Bolsonaro Orders Pazuello to Sign Decree Releasing Chloroquine to All Covid-19 Patients

RIO DE JANEIRO, BRAZIL – Appointed as acting head of the Ministry of Health, the portfolio’s executive secretary, General Eduardo Pazuello, is expected to release the use of chloroquine in patients with mild covid-19 symptoms.

The measure is President Jair Bolsonaro’s order, which oncologist Nelson Teich refused to comply with and, under pressure, resigned. Currently, the portfolio advises professionals in the public health system to prescribe the substance only in moderate or severe cases.

The Ministry’s experts hope that the criteria will be presented as early as next week before Teich’s replacement is chosen. According to reports by aides from the now ex-Minister, Pazuello himself was pressing for the signing of a decree extending the use of the drug, which has not yet been scientifically proven to be effective against the disease.

Teich had suggested to Bolsonaro that the portfolio should conduct a study to define new guidelines for recommending the substance in the fight against the coronavirus. The studies will be conducted, but the President demanded urgency. In a video call with entrepreneurs on Thursday, he even said he “demanded” a change in the Ministry’s protocol regarding the drug.

“I’m demanding the issue of chloroquine now as well. If the Federal Council of Medicine has decided that chloroquine can be used from the first symptoms, why will the federal government, through the Minister of Health, say it can only be used in serious cases? I am a commander, the President of the Republic, I decide, I go to any minister and talk about what is happening. And that’s the rule, that’s the way it is,” said Bolsonaro at the time.

Teich, who is an oncologist, had been resisting the change with the argument that chloroquine is still “unclear.” In a Twitter message on Tuesday, he cautioned about the side effects. “An important warning: chloroquine is a drug with side effects. So any prescription should be made based on a medical evaluation. The patient must understand the risks and sign the ‘Consent Form’ before starting to use chloroquine,” Teich wrote on Twitter.

The protocol to be endorsed by Pazuello should be based on the CFM resolution. In April, the body released the substance to patients with mild symptoms but stressed that the decision had not been made “based on science,” simply to end the division surrounding the drug.

With the decision, doctors are allowed to prescribe the drug. However, there is no protocol for distributing the drug so that patients can access it in the public system. The guidelines may also specify dosages to be administered.

In a statement released Friday night after Teich left, the Ministry said it is “finalizing the new guidelines.” “The goal is to start treatment before the patient’s worsening and need to use the ICU,” the portfolio said.

Currently, the Ministry of Health’s protocol is more cautious and follows what scientific societies have been saying. The drug can lead to severe side effects, such as cardiac arrest. This is one of the reasons for the resistance of health communities to recommend chloroquine without medical follow-up.

‘Subordinate’ Minister

Pazuello’s appointment as the Ministry’s number two was perceived as a kind of “safeguard” of the government’s military wing in Health after Teich’s predecessor, Luiz Henrique Mandetta, embraced an independent position from the Planalto Palace during his administration.

Since taking office, Teich failed to build his team and saw the portfolio taken over by the uniformed subordinates. In the last week, at least ten names connected to the Armed Forces took on strategic positions.

The Ministry of Health’s staff believes the body will be stripped of its posts. The working environment, they say, is “unbearable,” and there’s pressure from both advocates of ending social isolation and those who demand greater strictness from the government to halt the spread of covid-19.

Source: Estadão