Spain Launches Large-scale Study of Hydroxychloroquine and Antiretrovirals to Prevent COVID-19 in Health Workers

The Spanish government has announced it will be launching a clinical trial into whether hydroxychloroquine and certain antiretrovirals can prevent frontline health workers from contracting COVID-19.

The research, dubbed the Clinical Trial for the Prevention of Coronavirus Infection in Health Workers (EPICOS) will study 4,000 health workers, from wardens to doctors, at 62 hospitals in 13 regions in Spain.

The EPICOS investigation will evaluate to what extent existing medicines may offer protection against coronavirus.

One group of participants will be given the anti-malaria drug hydroxychloroquine, while another will take a combination of the antiretroviral medications emtricitabine and tenofovir, a medication currently used to treat and prevent HIV. A third group will be given a placebo.

The randomized double-blind clinical trial, which will be overseen by the Spanish Medicines Agency, will release its first results in four weeks' time.

The research is part of the World Health Organization's Solidarity trial, which was launched at the end of March as part of a global search for drugs to treat COVID-19. People aged 18 to 65 will be eligible to take part in the trial.

Health personnel wear face masks outside the 12 de Octubre Hospital in Madrid Pablo Cuadra/Getty Images

"This is the largest clinical trial of this nature in Europe and one of the largest in the world in which, in addition to medical and nursing personnel, caretakers, radiology and laboratory technician pharmacists, that is, a broad representation of all the professions that are acting against the virus in the hospital environment," said Spain's Health Minister Salvador Illa.

The aim is to assess the risk of developing coronavirus in high-risk healthcare personnel.

Spain has Europe's highest number of confirmed cases with more than 157,000. As of Friday, the country has reported 15,800 deaths. The country has approved a 15-day extension to the national state of emergency,

Spain's Prime Minister Pedro Sánchez announced the country is close to passing the worst of its COVID-19 outbreak. "The fire starts to come under control... This war against the virus will be a total victory," he told MPs in Madrid.

The drug hydroxychloroquine is one of several being explored in clinical trials for the potential to reduce the severity of coronavirus symptoms or provide protection against infection.

Although many have touted the medication, including President Donald Trump, its effectiveness against the disease in the wider population is not yet known.

Experts in virology and infectious disease have warned that hydroxychloroquine can cause severe and life-threatening side effects. The drug, which is used to treat some autoimmune conditions such as lupus, should not be used to treat conditions for which it has not been tested, they say.

There have been various reports on how effective it is, but there is not yet any concrete evidence from large peer-reviewed studies that the drug works against coronavirus.

Newsweek has contacted Spain's Ministry of Health for a comment on the EPICOS research.

The graphic below, provided by Statista, illustrates the spread of COVID-19 across the globe as of April 9.

coronavirus, map, covid-19, countries, world
A graphic provided by Statista shows the global spread of the new coronavirus as of early April 9. More than 1.5 million people have been afflicted, over 346,000 of whom have recovered and over 93,000 of whom have died. Statista

Centers for Disease Control and Prevention Advice on Using Face Coverings to Slow Spread of COVID-19

  • CDC recommends wearing a cloth face covering in public where social distancing measures are difficult to maintain.
  • A simple cloth face covering can help slow the spread of the virus by those infected and by those who do not exhibit symptoms.
  • Cloth face coverings can be fashioned from household items. Guides are offered by the CDC. (
  • Cloth face coverings should be washed regularly. A washing machine will suffice.
  • Practice safe removal of face coverings by not touching eyes, nose, and mouth, and wash hands immediately after removing the covering.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • Avoid close contact with others if you have any symptoms.
  • Stay at home if you feel unwell, even with mild symptoms such as headache and runny nose, to avoid potential spread of the disease to medical facilities and other people.
  • If you develop serious symptoms (fever, cough, difficulty breathing) seek medical care early and contact local health authorities in advance.
  • Note any recent contact with others and travel details to provide to authorities who can trace and prevent spread of the disease.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask and glove usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of the mask.
  • Do not reuse single-use masks.
  • Regularly washing bare hands is more effective against catching COVID-19 than wearing rubber gloves.
  • The COVID-19 virus can still be picked up on rubber gloves and transmitted by touching your face.