On 17 April 2020, US-based Georgian doctor, Professor of the University of Mississippi, Zurab Guruli, on his Facebook page commented upon the usage of plaquenil in Georgia to treat COVID-19: “Tbilisi colleagues, I do not know which one of you designed the protocol but administering Plaquenil to healthy people without symptoms, who have a normal CT and the disease is practically invisible, is absolutely unacceptable. Plaquenil has its special designation, but never for prophylaxis.”

On 20 April 2020, the co-author of the Georgian protocol and Head of the Coronavirus Clinical Control Group, Tengiz Tsertsvadze, stated that Zurab Guruli’s information was a “factual lie.” The next day Mr Tsertsvadze hosted a special briefing and said: “On the contrary, the protocol highlights that Plaquenil should not be administered to people without symptoms but instead to moderate, serious and critical patients. It reads that it is categorically forbidden to give Plaquenil for prophylaxis.” As clarified by Mr Tsertsvadze, a doctor might prescribe Plaquenil to a patient with mild symptoms but it is ruled out in the case of a patient showing completely no symptoms. FactCheck has already written about the usage of Plaquenil for the treatment of COVID-19.

The claim that Plaquenil is given for prophylaxis or to patients without symptoms does not correspond to the truth. In accordance with the COVID-19 clinical control protocol, COVID-19 patients who show no symptoms do not need treatment by hydroxychloroquine. It is underlined in the protocol that it is categorically forbidden to use this medication for prophylaxis of COVID-19 since using Plaquenil without a prescription might seriously harm a person’s health.

Later, Zurab Guruli provided explanation for his post: “I wrote because I received a number of very alarming messages about young patients in quarantine who are treated by this method. I was not surprised since one of the most famous and also young patients, whose disease was also without symptoms, stated openly in an interview that he was administered Plaquenil for treatment. In addition, on air on Ghamis Mtavari, Zurab Guruli further clarified: “This was simply a semantic dispute. In this case (referring to his Facebook post) I was not talking only about patients without symptoms but about patients with mild symptoms, when a person has a 37 degree temperature, has no other problem and his computer tomography is normal. This is a clinically asymptomatic case. If we take this to medical semantics, it is possible to argue there.”

In accordance with the protocol, Plaquenil is prescribed to mild, severe and very severe (critical) COVID-19 patients. However, following the same protocol, Plaquenil can also be administered to patients with mild symptoms, although the decision on treatment should be made on a case by case basis.

Tengiz Tsertsvadze also clarified that the “famous” patient, to who Zurab Guruli was referring in his statement, is Amiran Gamkrelidze’s son, Nika Gamkrelidze, who was not without symptoms and suffered from double pneumonia.

FactCheck does not rule out that Zurab Guruli did indeed receive a message about young quarantined patients being treated with Plaquenil but currently, quarantined people in Georgia are not treated with Plaquenil. The protocol gives a clear instruction that hydroxychloroquine (Plaquenil) is used only for laboratory confirmed cases and strictly after a doctor’s prescription.

The protocol also provides an explanation on the side effects of hydroxychloroquine Plaquenil) and that the medication should not be used without an authorised prescription.