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The Minister of Health, Nelson Teich, said on Thursday (23) that the decision of the CFM (Federal Council of Medicine) that frees doctors to prescribe chloroquine, even for mild cases of Covid-19 and domestic use, does not represent a recommendation of the Ministry of Health.
According to him, the paste should allow the use of the drug only when there is clear evidence that the drug works.
“Allowing the use at the discretion of the doctor does not represent a recommendation of the Ministry of Health. The recommendation will happen the day we have clear evidence that the drug works,” he said, who emphasized that the opinion carries a “authorization.”
“It is important to make clear that this is not our recommendation, it is an authorization. The recommendation depends on a solid scientific study,” he said.
Teich affirmed that the CFM measure is different from the position of the Ministry of Health, which maintains a protocol for the use of the drug in critically ill and critically ill patients and through monitoring in hospitals.
CFM’s announcement was made by the entity’s president, Mauro Ribeiro, after a meeting with President Jair Bolsonaro (without a party) and with Teich.
On the occasion, Ribeiro gave the authorities an opinion from the council on the administration of the substance in people with Covid-19.
The evaluation had been requested by former Health Minister Luiz Henrique Mandetta, amid government pressure to increase the supply of the drug.
Bolsonaro is an enthusiast of hydroxychloroquine and chloroquine for the treatment of the disease. He has argued that they should be used even at the early stage of symptoms.
The defense of the medication was one of the central points of Bolsonaro’s conflict with Mandetta, which was contrary to the general recommendation of the remedy for the coronavirus.
Commenting on the meeting, Teich denied that there had been a discussion on the subject. “It was not a discussion. The CFM came to achieve a position of the institution, and what remains is that it depends on the doctor, either in the hospital or on an outpatient basis, which is a little different from what we have in the Ministry de Salud, which is used in hospitalized, seriously or critically ill patients, “he said.
According to the CFM, there is still no scientific evidence to support the use of chloroquine for the treatment of Covid-19.
“It is a drug used for other diseases for 70 years, but in relation to the treatment of Covid, there is no prospective and randomized clinical trial, carried out by respected groups of researchers, published leading-edge journals, that indicate any type of benefit of the use of hydroxychloroquine. in treatment, ”said Ribeiro.
Despite this, in the opinion, the council decided to release the doctors to use the substance.
In practice, Ribeiro disclosed the indication of the drug in three situations. The first is for critical patients, in intensive care, in so-called compassionate cases. “In other words, the patient has virtually no therapeutic potential, and the doctor, with the permission of family members, can use this medication,” he said.
However, the council also published the prescription for patients who arrive with significant symptoms at the hospital, when there is “a moment of viral replication,” with or without a recommendation for hospitalization; and also at the onset of symptoms, as long as there is a confirmed diagnosis of coronavirus and the possibility that the person actually has a normal flu, dengue or H1N1 is ruled out.
In this case, the remedy can also be prescribed at home, says Ribeiro.
“It is also a decision shared with the patient, in which the physician explains that there is no proven benefit of the medication from using Covid and the risks of the medication.”
He noted that the CFM does not authorize the preventive use of hydroxychloroquine.
When asked about the reasons that led the council to release the drug even without scientific evidence, Ribeiro said that the coronavirus is a devastating disease and that, therefore, the entity gave greater importance to the observation reports, when the doctor describes the evolution of patients after the use of a particular substance, without the same value as scientific analysis.
On April 21, the US National Institute of Allergy and Infectious Diseases. USA (Niaid) published a document contraindicating the use of hydroxychloroquine and azithromycin to treat Covid-19 due to its possible toxicity. . The entity also does not indicate the use of lopinavir / ritonavir, drugs that are also being studied to treat the disease.
The recommendation was developed by a panel of experts with representatives from at least 13 entities, including government agencies (including the drug regulatory agency, the FDA and the Centers for Disease Control, the CDC) and American medical associations.
According to the document, the use of the mentioned drugs should only be done in clinical trials.
Regarding only hydroxychloroquine and chloroquine, Niaid states that there is still insufficient data for an indication for or against drugs in the treatment of Covid-19. However, the document advises that the use must be accompanied by a control of the adverse effects, considering the risk of cardiac changes and sudden illnesses.
In the last days, studies in the USA. The USA, France and Brazil have not shown benefits of chloroquine and hydroxychloroquine for the treatment of Covid-19.
A Brazilian study by Prevent Senior even started without the approval of the ethics committee, which may be a scientific fraud, according to the CNS (National Health Council), an agency that is part of the Ministry of Health.
