The WhatsApp message pinged at 10:01 a.m. on April 20.
“We deliver everyday to various customers in Canada,” it said. “Don’t worry about it.”
The message was sent by a drug supplier, who claims to be based in India, trying to sell hydroxychloroquine and ivermectin: two drugs that conspiracy theorists say cure COVID-19 and that scientists say are useless at treating the disease.
The seller said it would ship the drugs to Canada without a prescription. But importing medications, even with a prescription, is illegal in most circumstances.
In March, Global News registered with an online referral service that connects customers with drug suppliers in India. Sellers very quickly started emailing and texting offers to sell medications at very low prices.
“Shipment by India Post service,” the same supplier wrote over WhatsApp. “Customs cleared (and) home delivery within two weeks or earlier. You will get tracking number. Deal?”
In some cases, suppliers offered to sell hydroxychloroquine for one-tenth the cost of what it’s sold for in Canada. Other suppliers, which run websites targeting Canadian consumers, specifically advertise the medication as a treatment for COVID-19.
“Price per tablet: 16 cents,” a supplier wrote.
Experts say public willingness to seek out alternative sources of medications has increased during the pandemic.
A comparison of polling data from before the pandemic and after the second wave of the virus hit shows that the percentage of people willing to shop online for health care products, including medications, has tripled in the past three years.
And roughly a third of Canadians say they’d consider buying drugs from an unsanctioned source if it meant getting them faster or accessing medications not available elsewhere.
Drug shipments seized
The consequence of this heightened demand for unauthorized drugs has been seen at the Canadian border.
During the first six months of the pandemic, border officials stopped at least 535 illegal shipments of chloroquine and hydroxychloroquine from entering Canada.
The medications, meant to treat illnesses like malaria, lupus and rheumatoid arthritis, have been found ineffective by scientists at preventing and treating COVID-19. This hasn’t stopped conspiracy theorists and some politicians, including former U.S. president Donald Trump, from touting the drugs as magical cure-alls for the virus.
The seized shipments were flagged by the Canada Border Services Agency (CBSA) and inspected by Health Canada between March 1 and Nov. 25, 2020. The government said statistics about seizures after this point are not available.
“Honestly, it makes me really sad,” said Dr. Samantha Hill, a cardiac surgeon and president of the Ontario Medical Association.
“It makes me sad for the people who were hoping to get that shipment, thinking it would save them or save their loved ones, and how desperate and alone they must have felt.”
Neither Health Canada nor the CBSA would disclose who sent and who was supposed to receive the illegal drug shipments, citing confidentiality rules.
Global News has identified a number of online pharmacies willing to sell prescription drugs without a prescription and then ship them to Canada.
Representatives from the companies said they routinely ship drugs to Canada through the mail. Several companies provided screenshots of delivery confirmations to customers in Canada and the United States as proof of their ability to complete shipments.
It’s illegal to import prescription drugs into Canada under most circumstances. It’s also illegal for companies in Canada to make false or misleading claims about the efficacy and effectiveness of prescription and non-prescription products.
“Can hydroxychloroquine be used to cure or prevent COVID-19?” Global News asked a different supplier over WhatsApp.
“It is being widely used,” the supplier replied.
Although Health Canada didn’t refer any of the seized shipments to the RCMP for criminal investigation, various government departments told Global News they’ve taken measures to stop companies from illegally importing unlicensed drugs and to prevent false and potentially dangerous advertising.
Health Canada also said it’s opened an investigation into one of the online pharmacies in India based on information provided by Global News.
“These drugs are known to potentially cause liver or kidney problems, low blood sugar and nervous system problems, such as dizziness, fainting, or seizures,” said Health Canada spokesperson Geoffroy Legault-Thivierge. “The effects on heart rhythm, in the most serious cases, may be fatal.”
The scope of problematic online drug sales is huge.
According to the Alliance for Safe Online Pharmacies (ASOP) there are roughly 35,000 internet pharmacies and only about 1,400 of them — or roughly four per cent — are legitimate. The rest potentially expose consumers to fraud, counterfeit or tainted drugs, and illegal activities, such as importing medications without proper permission.
The government warns Canadians about purchasing drugs online, adding that it can be difficult to tell the difference between legitimate and illegitimate websites.
These warnings advise people on things to look out for, such as pharmacies that have no physical address or Canadian phone number, that offer drugs without a prescription, or that make “miracle cure” claims, like being able to treat COVID-19.
Joelle Walker, vice president of the Canadian Pharmacists Association (CPA), said that while issues with online pharmacies aren’t new, the willingness of consumers to trust these sites and to seek out alternative sources of medication has increased dramatically during the pandemic.
A lot of this, she said, is due to desperation, disinformation and distrust.
“For many years now, we’ve seen that people are looking for alternative sources for medications they can’t access here in Canada,” she said. “With the pandemic now, people are looking online for all sorts of things, medications included.”
In 2018, the CPA conducted a survey that found between 15 and 21 per cent of Canadians considered purchasing drugs online, rather than from a bricks-and-mortar pharmacy.
A March 2021 survey conducted for ASOP found that nearly six in 10 Canadians are now open to purchasing drugs, medical supplies and other health care products online.
The survey also found that roughly a third of Canadians would consider purchasing health products from an unsanctioned online source for cheaper prices, faster services, or a chance to “access COVID-19 specific medications not available anywhere else.”
“In the context of hydroxychloroquine or chloroquine, we saw a huge push early on in the pandemic to use it,” Walker said. “There’s a lot of misinformation and mistrust of official sources at times. That’s really an important piece of the puzzle.”
And it’s not only products from outside Canada that are creating problems.
A recent report from Jerry DeMarco, Environment and Sustainable Development Commissioner, found that Health Canada inspectors discovered 80 instances of natural health products sold in Canada during the pandemic that claimed to prevent, treat, diagnose, or cure COVID-19.
DeMarco’s audit also searched Canadian websites to determine whether products were making claims to prevent COVID-19 or protect against it. His team examined 30 websites that advertised these kinds of products and found that 25 of them made unauthorized claims.
Spread of disinformation
Despite claims made by conspiracy theorists, anti-vaxxers and some medical professionals that hydroxychloroquine can treat COVID-19, it’s not approved for treating the novel coronavirus in either Canada or the United States.
In the earliest days of the pandemic, researchers began clinical trials to see if any existing medications, including hydroxychloroquine, might be useful against the novel coronavirus. This strategy of trial and error is common when new viruses emerge because it often takes years to develop and thoroughly test new medications.
While a few early studies showed promising results linked to hydroxychloroquine, the overwhelming majority of research has found that the drug is completely useless at stopping COVID-19.
Joe Schwarcz, a chemist and McGill University’s director of science and society, said disinformation campaigns about these medications and other non-treatments for COVID-19, especially by members of the medical community, are disturbing.
He said the motivations for spreading these kinds of unfounded conspiracy theories — like the idea that big pharma, doctors and politicians are part of a global syndicate determined to hide the true benefits of hydroxychloroquine — are fantasies that in some cases are rooted in straight-up criminal activity, greed or delusion.
“What can I tell you? It’s sickening,” he said.
There are several groups in the United States, Canada and elsewhere that actively spread disinformation about unauthorized “treatments” for COVID-19.
These groups, some of which include licensed physicians, cite research that appears to suggest alternative therapies can be used to slow or reverse the harmful effects of COVID-19.
What’s missing from this research, Schwarcz said, is any kind of consistency that shows these treatments are effective on a large scale.
To date, there have been dozens of studies that looked at chloroquine, hydroxychloroquine, vitamin D, vitamin C and other possible ways of treating COVID-19, and the results have almost always been the same — nothing works.
This includes studies that Schwarcz describes as the “gold standard” of clinical research: the controlled, randomized, double-blind study with thousands of participants in which no one knows which patients receive the drug and which receive the placebo.
“At the beginning of this scourge, there really was nothing (that worked),” Schwarcz said. “So, of course, out of desperation, you try anything that you think has some possibility.
“But, in science, we go by the data, not by our wishes. And wishing that something works doesn’t make it work.”
Schwarcz also cautioned against relying on a single study or small group of studies to support a claim that a particular drug or treatment works.
Just because a group of patients with lower levels of vitamin D were more likely to get severely ill from the virus doesn’t mean vitamin levels make any difference against COVID-19, he said.
Similarly, if enough patients are given hydroxychloroquine — or just about anything really — some of them will recover naturally, he said. It’s faulty logic to attribute this improvement to the medication alone when study after study shows no benefit.
“The plural of anecdote is not data,” Schwarcz said. “With hydroxychloroquine, there’s no statistical significance that it does any good.”
Stopping illegal drugs
The government and Canadian law enforcement agencies have made efforts to stop illegal drug shipments entering Canada during the pandemic.
The CBSA said it identifies potentially problematic shipments and flags them for further inspection by Health Canada. Neither the CBSA nor Health Canada maintain an accurate database of the total volume of illegal medications stopped at the border.
When a shipment is seized by Health Canada inspectors, the government tells the intended recipient the reason their shipment was seized and provides them information on prescription drug import restrictions. The government also asks the importer to provide details about the company that sold the medication.
Health Canada said this information is reviewed and used to determine if further compliance and enforcement actions are warranted. It may also flag seized shipments of counterfeit or unlicensed health products to the RCMP.
Health Canada said it did not refer any of the seized shipments of chloroquine or hydroxychloroquine to the RCMP, adding that the risk associated with the import of the medications was “addressed” by the government.
“Incidents of non-compliance are prioritized and action is taken based on the risk they may pose to the general public,” Legault-Thivierge said.
The RCMP, meanwhile, said it can investigate illegal drug shipments when they pose a “serious health risk” to Canadians.
The force also said it co-operates with international policing partners to stop the trade of illicit drugs. In 2014, for example, the RCMP participated in Operation Pangea VI, which resulted in the worldwide seizure of $36-million worth of counterfeit and illegal medications.
The RCMP also jointly runs a national fraud tip-line with the Ontario Provincial Police and Competition Bureau of Canada. Consumers can contact these authorities to report fraud or online scams, including illegal and unauthorized medication sales.
The government is also taking proactive measures to prevent misleading and deceptive marketing strategies that make unauthorized or untested claims about the effectiveness of health care products during the pandemic.
“The Competition Bureau has been actively monitoring the marketplace and is taking action to stop deceptive marketing claims related to COVID-19,” said Josephine Palumbo, the bureau’s deputy commissioner of deceptive marketing practices.
Palumbo said the bureau has issued at least 40 warning letters to companies across Canada to stop potentially false, misleading and untested claims related to COVID-19.
These warnings were related to products that claimed to prevent, treat or cure the novel coronavirus, such as masks, food and natural products, and ventilation and air purification products, she said. The warnings were also related to the Canadian Emergency Response Benefit (CERB) and companies claiming to collect funds or to donate proceeds to COVID-related charities.
Most businesses who received warnings have taken “corrective action,” Palumbo said. This means either pulling products that raised concerns from their shelves or stopping the false or misleading claims.