/Trump goes with his gut, outside advice on decision to medicate with hydroxychloroquine

Trump goes with his gut, outside advice on decision to medicate with hydroxychloroquine

WASHINGTON – President Donald Trump’s announcement that he has been taking hydroxychloroquine to fend off coronavirus has evolved into the pandemic’s latest political dividing line Tuesday as aides scrambled to explain his embrace of the untested therapy.

Trump’s unprompted disclosure that he has been taking hydroxychloroquine for nearly two weeks despite warnings from the Food and Drug Administration once again prompted questions about whether he is following advice from his own medical experts or is trusting his gut as he navigates the worst public health crisis in generations.

From refusing to wear a face mask in public despite a recommendation from the Centers for Disease Control and Prevention to shelving federal guidance this month on reopening, Trump has framed his decisions as matters of personal choice rather than driven by science – a message that has resonated with some of his core supporters.

His moves have also drawn a sharp stylistic contrast with Democrat Joe Biden, whose campaign to unseat Trump has largely followed the advice of public health experts by refraining from events and urging Americans to follow public health guidelines.    

Name calling:Trump dismisses Nancy Pelosi calling him ‘morbidly obese’

Reaction:New warnings after Trump’s use of hydroxychloroquine

Hydroxychloroquine is FDA-approved to treat or prevent malaria as well as autoimmune conditions such as lupus and rheumatoid arthritis. Several studies have raised questions about the drug’s ability to fight the virus and its safety.

The FDA has warned that the drug should be avoided outside of hospitals or trials because of the risk of heart rhythm problems.

Trump rejected suggestions that the drug was unsafe during a Cabinet meeting and attacked one of the studies that indicated it could have serious side effects. He described the drug as “an extra line of defense” and said he’s “had no impact from it.”

“People are going to make up their own mind,” he said told reporters on Capitol Hill earlier in the day in response to questions about whether he was putting Americans at risk by touting hydroxychloroquine.

Trump attacked one of the studies that indicated the drug could have serious side effects. That study, which involved patients with confirmed cases of COVID-19 treated at Veterans Health Administration medical centers, found there were more deaths among those given hydroxychloroquine than those receiving standard care.

Trump described the study Tuesday as “the only bad survey” and a “Trump enemy statement” and said it involved patients who were “almost dead.”

But other studies have raised flags, too. Two recent observational studies of patients in New York hospitals, one published Journal of the American Medical Association and the other in the New England Journal of Medicine, found no statistically significant benefit from the drug. Another study from the NYU Grossman School of Medicine that has not yet been peer reviewed found evidence that adding zinc to hydroxychloroquine and azithromycin may have benefit for some patients.

The U.S. National Institutes of Health launched a large clinical trial of hydroxychloroquine given in conjunction with the antibiotic azithromycin last week. It is among multiple studies underway to see if the drug can help decrease hospitalization and death from coronavirus.

James Pfiffner, a George Mason University professor who studies the presidency, noted that the president’s statement seemed to highlight “his desire to blow off the warnings of experts and undermine confidence” in U.S. health authorities. “It is part of his rejection of expertise that seems to make him so appealing to his base,” Pfiffner said. 

President Donald Trump speaks with reporters before boarding Air Force One with first lady Melania Trump at Morristown Municipal Airport in Morristown, New Jersey.

Administration officials offered disjointed explanations Tuesday for Trump’s decision to take the drug as the controversy from his remarks a day earlier reverberated through Washington. White House physician Sean Conley prescribed the drug to Trump, a senior administration official speaking on the condition of anonymity told USA TODAY. That official said Trump is consulting with many physicians but declined to name them.

In his own telling, Trump raised the idea of taking hydroxychloroquine with Conley – not the other way around. Trump said he asked Conley, “What do you think?” and the physician responded, “Well, if you’d like it.” Conley released a vaguely worded statement Monday asserting that “the potential benefit from treatment outweighed the relative risks” and he noted that one of the president’s valets had tested positive for the virus. The White House confirmed that the valet had tested positive on May 7. 

Asked what evidence of the drug’s efficacy he is relying on, Trump said he gets “a lot of positive calls about” and cited a letter from a doctor from the New York City suburbs. White House officials declined to name the doctor or others who had spoken to Trump.

Trump first mentioned the drug publicly two months ago while visiting the Federal Emergency Management Agency headquarters. Over the next two months, he named it at least 33 times, according to a USA TODAY review of White House transcripts. He has been far less likely to discuss other potential therapies. By comparison, he mentioned remdesivir, under study as a treatment, 11 times during that period.

The president repeatedly came under fire for raising the untested drug and for several weeks had largely avoided the issue. But his past comments were brought to the forefront when vaccine expert Rick Bright filed a whistleblower complaint against the Department of Health and Human Services this month. Part of that complaint raised concerns about the the president’s focus on the drug.

President Donald Trump participates in a tour of Owens & Minor Inc., a medical supply company, Thursday, May 14, 2020, in Allentown, Pa.

The latest episode recalled a controversy in April when Trump said scientists should look into whether ultraviolet light or disinfectants could help treat coronavirus patients. His remarks prompted a rebuke from doctors and warnings from state health agencies against self-treatment. Trump later claimed he was being “sarcastic.” 

Presidential historians pointed to several themes in Trump’s decisions to try hydroxychloroquine, forgo masks and pressure states to reopen. One is the president’s self-styled trust of his own “gut” over his experts. Another is that Trump has never embraced the concept that a president models behavior for the rest of America.

“I don’t think Trump has ever desired whatsoever to see himself as role model, to hold up the best of what we can be,” said Jeffrey Engel, director of the Center for Presidential History at Southern Methodist University. “Trump’s entire ethos appears to be ‘I am different than the rest of you. The rules don’t apply.’ “

Democrats blasted Trump’s announcement about taking hydroxychloroquine. Senate Minority Leader Chuck Schumer, an outspoken Trump critic, suggested on MSNBC that Trump may have raised the issue to “divert attention from all the bad things happening.” Or, he said, “maybe he’s just lying.”

Allies of the president defended the decision, underscoring how the announcement – like face masks and reopening protests – are viewed through political frames. Tom Fitton, president of the conservative activist group Judicial Watch, tweeted Tuesday that while the drug was not without its risks, it was a “gamble worth taking.”

FDA Commissioner Stephen Hahn described the decision Tuesday as “between a patient and their doctor.” Vice President Mike Pence echoed that sentiment in an interview on Fox News, noting that he personally was not taking hydroxychloroquine but that he would “never begrudge any American taking the advice of their physician.”

Nivaquine, tablets containing chloroquine, and Plaqueril, tablets containing hydroxychloroquine,  have shown signs of effectiveness against coronavirus.

Jason Miller, a senior aide on Trump’s 2016 campaign who remains close with the White House, dismissed the controversy as a “one-day story, whether you’re a supporter, a swing voter or a detractor.” He said that most Americans “probably expect that President Trump is taking every possible drug that may be effective in fighting coronavirus.”

Trump told reporters Monday that along with taking the drug, he is being regularly tested for COVID-19. He said he is also taking zinc and took an initial dose of the antibiotic azithromycin. The White House tightened safety precautions after two aides tested positive for the virus and three members of the coronavirus task force quarantine over concerns they attended meetings with one of the affected staff members. 

Contributing: Adrianna Rodriguez and Elizabeth Weise