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Trump's hydroxychloroquine fixation is about a media narrative, not a medical one

“What do I know? I’m not a doctor.” It’s a phrase we’ve all heard at one point or another, when a friend or family member is offering questionable health advice about, say, swimming right after lunch or the health benefits of red wine. It’s probably not something that anyone ever expected the president of the United States to utter during a press conference promoting a dubiously effective medication as the salvation for a country in the middle of the worst pandemic in 100 years. Unfortunately, that’s the current state of President Trump’s coronavirus response. On Sunday night, Trump — for the second day in a row — hyped the benefits of the anti-malaria drug hydroxychloroquine, which has yet to be proven effective in treating COVID-19. “I have common sense,” Trump said, explaining that his belief in the drug’s utility came from a gut instinct. The night before, he’d urged doctors to prescribe the drug for coronavirus treatment despite the lack of evidence that it works. “What do you have to lose? Take it," he said. "I really think they should take it. But it's their choice. And it's their doctor's choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you'd like."

Hydroxychloroquine has emerged as hot topic in the right-wing media, which has rapaciously devoured stories of local doctors treating coronavirus patients with the drug. One upstate New York doctor has become a conservative media star after pushing the drug, which has also been hyped by the likes of Fox News host Sean Hannity and Rudy Giuliani, the president’s sober-minded personal lawyer.

The evidence just isn’t there yet, though. So far, studies in France and China have provided anecdotal evidence that the drug may help treat symptoms, but those studies have been criticized for lacking a control group. Other studies have proved inconclusive.

Dr. Anthony Fauci, the nation’s top epidemiologist who’s leading the coronavirus response, has tried to tamp down Trump’s enthusiasm for hydroxychloroquine before more testing can determine its actual value. On March 21, when asked point-blank if the drug will be able to treat COVID-19, Fauci responded, “The answer is no.”

On Sunday night, Fauci sounded a bit more measured when discussing the drug, though he still declined to endorse it. “In terms of science, I don’t think we can definitively say it works,” he said on CBS News. “The data are really just at best suggestive. There have been cases that show there may be an effect, and there are others to show there’s no effect.”

Fauci’s refusal to become a cheerleader for the president’s favored treatment has sparked tension with key players in the White House — both publicly and behind closed doors. At Sunday’s press conference, a reporter directed a question to Fauci about hydroxychloroquine, while the president was standing to the doctor’s side. “You don't have to answer the question," Trump snapped, stepping up near the lectern. "I answered that question 15 times." Fauci didn’t answer.

On Monday morning, Axios reported that Trump’s trade czar Peter Navarro had clashed with Fauci over hydroxycholoroquine during a private meeting in the Situation Room. Per a source, Navarro erupted at Fauci after the doctor said that the studies that have been conducted so far provide only “anecdotal” evidence that the drug works, and that more time is needed to determine whether it should be part of the government’s official coronavirus response. Fauci’s comments “just set Peter off," according to Axios’s source. Navarro has taken on the job of sourcing hydroxychloroquine as one of his main responsibilities. To date, the administration has ordered 29 million doses of the drug.

“This shouldn’t be a celebrity showcase. ... Are we going to deputize Dr. Drew [Pinsky] and Dr. Spaceman next?”

With the government’s top health care officials refusing to endorse his pet coronavirus cure, Trump’s wandering eye has reportedly settled on less reputable doctors who will support his desire for a magic bullet to make the disease go away. The Daily Beast reported Monday that the White House is interested in working with Dr. Oz, aka Mehmet Oz, the TV talk show host who has a reputation for peddling shoddy pseudo-science (including anti-vax rhetoric). On his show, Dr. Oz has recently been pushing hydroxychloroquine hard as a cure for COVID-19 despite the lack of proof that it actually works. A White House official who spoke to The Daily Beast under anonymity griped, “This shouldn’t be a celebrity showcase. ... Are we going to deputize Dr. Drew [Pinsky] and Dr. Spaceman next?”

It’s unclear whether any cameos are pending from Liz Lemon’s choice internist. In the meantime, perhaps testing will end up confirming that hydroxychloroquine actually does work as a coronavirus treatment, and lives will be saved by the government’s stockpile.

Of course, the alternative is that our president merely wants to look heroic, and is therefore jumping down the rabbit hole following an internet rumor about a possible miracle cure. There’s no real downside to the maneuver, at least from a PR perspective — either it works and he’s hailed as a hero, or it doesn’t, and everyone forgets about it as the crisis marches on.

There’s a real human cost, however, to wasting time on false promises. For one thing, an Arizona man died and his wife was hospitalized after they drank fish tank cleaner that contained chloroquine phosphate, an additive they mistakenly equated with hydroxychloroquine after hearing the president talk about the medication on TV. And there are now medical decisions being made according to Trump's instincts, too. On Monday afternoon, Texas Gov. Greg Abbott (R) announced that 30 patients in a Texas nursing home who have contracted coronavirus will be treated with hydroxychloroquine over the next several days.

Whatever the case, if Trump does end up using a talk show quack to justify his unproven theories, then at least his decision will be following a sort of grim internal logic: a reality TV solution, from a reality TV president.