Treatment of COVID-19

Treatment of COVID-19

March 25, 2020

Dear Colleague:

In the most recent days, there has been a surge in demand of potential treatments for COVID-19 for drugs commonly used to treat malaria, lupus, rheumatoid arthritis, HIV, bacterial infections and other conditions. This is leading to an inadequate medication supply for patients already taking these medications for chronic conditions and hospitalized COVID-19 patients being treated with these medications under facility-specific treatment protocols while studies are ongoing.

There are currently no antiviral drugs approved by the U.S. Food and Drug Administration (FDA) to treat COVID-19. Some in-vitro or in-vivo studies suggest potential therapeutic activity of some agents against related coronaviruses, but there are no available data from observational studies or randomized controlled trials in humans for the CDC to support recommending any investigational therapeutics for patients with confirmed or suspected COVID-19 at this time.

The Virginia Department of Health in consultation with the Virginia Department of Health Professions recommends the following:

  • Prescriptions for chloroquine, hydroxychloroquine, mefloquine and azithromycin should be restricted in the outpatient setting and should require a diagnosis “consistent with the evidence for its use.”
  • Community pharmacists should use professional judgement to determine whether a prescription is valid and that there is a bona fide practitioner-patient relationship prior to dispensing.
  • Prioritize treatment for continuation of existing medication therapy, inpatient settings, and other indications where there is not an alternative therapy.
  • Advise against hoarding these medications or stockpiling.

There is currently no available data from randomized clinical trials to inform clinical use.  Refer to the CDC for more information on therapeutic options for COVID-19. (https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html).

Sincerely,

M. Norman Oliver, MD, MA
State Health Commissioner