility did not properly care for residents needing special services” and then listed several health needs that one would expect a nursing home should be able to perform without issue.

Chloroquine may ultimately prove to have some net positive effect in the treatment of COVID-19. However, that effect is likely to be limited, because despite several studies currently underway, there is still no better evidence than early experiments conducted with no more rigor than what Armstrong has done. Had any of the randomized tests underway around the world shown unequivocal positive outcome in this situation, it’s very likely they would have suspended normal protocol to announce that result and issue preliminary findings. That has not happened.

 

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