Trump touts 'game changer' drug against coronavirus. What does the study show?

Like all Americans, President Trump can’t wait for the COVID-19 pandemic to be over. And while his administration struggles to get supplies and equipment out to hospitals facing critical shortages, he holds out hope that the disease, for which there is currently no proven treatment, can be eradicated with one stroke, by a medical coup.

Coronavirus is, of course, a worldwide disaster that could threaten the lives of millions of people, occurring on his watch. How much more he could have done to control the coronavirus spread in the U.S. is a politically charged question that will most likely play out in the coming election, but there’s no doubt the outbreak has thrown his messaging off its game. The stock market has fallen by as much as 30 percent, to below where it was when he took office, which deprives him of one of his favorite talking points. He has suspended the huge rallies that were a centerpiece of his campaign. Mar-a-Lago, where he might otherwise be spending an early-spring weekend on the golf course, is closed.

And as he acknowledged in Saturday’s White House press briefing, his business is taking a financial hit along with the rest of the hotel industry.

The White House, which has been accused of downplaying the dangers of coronavirus early in the outbreak, now seems well aware of the impending catastrophe.

But the main impression left by the briefing was how much Trump, who prides himself on his optimism, seems to be already looking forward to the time when this “invisible, horrible enemy,” as he refers to the coronavirus, will be vanquished, and the country will enjoy economic growth “like we’ve never seen before.”

President Trump with Ben Carson, secretary of Housing and Urban Development, left, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases Anthony Fauci. (Joshua Roberts/Reuters)
President Trump with Ben Carson, secretary of Housing and Urban Development, left, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases Anthony Fauci. (Joshua Roberts/Reuters)

“We will be successful very soon,” he promised, while other members of his coronavirus task force stood by, stone-faced, “hopefully very much sooner than people would ever think.”

He referred several times to the prospect of “celebrating a great victory in the not-too-distant future.”

In fact, just a few hours earlier Trump was excitedly tweeting that the victory was in sight, in the form of two drugs, hydroxychloroquine and azithromycin, taken together, which have “a real chance to be one of the biggest game changers in the history of medicine.”

Trump has been touting the potential of hydroxychloroquine for several days, noting that it has already been approved by the FDA for treating malaria and rheumatoid arthritis. That means it has been tested for safety (although it can have side effects, some of them unpleasant or dangerous) and can be prescribed by any doctor for any legitimate medical purpose, including so-called “off-label” uses. Azithromycin is a well-known antibiotic frequently prescribed for pneumonia, familiar to many Americans under the brand name Zithromax Z-Pak.

Trump’s tweet referenced an article in a medical journal, the International Journal of Antimicrobial Agents, which appeared online the day before in preprint, meaning it has not been put through “peer review” by other researchers and may or may not stand up to their scrutiny. The article was based on a single study in France that administered the drug regimen to 26 patients infected with the coronavirus, plus 16 in a control group who received only symptomatic care. Of the 26 who got the drugs, one died — a rate of 3.8 percent, which is about in line with the usual estimates of mortality from COVID-19. The experimental treatment was stopped for three when they went into intensive care and one dropped out of the study because of side effects from the drugs.

But the encouraging news from the study was that the people taking the drugs were cleared of the virus — i.e., tested negative — much more rapidly and completely than the control group.

That is very much short of the full clinical trial the Food and Drug Administration typically requires before approving a new drug, which can take a year or more, cost millions of dollars and involve thousands of patients. But, as the authors wrote in explaining why they rushed to publicize their findings, “despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.”

Trump’s excitement over this development was not shared by Dr. Anthony Fauci, a mainstay of the coronavirus task force briefings. Asked about Trump’s tweet near the end of the briefing, after Trump had left the podium, he said he was “not totally sure what the president was referring to.

“Many of the things that you hear out there are what I call anecdotal reports,” Fauci went on. They may be true. … The president is talking about hope for people, and it’s not an unreasonable thing.” He drew a distinction between his role as a scientist — finding treatments that stand up to rigorous testing for safety and efficacy — and the role of “others” who want to give hope to people for whom medicine has nothing else to offer.

“Those two things are really not incompatible, when you’re in an arena when you don’t have anything that’s really proven,” Fauci went on. “I’ve got to do my job as a scientist — and others have other things to do.”


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