Brazil expands approval of chloroquine to treat COVID-19. Utah canceled its big bet on the unproven drug.

Brazilian President Jair Bolsonaro announced Wednesday that the Health Ministry had expanded approved uses of the anti-malaria drug chloroquine to treat milder cases of COVID-19. Brazil now has the world's third-largest coronavirus recorded outbreak, after the U.S. and Russia, and hospitals and health systems in several states have gone over capacity. "There is still no scientific evidence, but it is being monitored and used in Brazil and worldwide," Bolsonaro said on his Facebook page.

Chloroquine is the predecessor of hydroxychloroquine, which President Trump says he is now taking in a preventative capacity. Bolsonaro, a conservative populist and admirer of Trump, has continually downplayed the severity of COVID-19 and is clashing with cities and states that have enacted lockdowns and other coronavirus mitigation efforts. Brazil ended one study of chloroquine after detecting an increase in heart arrhythmia, and several large observational studies have found no positive effect of the drug on COVID-19 patients and some negative outcomes.

The order to expand approved use of chloroquine was signed by interim Health Minister Gen. Eduardo Pazuello, who had no health experience when Bolsonaro made him the No. 2 official at the ministry in April. His appointment followed Bolsonaro's firing of Health Minister Luiz Henrique Mandetta after he publicly supported governors pursuing mitigation measures, and Pazuello got the top job when Mandetta's successor, Nelson Teich, resigned last week after he publicly clashed with Bolsonaro over chloroquine.

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Utah, meanwhile, caught hydroxychlorquine fever early, preparing plans to allow the drug to be distributed without prescription and ordering at least $800,000 worth of chloroquine and hydroxychloroquine from a pharmacist who was helping draw up those plans, Stat News reported Sunday. Utah canceled the order in late April and got a refund.

Hydroxychloroquine's rise and fall in Utah "provides a case study of what happens when hope and excitement about therapies outpace the evidence," Stat reports. "It underscores the pressure officials felt to demonstrate they were on top of the response, even as such efforts sowed confusion among the medical community and led them into initiatives they came to regret. And, mirroring the hydroxychloroquine debate in the Trump administration, it shows how experts scrambled to inject restraint and plead for leaders to follow evidence at a time when promises of easy remedies were more enticing." Read more about Utah's experience at Stat News.