It was the sort of anecdotal evidence about combating the coronavirus experts repeatedly have cautioned against, assessments of the success of a drug that could be influenced by placebo effects or accidental correlations. It was far from rigorous or determinative, but the phrasing was irresistible for Trump: He was right, and the “experts” were wrong.
On Tuesday, a new government study was published suggesting the drug didn’t offer any benefit in fighting covid-19, the disease caused by the virus, and worse, that its use was correlated with more deaths. This, too, was not a controlled trial and should be considered only with caution. But if Trump wanted to have a knife fight over perceptions of the drug’s effectiveness, here was a knife for his opponents.
During Tuesday’s daily coronavirus news briefing at the White House, Food and Drug Administration Commissioner Stephen Hahn was asked about the study conducted by the Department of Veterans Affairs. He offered the answer you’d expect: The FDA would wait for controlled trials before making a determination.
Then Trump was asked about it.
“I don’t know of the report,” Trump said. “Obviously, there have been some very good reports, and perhaps this one is not a good report. But we’ll be looking at it."
A reporter noted that a panel of experts organized by the National Institutes of Health was recommending against combining the drug with the antibiotic azithromycin out of concern for side effects, including possible heart problems. (The CIA had similarly warned its employees about using the drug.)
“Well, we’ll take a look at that,” Trump said. “I’m always willing to take a look.”
Before this week, Trump’s approach to the drug was significantly different. Forty-six times since March 19 Trump has discussed hydroxychloroquine, including boasting of the tens of millions of doses the government had secured to combat covid-19. He would occasionally temper his enthusiasm about the drug with asides about how he was operating more from optimism than medical expertise, but the idea of the drug as an important part of the coronavirus arsenal became part of his standard patter at the briefings.
His rhetoric was amplified by anchors on Fox News and Fox Business. The two networks mentioned the drugs nearly 1,000 times during the same period, no show more frequently than Laura Ingraham’s prime time. Ingraham also visited the White House with two doctors to push for the use of the drug.
You’ll notice the number of mentions by both Trump and Fox News has tapered off of late. The VA study wasn’t the first bit of bad news about the drug. Small controlled studies similarly suggested hydroxychloroquine wasn’t effective against covid-19. Fox and Trump mentioned it less and less.
Trump’s favorite network couldn’t entirely avoid the subject on Wednesday morning, however. The show “Fox and Friends” invited celebrity doctor Mehmet Oz on to discuss the subject. Oz has appeared on Fox repeatedly in recent weeks, often to tout the drug’s potential efficacy — with Trump reportedly taking notice.
“What's your reaction to that since you've been doing — we've all been doing heavy work to find out where — if this works or not,” host Brian Kilmeade said.
After explaining about the VA study, Oz suggested patience was in order.
“The fact that matters, we don’t know,” he said. “Thankfully, these medications are prescription only. So doctors are desperately awaiting the completion of the higher-quality randomized trials. And we’ve — you’ve covered them on the show several times: South Dakota, University of Minnesota now has over a thousand patients randomized. There’s additional trials going on. Let’s get that data so we know what we’re dealing with.”
“Isn’t it important to know what they’re combining with? And the dosage?” Kilmeade pressed. “Because it’s not supposed to be taken on its own.”
“Yeah,” host Ainsley Earhardt interjected. “Z-Pak?” she asked, mentioning a brand-name version of azithromycin.
“Don't you have the Z-Pak?” Kilmeade agreed.
“There’s a lot of variables, Brian,” Oz replied. “I got to say, I think at this point there’s so much data coming from so many places, we’re better off waiting for the randomized trials Dr. Fauci has been asking for. Otherwise, this is how we keep reacting to the back-and-forth for studies that show opposite results.”
Fauci, of course, is Anthony S. Fauci, a leading member of the White House task force targeting the virus. He has repeatedly urged caution on promoting the drug, including doing so judiciously while standing next to Trump at the daily briefings. Earlier this month, he tried to push back on Kilmeade and Earhardt during an appearance on their show as the hosts advocated for the medication.
“We operate on what evidence is and data is,” Fauci said on April 3. “So although there is some suggestion with the study that was just mentioned by Dr. Oz — granted that there is a suggestion that there is a benefit there — I think we’ve got to be careful that we don’t make that majestic leap to assume that this is a knockout drug.”
Bandying about complicated names of medicines while advocating complex dosing recommendations and using the word “efficacy” a lot is like walking around wearing a lab coat and stethoscope. You might not be an expert, but you certainly carry yourself like one. More broadly, though, the appeal for the Fox News hosts is the same as it is for Trump: to be the ones who were right when everyone else was wrong.
The beauty of playacting as a doctor is that, if needed, you can take off the lab coat and move on to something else. The world being what it is, lots of people probably will forget you ever put it on the first place.