Brazil expands use of unproven chloroquine as virus death toll soars

Use of the drug will be extended to reach patients with mild symptoms, as the country’s death toll soars.

Brazilian president Jair Bolsonaro has unveiled rules expanding the prescription of chloroquine, the predecessor of an anti-malaria drug promoted by US President Donald Trump, for coronavirus patients despite a lack of clinical proof that it is effective.

Chloroquine was already being used in Brazil for Covid-19 patients in a serious condition in hospital, but under the new regulations can be given to people with lighter symptoms such as abdominal pain, cough or fever, according to the Health Ministry.

“There is still no scientific evidence, but it is being monitored and used in Brazil and worldwide,” Mr Bolsonaro, who has likened the virus to a “little flu” and feuded with local governments over their stay-at-home measures, said via his official Facebook page.

He added: “We are at war: ‘Worse than being defeated is the shame of not having fought.’”

More than 291,000 coronavirus cases have been confirmed in Brazil, the third most in the world after the United States and Russia.

Outbreak Brazil — Cemetery workers in protective clothing carry the coffin of a Covid-19 victim for burial at the Vila Formosa cemetery in Sao Paulo, Brazil, on Wednesday (Andre Penner/AP)

Mr Trump has promoted treating Covid-19 with hydroxychloroquine, a variant considered less toxic and more effective than chloroquine, and he announced on Monday he was taking the drug as a precaution.

No large, rigorous studies have found either drug safe or effective for preventing or treating the virus.

Mr Bolsonaro, a conservative populist and nationalist, has long expressed admiration for Mr Trump and enthusiasm for chloroquine.

Brazil’s new guidelines were approved by interim Health Minister, General Eduardo Pazuello, who had no health experience prior to becoming the ministry’s No. 2 official in April.

Mr Teich did not explain why he left, but he had publicly disagreed with Mr Bolsonaro over chloroquine.

Speaking on Wednesday to a group of street cleaners in the capital, Brasilia, Mr Bolsonar suggested he had no plan to replace Gen Pazuello: “This one is going to stay for a long time”.

Officials say nearly 19,000 people have died of the coronavirus in Brazil so far, and experts warn that low testing rates mean the true number of cases is likely far higher.

Health systems in various states have gone over capacity, with overwhelmed intensive care units unable to take in new Covid-19 patients, and experts say rising numbers of people are dying at home.

Virus Outbreak Brazil — A man cries over the coffin of 22-year-old Covid-19 victim Amanda da Silva at the Caju cemetery in Rio de Janeiro, Brazil, on Wednesday (Silvia Izquierdo/AP)

Gen. Pazuello appointed nine more military officers to the Health Ministry on Tuesday, Folha de S. Paulo reported, including his No. 2, Col. Antonio Elcio Franco Filho.

Mr Bolsonaro continues to oppose governors and mayors who are renewing stay-at-home recommendations or introducing stricter measures.

The former army captain has argued in favour of restarting the economy, even though experts say Brazil has yet to reach the peak of the pandemic. He believes that containment measures are too painful in a country where tens of millions of workers depend on low-paid jobs in the informal sector.

Several large observational studies, including one in US hospitals for veterans, have not found benefit from hydroxychloroquine for treating Covid-19.

Earlier this year scientists in Brazil stopped part of a study of chloroquine after seeing heart rhythm problems among patients taking a higher of two doses being compared.