Fauci tempers Trump's optimism on chloroquine use for coronavirus

President Trump and the leading scientific expert on infectious diseases on his coronavirus task force offered starkly different views Friday about whether Americans should feel hopeful that the antimalarial drug chloroquine could be used to stop the spread of COVID-19.

One day after Trump said chloroquine had shown “very encouraging early results” treating COVID-19 and would be rolled out to patients “almost immediately,” Dr. Anthony Fauci was asked at a briefing in Washington whether there was any evidence to suggest that taking the drug would help prevent a person from coming down with COVID-19.

“The answer is no. And the evidence that you’re talking about, John [Roberts, Fox News correspondent], is anecdotal evidence, so as the commissioner of FDA and the president mentioned yesterday, we’re trying to strike a balance between making something with a potential of an effect to the American people available, at the same time we do it under the auspices of a protocol that would give us information to determine if it’s truly safe and truly effective,” Fauci said. “But the information that you’re referring to specifically is anecdotal; it was not done in a controlled clinical trial, so you really can’t make any definitive statement about it.”

There have been reports from France and China that chloroquine has helped some COVID-19 patients, but there has been nothing like a large-scale clinical test in which, ideally, thousands of patients are treated with the drug and their outcomes compared with those of others who did not receive it. Such trials cost millions of dollars and can take months to run but are considered the gold standard in scientific evidence.

Typically such a trial would be conducted before the FDA approved a drug for use against a specific disease. In the case of chloroquine, it is already approved for use against malaria, and doctors can legally prescribe it for so-called off-label uses, which could include treating the coronavirus. Trump appeared to be encouraging this practice, based on his being a “big fan” of the drug.

After Fauci’s answer, Trump returned to the briefing room podium and continued to promote the idea that chloroquine could be a “game changer” in the fight against the coronavirus, which, as of the hour the briefing was held, had infected more than 15,000 Americans and killed more than 200.

“I’m probably more of a fan of that [chloroquine] maybe than anybody, but I’m a big fan, and we’ll see what happens. We all understand what the doctor said is 100 percent correct, it’s early. But I’ve seen things that are impressive — we’ll see; we’re going to know soon,” Trump said. “We’re going to know soon, including safety, but, you know, when you get to have safety, this has been prescribed for many years for people to combat malaria, which was a big problem, and it’s very effective. It’s a strong drug. So we’ll see.”

Trump was then asked by Roberts whether chloroquine had been shown to be effective against SARS during the 2002-03 outbreak of that virus.

“It was very, as I understand that,” Trump said before turning to Fauci. “Is that a correct statement? It was fairly effective against SARS.”

Fauci then stepped to the podium to throw cold water on that characterization.

“You’ve got to be careful when you say ‘fairly effective.’ It was never done in a clinical trial that compared it to anything. It was given to individuals and felt that maybe it works,” Fauci said.

President Trump and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. (AP/Evan Vucci)
President Trump and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. (AP/Evan Vucci)

While Trump deferred to Fauci’s expertise, he also seemed to push against it at times during the briefing.

“Let’s see if it works. It might and it might not. I happen to feel good about it, but who knows? I’ve been right a lot. Let’s see what happens,” Trump said.

The FDA has yet to approve chloroquine for prescriptions to treat or prevent COVID-19, but Trump has been pressuring officials at the agency to speed up that process.

“We’ll use it on people who are not doing great, or even at the beginning of not feeling well,” Trump said, adding, “What do we have to lose? It’s been out there for so long. We hear good things. Let’s see, maybe it works and maybe it doesn’t.”

Despite an apparent divergence with the president on how to regard the potential for chloroquine to end the pandemic, Fauci insisted that his science-based conclusions were compatible with Trump’s “feeling about it.”

“There really isn’t that much of a difference in many respects in what we’re saying. The president feels optimistic about something, his feeling about it. What I’m saying is that it might be effective; I’m not saying that it isn’t,” Fauci said. “It might be effective, but as a scientist, as we’re getting it out there, we need to do it in a way that while we are making it available for people who might want the hope that it might work, you’re also collecting data that will ultimately show that it is truly effective and safe under the conditions of COVID-19. So there really isn’t a difference; it’s just a question of how one feels about it.”

Asked if there is any reason to believe chloroquine is not safe to take to combat the coronavirus, Fauci again tried to temper Trump’s optimism.

“Any drug, John, has some toxicities. The decades of experience that we have with this drug indicate that toxicities are rare, and they are, in many respects, reversible. What we don’t know is, when you put it in the context of another disease, whether it is safe.”


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