Actually he doesn't monitor that
ETC
About your good doctor only checking QTc for people with a cardiac history: not safe. He should do better. Think of ziprasidone, for example. It's notorious for QTc prolongation but the FDA insert doesn't go far enough to recommend an EKG check before prescribing it, although it does contain the warning about the QTc. Me, I have NEVER prescribed it without checking an EKG first, regardless of cardiac history, especially because patients are not always reliable historians, and people with an isolated QTc prolongation don't necessarily have any other cardiac symptom, and they may have it without knowing about it, especially if it is just below the dangerous threshold (but would be pushed above it if given a drug that prolongs QTc). Not to forget, the drug prolongs the QT interval in people that previously had it normal, too, so it's advisable to check it again after initiation.
Dear, read this. It's in the freaking FDA insert for HCQ:
Postmarketing cases of life-threatening and fatal cardiomyopathy have been reported with use of hydroxychloroquine sulfate as well as with use of chloroquine. Patients may present with atrioventricular block, pulmonary hypertension, sick sinus syndrome or with cardiac complications. ECG findings may include atrioventricular, right or left bundle branch block. Signs or symptoms of cardiac compromise have appeared during acute and chronic treatment. Clinical monitoring for signs and symptoms of cardiomyopathy is advised, including use of appropriate diagnostic tools such as ECG to monitor patients for cardiomyopathy during hydroxychloroquine sulfate therapy. Chronic toxicity should be considered when conduction disorders (bundle branch block/atrio-ventricular heart block) or biventricular hypertrophy are diagnosed. If cardiotoxicity is suspected, prompt discontinuation of hydroxychloroquine sulfate may prevent life-threatening complications.
Hydroxychloroquine sulfate prolongs the QT interval. Ventricular arrhythmias and torsades de pointes have been reported in patients taking hydroxychloroquine sulfate (see OVERDOSAGE). Therefore, hydroxychloroquine sulfate should not be administered with other drugs that have the potential to prolong the QT interval (see DRUG INTERACTIONS).
So, if this "good doctor" chooses to pay little attention to this, and boasts that he hasn't encountered any problems... this is only good until... he does encounter one. That's how people get sued for malpractice.
Again, no, it's not true that Trump never told people to use it. Unfortunately, he did. To his credit he did say "as long as your doctor agrees" but this didn't stop people from rushing to the pharmacy to hoard the medication. You'll say, well, some doctor did agree because it's a prescription medicine, not over-the-counter. It sure is, but there are loopholes, unfortunately, like prescription mills online, or complacent, naive doctors who will write a script if someone insists very strongly.
This is so true, that I posted here a letter from my State Medical Board to all licensees, lamenting this situation and urging people to stop this practice.
So, Trump's "as long as your doctor agrees" wasn't good enough. What people heard was "take it, you have nothing to lose."
Yes, thousands of doctors agree... not a single one of them, able to quote solid scientific evidence that it works, for the simple fact that there isn't any, yet. In May we may have some, but not yet. Those opinions are of very little value. I've mentioned here that I've personally seen many doctors, on the clinical side of clinical trials, when their patients were recruited for a randomized double blind trial, swearing that the drug was working and stating they were sure their patients were taking the active drug... just to be surprised at the end, when the envelopes were opened, and their patients were taking... placebo. I don't much value this kind of impression when a condition only kills 1% of patients and 99% recover. All these wonderful anecdotes include no proof that these people wouldn't have recovered just as well without HCQ. Only a double-blind, randomized, placebo-controlled trial with a sufficient number of subjects and field-validated outcome measures will provide the answer, but we haven't had those, yet, so, hold your horses.
Continued below
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