Dr. Kalil is haunted by memories of the Ebola outbreak that ravaged Africa from 2014 to 2016. Then, too, doctors said they could not wait for scientific evidence, and untested drugs were given to suffering Ebola patients by optimistic physicians with noble intentions. In the long run, none of the drugs was ever approved in the United States for treatment of the disease.

Extraordinary times do not mean we should abandon our guiding principles for research and treatment. We need to be methodical, thoughtful, and, when possible, move fast but never forget the potential harm unproven treatments cause. Pandemic conditions suggest an upset in the risk-benefit calculation–without many options, any potential benefit surely must outweigh the risk of the known side effects. However, opportunity cost is systemic risk and must also be considered. While we are investigating chloroquine and hydroxychloroquine [1], ramping up its production and distribution, we may be missing more promising opportunities.

These anti-malaria drugs have been tested against SARS, MERS, dengue, Ebola, chikungunya and influenza with some evidence of effect, but never worked in treating actual patients. ↩