Public Demand for Unproven COVID-19 Therapies Soars with High-Profile Endorsements

How have high-profile endorsements of the unproven COVID-19 drug therapies chloroquine and hydroxychloroquine affected
the scope of public demand for them?

Bottom Line: Broad amplification of accurate information is essential to counteract the massive increase in demand for unproven and potentially hazardous COVID-19 treatments prompted by high-profile endorsements.

Commentary: “This paper describes the frequency of internet searches for unproven COVID-19 therapies in the U.S. It highlights why we, physicians and members of the healthcare workforce, cannot simply shrug off lay press headlines that we know from our training are probably not rooted in strong evidence. As the authors state, the endorsement of questionable therapeutics by high-profile individuals can draw ’massive public attention that could shape individual decision-making.’ Indeed, the web searching and overall demand for chloroquine and hydroxychloroquine substantially increased following such endorsements, compounded by the fact that chloroquine-containing compounds are available for sale online. Our patients are likely familiar with these headlines too. We must be equipped to answer their questions.” —Jennifer A. Villwock, MD

Background: Although there are no highly effective prescription drug therapies supported by reliable evidence for COVID-19, high-profile figures have endorsed the anti-malarial chloroquine, and the lupus and rheumatoid arthritis treatment hydroxychloroquine, to treat the virus. Both of these therapies have potential cardiovascular toxic effects, and can be confused with toxic, commercially available products containing chloroquine.

Study design: Internet search analysis.

Setting: The Center for Data Driven Health, Qualcomm Institute, University of California, San Diego, Calif.

Synopsis: Researchers examined daily Google searches originating from the United States from Feb. 1, 2020, to March 29, 2020, that included the terms buy, order, Amazon, eBay, or Walmart in combination with chloroquine or hydroxychloroquine. They evaluated two post-periods of interest: 1) all days after March 16, when entrepreneur Elon Musk endorsed the drugs, including President Donald Trump’s endorsement on March 19; and 2) all days after March 22, when reports on chloroquine-related poisonings were published. Researchers calculated query fraction per a total of 10 million searches to purchase chloroquine and hydroxychloroquine. The first and largest spikes corresponded with Musk’s tweet and Trump’s first televised endorsements, respectively. Searches remained substantially above expected levels following news reports of poisoning. Additional surveillance will clarify findings, including estimating the number of sales of chloroquine-containing products. Results indicate that drug endorsements made prior to conclusive studies of efficacy can lead to unsupervised product use and negative health consequences for people who take them. Moreover, medication hoarding may create shortages for people who need them for legitimate purposes.

Citation: Liu M, Caputi TL, Dredze M, et al. Internet searches for unproven COVID-19 therapies in the United States [published online ahead of print April 29, 2020]. JAMA Intern Med. doi:10.1001/jamainternmed.2020.1764.