Growing Number of Doctors Agree with Senator Pennacchio

Physicians Wrote to Governor Calling for Early Treatment with HCQ

An additional group of doctors has contacted a New Jersey State Senator calling on the State to lift restrictions on the use of hydroxychloroquine (HCQ) for the therapeutic treatment and prophylactic early treatment of COVID-19.

The doctors are echoing Senator Pennacchio’s appeal for New Jersey to accumulate a stockpile of the medication.

“Major pharmacies that have a presence in New Jersey have committed to donating more than 100 million pills,” said Pennacchio. “How many has the Administration secured for us?”

Pennacchio also wants the State to immediately compile a priority list for the HCQ distribution, ensuring enough medication for those currently prescribed for maladies including Lupus and RA, distribution to patients who have developed COVID-19, and for citizens as a preventive treatment.

“I am optimistic these measures would decrease the severity and duration of the disease,” said Pennacchio. “The goal must be breaking the pandemic so people can be allowed to return to their normal lives.

“Allow doctors to be doctors. Remove the State’s unnecessary shackles, and let them save lives,” Pennacchio urged.

Doctor’s Letter to Governor

Dear Governor Murphy,

Based on the current circumstances of an extremely contagious deadly COVID19 virus that is creating chaos in our state and the world, your order to restrict physicians from writing prescriptions to treat their patients with Hydroxychloroquine (HCQ), we believe, is contrary to the best practices of medical care. We, as perhaps you, believe in the sanctity of the patient-physician relationship in personalized individual management and care, and that it must lie in the knowledge and wisdom between those two entities and not artificially imposed by others.

Your administration’s order of restriction to use HCQ, prevents patients’ access to a potential life-saving medicine, especially when administered in the early phase of the disease. (1) Creating such a mandate may risk the lives of many New Jersey residents.

Timely access to these medications may mean the difference between life or death for patients facing the battle of their lives. We respectfully suggest that working with New Jersey’s robust pharmaceutical industry to increase the supply of these drugs, both for NJ and the rest of America would benefit the residents of New Jersey and across the country.

Early treatment is crucial for keeping patients out of the hospital and off ventilators. Delaying treatment results in the opposite, more sick patients ending up in overburdened facilities.
HCQ prevents the virus from gaining access to the human cell and in doing so it prevents the infection. Additionally, in those patients who already have infection in their system, HCQ prevents access to the cellular structure called Endoplasmic Reticulum where it replicates. Preventing such replication, reduces the viral load and hence allows the human immune system to fight off the infection. Without this drug, many valuable human lives will be cut short with such an order as proposed and promulgated by your administration. (2)

Other State Governors of Nevada and Michigan formulated similar mechanisms of restrictions to the use of Hydroxychloroquine but seeing the burgeoning loss of life quickly reversed course. If restriction is to prevent hoarding of the medication, then perhaps using the Texas model of limiting the drug dosing for 10 days (20 pills) might be more appropriate. It prevents harm to our vulnerable, sick and infirmed patients. (3)

HCQ has many decades of history as used in the care of patients with Malaria and Rheumatoid Arthritis. Knowing its very low toxicity and it poses very little if any threat to the patient, clinicians in New York, Kansas, elsewhere are reportedly preventing deaths and ARDS/ventilator dependent long ICU stays. Waiting for placebo-controlled trials is not a wartime battlefield strategy, given the urgency of treatment.

As physicians it is our duty to treat patients with the best available therapy and available evidence to circumvent disease at its earliest phase, so as to prevent the loss of life and any future morbidity. It is with that wisdom and acquired knowledge that we respectfully ask you to reconsider this restrictive mandate.

That these drugs are effective against COVID-19 has been proven in laboratory experiments. (4) And now evidence is mounting that these drugs are working to decrease viral load in patients. Decreased viral loads means patients not only avoid the hospital but are less infectious to others.(1) There is growing evidence that early administration even in mild cases of COVID-19 prevents progression to worse disease, likely attenuating the need for ventilators and ICU beds and improves symptoms. (5) This will decrease the burden on the healthcare system and upon the doctors and nurses that bear the ultimately responsibility of the patient’s care.

The information available from across the world suggests that the prudent course of action is not to put hurdles in the path of patient care by restricting most valuable medications that can protect a human life. In fact, India is officially recommending health care professionals and family members of sick patients prophylactically take HCQ. (6) The New York Times reports of a recent study: “Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug.” (7)

We respectfully ask that you review this decision, given the influence of such overwhelming evidence to the contrary. It is with great respect and urgency that we ask you to reconsider this decision that can potentially cause a significant loss of life in the state of New Jersey. Each patient care decision is unique to an individual and their own personal situation and value system. Patients and their physicians must carefully weigh the risks and benefits of every potential intervention. The confidential patient-physician relationship must be held sacrosanct for this purpose.

Best health,

Craig M. Wax DO, Family Medicine
Parvez Dara, MD, Hematology/Oncology
Jim Thomas, MD, Interventional Radiology
Theresa Thomas, MD
Joeseph J. Fallon, Jr., MD, Endocrinology
Carl J. Minniti Jr., MD Medical Oncology & Hematology
Charles Dietzek, DO Vascular Surgery
Indrani Sen Hightower, MD, Neurology
Alieta Eck, MD, Family Medicine
Kelly Victory, MD, Trauma and Emergency Medicine,
Disaster Preparedness and Response
Christine Saba, MD, Pediatrics
Kim Legg Corba, DO, Family Medicine
Marion Mass, MD, Pediatrics
Katerina Lindley, DO, Family Medicine
Theresa Thomas, MD, Internal Medicine
Thomas W Kendall, MD
Family Medicine
Robert Campbell MD
Anesthesiology
Pain Management
Jane Hughes, MD, Ophthalmology
Kris Held, MD, Ophthalmology
Michael J. A. Robb, M.D., Oto-Neurology
Joel L. Strom, D.D.S.,M.S., General Dentistry
Independent Physicians for Patient Independence

References:

1. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial
2. COVID-19 Drug Therapy – Potential Options
3. Gov. Whitner reverses course on coronavirus drugs
4. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
5. Efficacy of hydroxychloroquine in patients with COVID-19
6. Recommendation for empiric use of hydroxy-chloroquine for prophylaxis of SARS-CoV-2 infection

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