LIMA, Peru — Peru’s government has been forced to back down in a dispute over its list of officially recommended COVID-19 treatments after a study revealed the medicines might be killing patients.
Despite scarce research, the Health Ministry in the badly hit South American nation has for months been encouraging doctors to administer hydroxychloroquine — the antimalarial once touted by U.S. President Donald Trump as a coronavirus miracle cure — along with antibiotic azithromycin to those hospitalized with the disease.
But a new study by the ministry’s medical research agency, IETSI, has found that patients given the two drugs together after being admitted to hospital had a 49% higher risk of ending up in intensive care, a 70% higher risk of needing oxygen and an 84% higher risk of dying. The research involved 5,683 patients.
Elmer Huerta, Peru’s best known doctor, who offers health advice on CNN’s Spanish language network, described the use of hydroxychloroquine as part of a COVID-19 healthcare strategy “from the stone age”.
The initial response of the administration of President Martin Vizcarra was to fire the head of IETSI, Patricia Pimentel, supposedly for breaching research guidelines by publishing the study before it could be reviewed by Health Ministry officials.
Asked about the sacking, Vizcarra this week said: “We all know this is a new disease. At the moment, there is no exact science to know what the treatment is.”
But a few hours later his administration caved, abruptly announcing on Tuesday that public hospitals would no longer administer the two drugs to coronavirus inpatients. It will, however still recommend their use for outpatients and refused to reinstate Pimentel.
The government’s handling of the study may provide a clue as to why Peru has by far the highest COVID-19 death rate in the world. According to Johns Hopkins, the Andean nation has seen the pandemic kill 104 people for every 100,000 residents. The second worst-hit nation, Brazil, has a mortality rate of 72 per 100,000.
Scientists and doctors have repeatedly accused Vizcarra’s administration of failing to listen to experts even after it implemented one of the Western Hemisphere’s toughest and earliest lockdowns. The use of hydroxychloroquine was a particularly sore point, after international studies revealed it had no benefit for coronavirus patients yet Trump politicized its use.
The pandemic’s high level of lethality in Peru has been attributed to a combination of poverty, the country’s decades of underinvestment in public healthcare, strategic blunders by the government, and Peruvians’ disinclination to comply with the law, a tendency partly rooted in frequent official corruption and inefficiency.
One of the biggest mistakes was the government’s decision back in March to predominantly use cheap blood tests, which only pick up that a patient has developed antibodies to the coronavirus, rather than the pricier molecular tests, which use nasal swabs or saliva, and detect active infections.
Experts say the blood tests miss the first days, and sometimes even weeks, of a patient being contagious and should only be used to reveal whether someone has already had the virus. Although the Vizcarra administration has argued that international shortages left it with no choice, Peru was the only country in the world to adopt that testing strategy.
Huerta, the CNN doctor, warned that the Peruvian government urgently needed to now also stop prescribing the drug to outpatients, who make up 95% of those infected with COVID-19 in Peru: “The damage that this hydroxychloroquine is doing to thousands of people … it’s very important that we reflect on this.”
Officially, Peru, with a population of 31 million, has had more than 850,000 COVID-19 cases and 33,357 fatalities, although most experts think that is a significant undercount. The rate of new infections had been steadily falling for two months but began to rise gently again a week ago.
Cover: Members of a mobile medical team speak with a COVID-19 patient in Cusco, Peru, in October 2013. Credit: Angela Ponce/Bloomberg via Getty Images