But the evidence that hydroxychloroquine could actually be an effective treatment is, at this point, extremely thin. Might it be some kind of aid in treating the disease, for some patients? Yes, it’s possible. But Trump’s enthusiasm for it is so out of proportion, and so relentless, that one has to ask: What the heck is going on here?
Some people are inclined to believe that Trump must have a financial motive, and the New York Times did report that he owns some stock in Sanofi, a company that makes the name-brand version of the drug. But I doubt that’s what’s at work. Instead, I think there are two reasons Trump is working so hard to convince everyone that hydroxychloroquine is a miracle cure, neither of which are about Trump’s own bank account.
The first is that Trump is listening to all the wrong people. We know that he finds those with advanced degrees extremely intimidating, activating his contempt and envy for experts. So when all the doctors and public health experts and epidemiologists tell him that while we can look into the potential of hydroxychloroquine, there’s no reason to think it’s going to be transformative, it makes him more, not less, convinced that it must be spectacular.
Trump compensates for his own insecurity by working to convince himself and everyone else that the experts don’t know what they’re talking about, and he knows more than them about everything. As he said in an appearance at the Centers for Disease Control and Prevention, “Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.” The scientists standing with him neither burst out in laughter nor began weeping uncontrollably, a tribute to their self-control.
So who is he listening to? Here’s an excerpt from a recent New York Times article:
Mr. Trump first expressed interest in hydroxychloroquine a few weeks ago, telling associates that Mr. [Larry] Ellison, a billionaire and a founder of Oracle, had discussed it with him. At the time, Dr. Mehmet Oz, the host of television’s “The Doctor Oz Show,” was in touch with Mr. Trump’s advisers about expediting approval to use the drug for the coronavirus.Mr. [Rudolph] Giuliani has urged Mr. Trump to embrace the drug, based in part on the advice of Dr. Vladimir Zelenko, a self-described simple country doctor who has become a hit on conservative media after administering a cocktail of hydroxychloroquine, the antibiotic azithromycin and zinc sulfate.
So: Trump is getting his medical advice from CEOs, a TV doctor who has been assailed for promoting “quack treatments,” and Giuliani. One of Giuliani’s main sources of information on this topic is a guy who runs a company providing medical supplies to cruise ships and who was once sentenced to a year in jail for extorting Steven Seagal.
Fox host Laura Ingraham and two doctors who are regular on-air guests in what she dubs her ‘medicine cabinet’ visited the White House last Friday for a private meeting with Trump to talk up the drug.
This creates a feedback loop with Trump’s brain: He talks about it so Fox talks about it, and he watches them talk about it and becomes more convinced that he’s right about it.
But that’s only a partial explanation for Trump’s enthusiasm for hydroxychloroquine. The most important factor is that he’s desperate, he wants to come out of this a hero and it’s the only drug he’s heard of that might give him the opportunity.
The election is seven months away. We’re facing a public health crisis that could kill hundreds of thousands of Americans, and the economy has been put into a medically induced coma. Even if our social distancing measures are successful and we can restart somewhat normal life in a couple of months, it may take years for the economy to fully recover.
And even before the pandemic, Trump’s chances at reelection were probably 50-50, given his historic unpopularity and the steady demographic shifts that have made the country even younger and more diverse than it was four years ago when he squeaked out an electoral college victory despite getting 3 million fewer votes than his opponent.
Looking across that landscape, Trump needs a miracle if he’s going to get reelected, and he knows it. Or more precisely, a miracle cure.
If Trump can claim that he personally defeated covid-19, then he might just win. If hydroxychloroquine somehow turns out to be an effective treatment, he can point to all the time he spent promoting it while others were skeptical and say, “I did it, America. I saved all your lives, because I’m a genius and the so-called experts are idiots.”
That is the outcome Trump is hoping for. Is it spectacularly unlikely? Of course. But at this point it may be his only hope of reelection.