The Washington PostDemocracy Dies in Darkness

The wide and dangerous gap between Trump’s covid recommendations and his treatments

President Donald Trump boards Marine One at the White House on Oct. 2, 2020, en route to Walter Reed National Military Medical Center, after testing positive for the coronavirus. (Amanda Voisard for The Washington Post)
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There’s a telling scene in Mark Meadows’s new book about his time as Donald Trump’s White House chief of staff. It comes just after Meadows had pulled aside reporters to inform them that, despite the vague claims made by doctors from Walter Reed National Military Medical Center about the president’s coronavirus infection, Trump’s health was in bad shape. Meadows had asked to be unnamed in news reports, but he’d been caught on camera asking to do so. In other words, it wasn’t hard to figure out the source for the information — accurate information, but not what Trump wanted Americans to hear.

“President Trump was not happy when he read the original anonymous quote, and he was even less happy when he found out that it was me, his chief of staff, who had let the press know what rough shape he was in,” Meadows writes. Trump called him in to his hospital room. “Although he didn’t have much to say about the incident,” Meadows says, “he pointed out that the stories were all about my comments” — what he says Trump called a “rookie mistake.”

The tone of Meadows's book is universally fawning, with nearly every section eventually transitioning into some acclaim for Trump's handling of events or some excoriation of his critics. So it's safe to assume that in that hospital room that day, Trump might have done a bit more than offer Meadows job performance feedback. That the release of the book has led to multiple reports about Trump's anger over Meadows's general openness tends to bolster the idea that maybe Trump was less enthusiastic about that day's events.

What Trump should be annoyed about, in fairness, is what Meadows doesn't say. For months, Trump tried to insist that hydroxychloroquine was an effective treatment against covid-19. Meadows describes that effort — but then reveals that the drug was not part of Trump's treatment regimen. For all of Trump's bluster on the subject, when his life was on the line, hydroxychloroquine was apparently not part of the picture.

It’s worth remembering why Trump embraced the drug in the first place. In spring 2020, Trump briefly endorsed a broad retraction of economic activity to halt the spread of the coronavirus. In short order, though, his view reverted to where it had been for much of January and February: Worried about reelection, Trump insisted on returning the country to normal, virus be damned. That meant elevating all sorts of false claims about the pandemic, including that the virus would soon simply go away, that the danger was overstated or that there existed wonder drugs that would soon make infection a nonissue. All of it was pointed at downplaying the risk and, therefore, opening up the economy.

Hydroxychloroquine, championed by the Fox News hosts Trump regularly watched, soon became a fixture of the cultural fight over the pandemic. Health experts such as the country’s top infectious-disease expert, Anthony S. Fauci, pointed out that it was not proved to be effective in clinical trials. But Trump and Fox News’s Laura Ingraham elevated isolated, uncontrolled experiments to say that it was. This became an elites-versus-Trump fight, one that he invested in heavily. Eventually, the Food and Drug Administration withdrew its authorization for experimental use, citing concerns about side effects.

In his book, Meadows goes on at great length about how Trump was administered Regeneron’s monoclonal antibody treatment, for which the FDA granted the White House special approval. The timeline on Meadows’s interactions with the CEO of the company that makes the drug — someone whom Meadows describes as a friend of Trump’s who had played golf at Trump’s course in New Jersey — is murky.

“One afternoon, in the middle of the fight to get Judge Amy Coney Barrett confirmed to the Supreme Court,” Meadows writes, “the president called me into the Oval Office with an idea.” Trump had seen a story about the drug — “which, amazingly, the president seemed to understand about as well as any of the so-called experts we’d been dealing with,” Meadows gushes — and wanted Meadows to reach out. But by the time the White House was “in the middle” of the Barrett nomination fight, Trump was probably already infected with the virus. He’d tested positive for it immediately after Barrett’s nomination event in the White House Rose Garden. Meadows implies that Trump was ahead of the game; the timeline suggests that he was, instead, behind it.

Regardless, when Trump was confirmed by a second test days later to have the virus, Meadows had the drug flown to D.C. It wasn’t enough to forestall Trump’s trip to the hospital, where, Meadows says, he was treated with what Meadows calls the “covid cocktail”: “Pepcid, melatonin, zinc, and aspirin, in addition to the first round of Regeneron.”

You'll notice what's missing.

Trump had publicly announced earlier in the year that he was taking hydroxychloroquine prophylactically, despite any robust evidence that doing so was useful. This was part of the rhetoric: proving that it was important and safe and useful from a firsthand point of view. But when his life was actually on the line, this theoretical treatment was not included.

Despite that, Trump continues to insist that hydroxychloroquine has some efficacy in treating covid. This June, he included “Hydroxychloroquine works” on a list of things that “they” were “now admitting” he was right about. (He probably saw this unsupported claim on Fox News or One America.) Even despite the lack of evidence for this claim — and, importantly, despite his not being treated with it himself when he contracted the virus — he still finds the rhetoric useful. It’s very much akin to his soft-pedaling the coronavirus vaccine when confronted by angry supporters, even though he’d quietly been vaccinated at the White House before leaving office.

So much of the state of the pandemic is downstream from Trump’s efforts to position himself politically last year. Without his insistences that the experts didn’t know what they were doing and without his focus on hydroxychloroquine, it’s likely that ivermectin wouldn’t have emerged as 2021′s not-quite-miracle-alternative to expert recommendations. Without his undercutting the government’s response where it was inconvenient, we probably wouldn’t see the wide partisan divide in vaccinations that exists.

So it’s useful to remind people of the reality. When Trump’s life was on the line, he didn’t use hydroxychloroquine but traditional treatments and monoclonal antibody therapy, later approved for broad use. When he wanted to protect himself moving forward, he got the vaccine.

When it was his life, the experts’ expertise was more than welcome.