Texas City nursing home doctor explains using hydroxychloroquine for COVID-19 patients

The doctor who prescribed an unproven medication to more than two dozen COVID-19 patients at the Resort at Texas City, the site of one of the largest outbreaks in the Houston area, said the decision was between him and his patients and did not notify families before the drugs were administered.

Dr. Robin Armstrong said he thought the potential benefits outweighed the risks.

While hydroxychloroquine is not approved for treating COVID-19, which so far has no cure, preliminary studies have suggested it might tamp down its symptoms.

State health officials say 10,000 bottles of the drug — commonly known by its brand name Plaquenil — have also been provided to 61 Texas hospitals for use on coronavirus patients.

Armstrong, who is a Texas Republican National Convention committee member, said the drug has been around for decades and that he understands well how it works.

“I am confident that the risk of the medication is low, and the failure rate, if they’re not treated, is fairly high,” Armstrong said. “So I am making the call that it is worth treating them with medications that we’re very familiar with that has a very low risk factor profile and it’s worth doing that as opposed to allowing them to go out into the community, allowing them to go to the hospital where the mortality rate is very high.”

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He added, “If I had a loved one who was COVID-19 positive and they had the risk factors that I’ve outlined, I would certainly start them on it.”

Armstrong said most of those that learned about the treatment were excited to hear that the drug was available to try.

Patients were evaluated for eligibility for the treatment based on the severity of their symptoms, such as low oxygen saturation levels, he said.

President Trump has repeatedly touted the drug as a potential cure, though health experts have warned that it could cause major potential side effects, especially for the heart. The government’s top infectious disease expert Dr. Anthony Fauci has said more testing is needed before it’s clear that the drug works against the virus and is safe for use.

Armstrong, a former vice chair of the Texas GOP who serves on the advisory board of the Black Voices for Trump coalition, said his politics don't play into his medical decisions.

“Completely separate. Completely unrelated,” Armstrong said. “If the results aren’t good, we’ll stop it. The science will guide us and lead us there. The political part of it is irrelevant to me.”

The cluster of cases at the home was discovered a little over a week ago when an employee tested positive for the virus, leading Galveston County health officials to test 146 residents and employees. Eighty-three residents and employees originally tested positive, and so far, one has died. As of Tuesday, Armstrong said 56 were positive.

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In total, 27 patients are taking hydroxychloroquine in combination with the antibiotic azithromycin and the vitamin zinc, Armstrong said. Some started as early as Saturday, others started in the two days following. The treatment will last five days.

The drugs became accessible for Armstrong after Amneal Pharmaceuticals donated 1 million tablets to the Texas Department of State Health Services pharmacy.

State Sen. Bryan Hughes, R-Mineola, said he helped arrange the donation after a colleague at his law firm, who is friends with a board member at Amneal, mentioned the company was interested in giving away the drug to patients who needed it.

“Many physicians are saying it’s helpful in treating their COVID-19 patients,” Hughes said. “So we want to make sure that the doctors have every tool available to them.”

Hughes said he has also coordinated conversations between the company and other states about future donations, including Lousiana where officials last week accepted 400,000 tablets, as well as Mississippi, Arkansas and Georgia.

DSHS spokesman Chris Van Deusen said the state’spharmacy has been giving the drugs out upon request and has provided 559 bottles of hydroxychloroquine to 61 hospitals, including HCA Houston Healthcare Kingwood, Twelve Oaks Hospital and Lyndon B. Johnson Hospital in Houston. Each bottle contains 100 pills.

Armstrong said he doesn’t want to minimize the potential risks of the drug or its interactions with other drugs, but he said he doesn’t see the concerns about it causing heart rhythm problems all that different from those involved with many medicines.

Armstrong said it’s too early to say whether the treatment is working . Some patients have seen improvements in their oxygen saturation levels, but it’s unclear whether that is related to the treatment.

“We’re trying to catch these elderly folks very early because what the evidence has shown is that specifically when they get so sick that they have to go to the hospital, their mortality rates go through the roof,” Armstrong said. “Our ultimate goal is to keep them well and to keep them out of the hospital and to make sure that they’re able to survive through this.”

A previous version of this article misstated Bryan Hughes' title. Hughes is a state Senator.


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