Cyprus in the mix as world seeks cure

An Israeli military aircraft has delivered five tons of chloroquine to Cyprus this week, amid reports of secret wars over limited access to the drug but also uncertainty over its effectiveness in the fight against the coronavirus pandemic.

Health Minister Constantinos Ioannou told a press briefing on Wednesday that the Republic of Cyprus had managed to secure chloroquine quantities enough for 240,000 people, giving public assurances that there were sufficient quantities of the immunosuppressive drug.

Trump intervenes to get India ban lifted

But access to the active ingredient of the drug, which was flown from India to Cyprus on an Israeli military plane, was up in the air for many days after India had decided on Sunday to issue a no-exceptions ban on exports of hydroxychloroquine and paracetamol.

Following the ban, US President Donald Trump warned of retaliation on Tuesday, prompting the Indian government to backtrack on Wednesday and commit to fulfill “all existing orders” as well as make exceptions on a case-by-case basis for a number of countries affected by the pandemic.

Teva Pharmaceutical Industries, an Israeli-based company which operates a facility in India, had been hugely affected by the ban, after the firm had promised to donate more than 10 million tablets of hydroxychloroquine sulfate, a less toxic version of chloroquine, to hospitals across the United States.

Cyprus in the mix as world seeks fast cure

Michael Neoptolemou, the CEO of Cypriot-based pharmaceutical firm Remedica, said in an official statement that his company would use the newly-arrived active ingredient to manufacture and ship chloroquine to Israel.

“In a top-secret mission, 5 tonnes of chloroquine from India arrived in Cyprus by Israeli military plane,” Neoptolemou said.

It was not immediately clear whether Cypriot-made hydroxychloroquine would make its way to the United States, but Neoptolemou added that “Remedica is currently addressing the virus and is taking private initiatives to help Cyprus and other countries to tackle the pandemic as soon as possible.”

Chloroquine and the New York doctor

The anti-malarial drug has been touted by US President Donald Trump as a “game changer” and potential treatment for the coronavirus, after a New York doctor said he had successfully treated the symptoms of coronavirus patients using a mixture of hydroxychloroquine sulfate, zinc, and azithromycin.

Vladimir Zelenko, a Chabad doctor in an Orthodox Jewish Hasidic community, did not have solid data to back up his claims except his own observations, saying the treatments appeared to be effective, meaning no hospitalizations and no deaths.

But Chinese authorities have cautioned doctors and health officials in that country about the drug’s side effects, calling on local health administrations to monitor closely any adverse effects including rapid death that could result from even a moderately low overdosage.

In the Republic of Cyprus, some infected patients with the novel coronavirus, who were otherwise healthy, have died in hospital. It was not clear whether they had received chloroquine and whether it had been effective. Local media have confirmed that the drug has been used in state hospitals in combination with other medical drugs during the coronavirus outbreak.

Doctors and hospitals around the world have since began clinical trials based on early signs that Zelenko’s experimental antiviral treatment for people who become very sick from the coronavirus may work fairly quickly by blocking the virus from reproducing itself in the body.

More clinical trials needed

Chloroquine has long been used for the treatment of autoimmune diseases because of its profound immunomodulatory effects, but health experts and agencies, including FDA in the United States, have said more clinical trials on a large scale were needed before evaluating the drug’s effect on Covid-19.

Zelenko, a mild-mannered physician who uploaded a video on Twitter last month, called on young adults to “relax” adding that most people would likely get better without any treatment.

“I’m not claiming any miracle cures,” Zelenko was quoted as saying in foreign media. “I am creative and I think outside the box. We have an unprecedented health crisis and it requires unique thinking.”

European health regulators have also refused to approve chloroquine for Covid-19, with the European Medicines Agency calling for chloroquine and hydroxychloroquine to be used only to treat the virus in clinical trials and in severe cases.

Chloroquine, which is used to treat malaria and autoimmune diseases such as lupus and rheumatoid arthritis, has not been approved for treatment or cure of the COVID-19 disease. But countries around the world, including Cyprus, have authorized protocols for off-label uses and clinical trials.

Chloroquine craze

But following Trump’s call to US agencies to stock up on chloroquine, reports around the world began to emerge suggesting people were taking it upon themselves to self-medicate.

Authorities in Cyprus were alarmed when a man broke self-quarantine rules to drive to local pharmacies in search of chloroquine, a drug only available via electronic prescription by a medical doctor and under strict health protocols.

Chloroquine phosphate, which can cause a heart attack from even a moderately low overdosage, was also found to be sold online with prices on eBay reaching hundreds of dollars apiece.

A man in Arizona died and his wife was hospitalized after the couple ingested chloroquine phosphate in an apparent attempt to self-medicate for the novel coronavirus, while three people in Nigeria were rushed to the Emergency Room after overdosing on the drug.

Ioannou said treatment protocols both for adults and children were approved ten days ago, adding that Cyprus was one of the first countries to establish national protocols.