Oregon relaxes new restrictions on drugs to fight virus

SALEM, Ore. (AP) — A doctor at a veterans home in Lebanon used a malaria drug to treat eight patients there for coronavirus, but said a state rule enacted last month would prevent him from treating any more veterans there.

After pushback against the Oregon Board of Pharmacy’s March 25 rule, the board amended it on Wednesday to allow the drug to be used not only in hospitals for confirmed COVID-19 cases, but also long-term care facilities like the Oregon Veterans’ Home in Lebanon.

Hydroxychloroquine and a similar drug, chloroquine, showed encouraging signs in small, early tests against the coronavirus but has not proved safe or effective for this in any major scientific studies yet. It’s approved now for treating malaria, lupus and rheumatoid arthritis.

In the second week of March, the first cases of the coronavirus began emerging at the Oregon Veterans’ Home in Lebanon, Oregon, when two men in their 80s fell ill with COVID-19. Then more got sick.

After hearing that hydroxychloroquine could be effective, Dr. Rob Richardson began treating eight of the veterans with it and an antibiotic called azithromycin, also known as Z-Pak.

“I was using it to give them a fighting chance,” Richardson told The Associated Press in a telephone interview.

On March 25, the Oregon Board of Pharmacy adopted a temporary emergency rule prohibiting the dispensing of chloroquine and hydroxychloroquine “for presumptive treatment or prevention of COVID-19 infection.”

The board said it was taking the action to preserve supplies for treatment of malaria, inflammatory conditions, and documented COVID-19 infection in hospitalized patients.

It was the “hospitalized” part that would have prevent Richardson from treating more patients with the same drugs that the federal Food and Drug Administration, on March 28, allowed to be used on COVID-19 patients.

“We’re not a hospital,” Richardson said in a telephone interview. “We’re a skilled nursing facility.”

But late Wednesday, the pharmacy board changed its regulation, allowing “for a seriously ill patient in an institutional setting, such as Correctional Facilities and Long-Term Care Facilities, who would otherwise be hospitalized” to receive the drugs.

“It was never our intent to exclude seriously-ill COVID-19 patients in institutional settings, who would otherwise be hospitalized, from receiving these treatments as prescribed by a doctor, and our guidance has been updated to reflect that,” Joe Schnabel, executive director of the Oregon Board of Pharmacy, said in an email.

Of the eight patients that Richardson treated with hydroxychloroquine and Z-Pak, seven recovered and one — a 91-year-old patient — died. Richardson has no conclusive evidence that the treatment led to their recovery but there were no negative side effects.

Denise Hinton, chief scientist of the federal FDA, wrote on March 28 that “it is reasonable to believe that chloroquine phosphate and hydroxychloroquine sulfate may be effective in treating COVID-19.”

In her letter, she authorized use of the two drugs “during the COVID-19 pandemic to treat patients for whom a clinical trial is not available, or participation is not feasible.”