No Agenda
This project never started with an agenda. It started with this writer's plan to travel to Africa in March, 2020. That trip was ultimately cancelled due to the pandemic but before that there was a great deal of attention paid to the early spread of the COVID-19 pandemic in Africa. There were some early cases in northern Africa. The first case in sub-Saharan Africa ("SSA") was noted in Lagos, Nigeria on about March 1, 2020, almost exactly the same time as the first cases were noted in New York City.
Unexpected Phenomon - Better Outcomes in Africa
Experts predicted COVID catastrophe in Africa. This writer and others noted a most unexpected phenomenon. There exists a relative paucity of coronavirus cases and deaths in many areas of the world. It was noticed early on that there were fewer coronavirus infections in India. Like other south Asian countries, India is known to have some endemic prevalence of malaria. India is the world's largest manufacturer of hydroxychloroquine. Quinine, the predecessor of hydroxychloroquine has been used to treat malaria in India since 1800. This begs the question - what is the relationship between coronavirus and malaria. Further, what is the relationship between coronavirus and hydroxychloroquine other anti-malarial drugs. India is a massive country with variable malarial prevalence. Thus, a study of India may not provide clear answers. Here, attention was focused on countries with a more serious or defined malarial prevalence. Attention was focused on six SSA countries with the world's highest prevalence of malaria. Here, even the initial data was striking. On a population-adjusted basis, the risk of dying of coronavirus in the U.S. and the industrialized West is found to be one hundred and fifty times greater than that of SSA.
Crossover Prophylaxis
This led to the hypothesis that antimalarial drugs taken as prophylaxis in these SSAs also have a crossover prophylactic effect against coronavirus. This data has now been followed and updated for several months. The data was age-adjusted in order to ensure the data would be the most accurate possible. Still, the profound disparity persists, month after month. When adjusted for age, the most accurate data possible, the risk of dying of coronavirus in the U.S. and the industrialized West was found to be about thirty times that of SSA. This figure remains steady, month after month.
No Impact on U.S. or Western COVID Care
Some have questioned the integrity of this data coming out of SSA. The integrity of the African data is discussed more thoroughly here. Others seemed to have simply ignored this data. Some have offered other speculative hypotheses as to why SSA countries have improved COVID outcomes. Some of these alternative hypotheses are discussed here. None of these speculative hypotheses appear to have appreciably impacted clinical care in the U.S. or Europe. None of these speculative hypotheses appear to have appreciably impacted clinical care in the U.S. or Europe.
Please, Follow the Data!
This writer suggests that we (our medical and scientific experts and leaders) should follow the data. We should go where the data leads. The data may appear "too good to be true." In the midst of a pandemic where a million people have died, we must investigate this data for all it is worth.