So what states are most effective in preventing death from COVID-19? It seems as though the Republican states are. Let’s take a look.
Consequences of the anti-HCQ Media Operation
The situation was aggravated by actions of some state governments, which started restricting access to HCQ for COVID-19 victims. The Governor of New York outright denied HCQ to COVID-19 victims, except for inpatient treatment and clinical studies. Physicians felt pressured to postpone HCQ treatment for COVID-19 patients. Instead of beginning HCQ treatment as early as possible, they postponed its use the late stages of the disease.
Late treatment with HCQ was frequently used as compassionate care for the most desperate causes. Delaware’s HCQ policy illustrates this thinking in late March: “This drug is used in very limited instances for very critically ill patients with COVID-19, in a clinical setting.” This led to statistics in which use of HCQ was correlated with worse outcomes. Bad actors exploited the correlation-as-causation fallacy to advocate against HCQ.
Apparently, in the early April the medical establishment in the North East (inclusive of NY, NJ, MA, CT, PA, MD, and DC) decided against the use of HCQ as a COVID-19 treatment. Coincidentally or not, this area became the main COVID-19 death cluster, responsible for more than 60% of the US COVID-19 deaths.
HCQ State Orders
Lacking the authority to completely ban doctors from prescribing HCQ, some governors restricted pharmacies from fulfilling prescriptions to COVID-19 patients, but not to other patients. Notice that the rational policy to deal with shortage would have been to limit dispensed quantities of HCQ to everyone. This would have ensured that all patients receive the drug. The effect of the inverted policy was suffering of COVID-19 victims, stockpiling of the drug by users with 90-day prescriptions, and increased shortages. New York and Michigan outright banned dispensing HCQ to COVID-19 victims, with rare exceptions, and allowed stockpiling by other users. Apparently, when pharmacies in New York ran out of HCQ, lupus patients raided neighboring states.
Some states did not ban, but created obstacles for COVID-19 victims, like the requirement that the patient tested positive for COVID-19 (when the availability of tests was limited). In the best case, the result was delay of HCQ treatment, sharply decreasing its anti-viral efficiency.
NY’s policy on HCQ fulfillment was probably the worst (score: 10):
No pharmacist shall dispense hydroxychloroquine or chloroquine except when written as prescribed for an FDA-approved indication; or as part of a state approved clinical trial related to COVID-19 for a patient who has tested positive for COVID-19, with such test result documented as part of the prescription. No other experimental or prophylactic use shall be permitted, and any permitted prescription is limited to one fourteen-day prescription with no refills.
The result of banning the use of Hydroxychloroquine in those states was a very high death rate:
This map shows the states with higher than average US COVID-19 mortality rates. Darker red indicates states with more than 500 deaths per million. Lighter red indicates more than US average, or 250-500 deaths per million. New York, a few surrounding states, and DC create a cluster, which accounts for more than 60% of US COVID-19 deaths. This cannot be explained by residents’ traffic. While people from NJ and CT commute to NYC, there is not much regular traffic between NY and MA or PA. It is likely that the unreasonable HCQ policies in NY and NJ caused shortages of HCQ, which spilled over to the neighboring states. This suggests that lack of HCQ for COVID-19 patients was a factor in increasing COVID-19 mortality rates.