Imagine a person — you probably know one — who believes that President Donald Trump is the best person to listen to about how he or she should deal with the ongoing novel coronavirus pandemic. That person has gone from never or barely having heard of the coronavirus in January, to wondering what the hell was going on in China in February to wondering when we're all going to be allowed to go back outside in March.
That person has also been listening to an increasingly loud barrage of proclamations from the president about hydroxychloroquine, an anti-malarial drug that's also frequently used to treat those with autoimmune conditions like lupus and rheumatoid arthritis. Trump insists that hydroxychloroquine, which has been used among a small sample of COVID-19 patients in France and China, could be a miracle drug.
"I think it could be, based on what I see, it could be a game changer,” Trump said at a White House press briefing on March 19.
The president argued a few weeks later that Americans risked nothing by taking the drug.
“What do you have to lose? I’ll say it again: What do you have to lose? Take it. I really think they should take it,” Trump said, at another briefing.
As French doctors have continued to administer hydroxychloroquine to COVID-19 patients, dozens of those taking the drug have reported heart incidents, according to a report in The Hill. Elsewhere, doctors have tamped down expectations about the drug's efficacy against the coronavirus.
“That’s our goal, to really rapidly identify as quickly as possible, does this actually work or not? Because there’s a lot of hubbub about it now,” David Boulware, a professor of medicine at the University of Minnesota, told The Washington Post. “But there’s very little evidence that we actually have that this has a clinical benefit, which is kind of bad for something that’s being very heavily promoted. We should probably have some data and some science behind it.”
Boulware is running a clinical trial to determine hydroxychloroquine's potential for prevention and early treatment of the coronavirus.
In Texas, Robin Armstrong, the medical director of a nursing home in Texas City, is conducting a study of his own. Armstrong, the former vice chairman of the Republican Party of Texas, called Texas Lt. Gov. Dan Patrick, according to NPR, and asked for access to the drug after patients at The Resort began testing positive for COVID-19.
Patrick, with help from state Sen. Bryan Hughes, an East Texas Republican, hooked Armstrong up.
Armstrong told NPR that, while most of the nursing home residents to whom he administered the drug were aware of what they were taking, some patients had dementia and did not know.
Hydroxychloroquine is a serious drug. Susan Horan — a former emergency room nurse and, it should be noted, the wife of Observer copy editor Jeff Cavallin — takes the drug for her rheumatoid arthritis. Due to the drug's potential side effects, she has to undergo a specialized eye exam yearly as well as periodic cardiac checks.
Dr. Dona Murphey, the director of medical initiatives for Project Lifeline, a human rights organization focused on medical issues, said she's troubled by Armstrong's ad hoc trial, questioning Armstrong's political ties and comparing the trial itself to the Tuskegee Experiment.
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"This kind of thing is just really, really disconcerting," Murphey said, "particularly because the accountability is just not there because people are not aware of what is happening."
Dr. Jason Westin, the leader of the diffuse large B-cell lymphoma research team at the University of Texas MD Anderson Cancer Center, said Armstrong's experiment isn't typical of clinical trials.
"There's a set way of doing clinical trials. Normally, we go through a significant review process, and look at the ethics and make sure it is ethical to do this," the doctor says. "In a pandemic, I understand the need to push the envelope and move quickly, but we are basing a lot on very little. The data supporting (the use of) hydroxychloroquine or the antibiotic azithromycin is based on really weak data. Look at the data in France, there was a series of patients and they were treated with this.
"They got better — 10 or 15 patients total — this is not a randomized trial of 100 patients or 1,000 patients, this was a small group that did not have a comparative arm to see what happened if you didn't treat people. We don't know if they were all going to get better anyway, so these are basically anecdotes — examples without any scientific evidence that we're using to treat people with drugs that we know have risks. We know these drugs can cause cardiac arrhythmias. They can be harmful."