PANDEMIC TIMELINE: PAGING DR. TRUMP?

The Pandemic Timeline page at BillMoyers.com collects all installments in this series here.

When Trump Plays Doctor, People Die

For years, Trump failed to prepare America for a pandemic. For months after COVID-19 emerged, he downplayed its danger. Now he’s touting a dubious miracle cure.

Facing relentless criticism amid mounting deaths, Trump has been telling first responders, doctors, nurses and the public that hydroxychloroquine and chloroquine will keep them from contracting COVID-19 — something that no infectious disease expert has ever suggested.

“What do you have to lose?” he asks repeatedly.

Trump’s COVID-19 Briefings: A Public Health Menace

Mar. 19, 2020: At a press briefing, Trump says that hydroxychloroquine and chloroquine — drugs that successfully treat malaria, lupus, and rheumatoid arthritis — have been approved by the Food and Drug Administration to treat COVID-19. That’s false. He adds, “The nice part is, it’s been around for a long time, so we know that if it — if things don’t go as planned, it’s not going to kill anybody.” Also false.

FDA Commissioner Stephen Hahn corrects Trump, saying that clinical trials are required to determine whether the drugs are safe and effective in treating COVID-19. Otherwise, it’s impossible to know whether they are better, the same, or worse than doing nothing at all.

Mar. 19-20: In response to Trump’s misinformation, demand for the drugs surges, creating shortages for lupus and rheumatoid arthritis patients who need it.

Mar. 20: A controversial French expert in infectious diseases, Dr. Didier Raoult, publishes his study on the use of hydroxychloroquine combined with azithromycin to treat 26 infected COVID-19 patients. Four (15%) actually got worse: three were transferred to the ICU and one died on the third day of treatment. The study notes the limitations of his work: “a small sample size, limited long-term outcome follow-up, and a dropout of six patients from the study.”

Mar. 20: At a press briefing, Trump continues to promote hydroxychloroquine. Asked whether it is effective for treating COVID-19, Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, responds bluntly: “The answer is no, and the evidence that you’re talking about … is anecdotal evidence.”

Mar. 21: Citing Dr. Raoult’s publication, Trump tweets: “HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine…. Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents) be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST.”

Mar. 23: An otherwise healthy Arizona man dies and his wife is hospitalized in critical condition after drinking a small amount of veterinary chloroquine phosphate. Concerned about catching COVID-19, they recognized the name “chloroquine” from Trump’s press briefings and took it based solely on his recommendation.

Mar. 24: Nationwide shortages of hydroxychloroquine and chloroquine worsen as doctors hoard the drugs by prescribing them to themselves and family members, ProPublica reports.

Mar. 25: The head of the Mayo Clinic’s Sudden Death Genomics Lab issues public guidance to physicians warning that some patients taking hydroxychloroquine as an experimental COVID-19 treatment are at increased risk for sudden cardiac death.

Mar. 28: Trying to replicate Dr. Raoult’s study, French infectious disease experts apply his protocol to 11 patients: one dies, two are transferred to the ICU and a fourth patient suffers adverse cardiac effects requiring discontinuation of the drugs. The study finds no evidence of a clinical benefit in using hydroxychloroquine and azithromycin to treat patients with severe COVID-19.

Mar. 28: The FDA authorizes emergency use of hydroxychloroquine and chloroquine, allowing doctors to prescribe them on a limited basis to certain COVID-19 patients. But the FDA emphasizes that the untested drugs have not been approved for general use to treat the virus.

Mar. 30: At a press briefing, Trump again touts hydroxychloroquine and chloroquine as COVID-19 treatments.

Mar. 31: “[D]ue to a significant surge in demand,” the FDA adds hydroxychloroquine and chloroquine to its drug shortages list.

Apr. 3: The International Society of Antimicrobial Chemotherapy — publisher of the medical journal where Dr. Raoult’s study appeared — issues an unusual statement expressing “concerns” that the study “does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety.”

Apr. 4: During a meeting in the White House Situation Room, Trump’s trade adviser Peter Navarro says that studies of hydroxychloroquine and chloroquine show “clear therapeutic efficacy.” Dr. Fauci disagrees, saying that the evidence is only anecdotal. Navarro raises his voice, and Jared Kushner turns to him saying, “Peter, take yes for an answer.”

At a later press briefing, Trump says he is placing millions of doses of hydroxychloroquine in the federal stockpile of emergency supplies. Asserting that he might take the drug himself, he adds, “What do you have to lose? Take it. I really think they should take it. But it’s their choice. And it’s their doctor’s choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you’d like.”

Apr. 5: No medical evidence supports using hydroxychloroquine to prevent COVID-19. Nevertheless, Trump suggests that doctors, nurses, first responders, and medical personnel going into hospitals should take the drug prophylactically. Again he says, “What do you have to lose?”

Although the FDA has not approved the drug for general use in treating COVID-19, Trump also repeats his earlier lie that “[the FDA] gave it rapid approval.” When a reporter asks Dr. Fauci about the drug’s effectiveness, Trump interrupts and physically interposes himself between the doctor and the microphone before he can answer.

Also on Apr. 5: Responding to Trump’s question —“What do you have to lose?” — the president of the American Medical Association tells CNN, “You could lose your life.”

Apr. 6: Following reports that the drug is causing severe adverse side effects, including seizures and vision loss, several hospitals in Sweden stop administering chloroquine to COVID-19 patients.

Also on Apr. 6: At a press briefing, a reporter asks Trump if there is a system in place to track the side effects of hydroxychloroquine. Trump answers, again falsely, “The side effects are the least of it. You have people dying all over the place. And generally, the side effects are really with the Z-Pak having to do with the heart. The Z-Pak — that’s the antibiotic. Not with the hydroxychloroquine… And I say, ‘Try it.’”

Apr. 7: The head of cardiology at Nice University Hospital in France says he restricted treating patients with hydroxychloroquine combined with azithromycin because of side efffects including heart issues.

Apr. 8: At a press briefing, Trump continues pushing hydroxychloroquine and azithromycin as COVID-19 treatments saying, “[Z]inc — they say zinc — they say you should add zinc.”

Apr. 12: A study in Brazil is halted early for safety reasons after COVID-19 patients taking higher doses of chloroquine develop irregular heart rates that increased their risk of a potentially fatal heart arrhythmia. Of 81 patients in the study, 11 (14%) died by the sixth day of treatment.

Apr. 14: Medical researchers in China publish a study of 150 patients, concluding that hydroxychloroquine does not help outcomes and produces adverse side effects in some patients.

Also on Apr. 14: Medical researchers publish a study involving 181 COVID-19 patients in four French hospitals, 84 of whom received hydroxychloroquine within 48 hours of admission. The drug did not significantly reduce transfers to the ICU or death.

Apr. 21: A study of 368 patients in VA hospitals “finds no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with COVID-19. An association of increased overall mortality was identified in patients treated with hydroxycholoroquine alone.”

Also on Apr. 21: A panel of experts convened by the National Institute of Allergy and Infectious Diseases (NIH) that Dr. Anthony Fauci directs recommends against using a combination of hydroxychloroquine and azithromycin to treat COVID-19 patients because of potential adverse heart effects. The panel says that there is “insufficient clinical data to recommend either for or against.”

Apr. 23:  Undeterred by the growing body of medical evidence against hydroxychloroquine as a viable treatment for COVID-19, the president seeks another miracle cure. In a coronavirus task force briefing President Trump suggests that powerful light brought inside the body could combat the virus.The president goes on to say that ingesting disinfectant could be a possible magic bullet: “[D]isinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that.”

Apr. 24: The FDA “cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems.” It notes the increased use of the drugs through outpatient prescriptions and reminds health care professionals and patients of the known risks associated with the drugs, which “have not been shown to be safe and effective for treating or preventing COVID-19.”

Industry members. including Lysol, issue warnings and doctors around the world are quick to contradict the president’s suggestions.

What Do You Have to Lose?

Your health, your eyesight, your life, and the wellbeing of chronically ill fellow citizens who need hydroxychloroquine and chloroquine to survive. That’s what you have to lose.

Here are links to: Part I, Part II, Part III, and Part IV of this series on Trump’s Lies and Deceptions. An earlier background piece is here.

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