US President Donald Trump has revealed he is taking the drug hydroxychloroquine to ward off the coronavirus, despite warnings from doctors who say it’s unproven and can cause serious side effects in some cases, including death.
“A lot of good things have come out about the hydroxy. A lot of good things have come out,” Mr Trump told reporters at the White House today.
“And you’d be surprised at how many people have taken it, especially the frontline workers, before you catch it. The frontline workers, many, many are taking it.
“I happen to be taking it. I happen to be taking it. I’m taking it, hydroxychloroquine. Right now, yeah.”
The President said he had started taking the drug “a couple of weeks ago”, but “never had a chance” to tell the media before today “because you never asked me the question”.
“Because I think it’s good. I’ve heard a lot of good stories. And if it’s not good, I’ll tell you. I’m not going to get hurt by it. It’s been around for 40 years, for malaria, for lupus, for other things,” he said.
“I take it. Frontline workers take it. Lots of doctors take it. I take it. You know, I hope to not be able to take it soon, because I hope they come up with some answer. But I think people should be allowed to.”
The President first started boosting the drug as a potential coronavirus cure in late March, saying it had “a real chance to be one of the biggest game changers in the history of medicine” and should be used to treat the virus “immediately”.
“What the hell do you have to lose?” he mused at the time.
Doctors quickly warned that hydroxychloroquine can have severe side effects in some situations, including death.
Subsequent studies have suggested the drug is not effective at treating the virus, and might even increase patients’ risk of dying.
America’s Food and Drug Administration (FDA) has cautioned against its use for the coronavirus outside of a hospital setting or clinical trial, as it can cause “serious heart rhythm problems” and “a dangerously rapid heart rate”.
After Mr Trump’s revelation today, reporters asked him whether the White House doctor had recommended that he take hydroxychloroquine.
“Yeah, the White House doctor. No, he didn’t recommend it. I asked him, ‘What do you think?’ He said, ‘Well, if you’d like it.’ I said, ‘Yeah I’d like to take it.’ A lot of people are taking it,” the President clarified.
“I don’t take it because – hey, people said, ‘Maybe he owns the company.’ I don’t own the company. You know what? I want the people of this nation to feel good. I don’t want them being sick. And there’s a very good chance that this has an impact, especially early on.”
Mr Trump revealed he had also taken a dose of the antibiotic azithromycin, which the FDA has not approved for use with the coronavirus. He said frontline workers were using it as a preventative drug.
“I haven’t taken that other than as an original dose, because all you need – you don’t have to take it simultaneously. But the zinc, you do take. So I’m taking the two, the zinc and the hydroxy.
“All I can tell you is, so far I seem to be OK.”
Asked why, exactly, he had decided to take the drugs, Mr Trump said he was prompted by a letter he received from a doctor in Westchester, New York.
“I’ve had so many letters from people,” said the President.
“He doesn’t want anything. I don’t know him. But he treats people that we’re talking about. He said out of hundreds of people that he’s treated, he hasn’t lost one. And he just wanted me to know about it. That’s all.
“He wasn’t saying, ‘Gee, can I have dinner with you Mr President? I’d like to come to the White House.’ But I’ve received many such letters.”
In his final pitch, the President echoed his infamous comment from a couple of months ago.
“I say, hey – do you know the expression I’ve used? What do you have to lose? What do you have to lose?”
HOW DANGEROUS ARE THESE DRUGS?
As Mr Trump said, hydroxychloroquine has been around for decades. The FDA has approved its use to treat and prevent malaria. Hydroxychloroquine sulfate is approved to treat lupus and rheumatoid arthritis.
At the end of March, the FDA did grant an emergency use authorisation to allow doctors to prescribe hydroxychloroquine to patients who were hospitalised and not responding well to other treatments.
However, a month later it issued an official warning about the drug, saying it had “not been proven safe or effective” for treating the coronavirus.
Clinical trials are underway and more are being planned to firmly determine whether the drug could benefit patients with the virus. Those trials will also examine whether it’s effective as a preventative measure among health care workers.
In the meantime, the FDA has warned of case reports showing “serious heart-related adverse events and death” in patients who received hydroxychloroquine, either alone or combined with the other drug Mr Trump mentioned he was taking, azithromycin.
The “adverse events” in question include abnormal heart rhythms, QT interval prolongation, ventricular tachycardia (a dangerously rapid heart rate) and ventricular fibrillation.
“The FDA is aware of reports of serious heart rhythm problems in patients with COVID-19 treated with hydroxychloroquine or chloroquine, often in combination with azithromycin and other QT prolonging medicines,” the regulatory body says.
“We would like to remind healthcare professionals and patients of the known risks associated with hydroxychloroquine.
“Hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19.
“Hydroxychloqoruine and chloroquine can cause abnormal heart rhythms such as QT interval prolongation and a dangerously rapid heart rate called ventricular tachycardia. These risks may increase when these medicines are combined with other medicines known to prolong the QT interval, including the antibiotic azithromycin, which is also being used in some cases without FDA approval for this condition.
“Patients who also have other health issues such as heart and kidney disease are likely to be at increased risk of these heart problems when receiving these medicines.”
America’s National Institute of Health (NIH) currently says there is “insufficient clinical data” to recommend “either for or against” using hydroxychloroquine as a coronavirus treatment.
It has explicitly recommended against using it in conjunction with azithromycin, citing “the potential for toxicities”.
Last week the NIH announced it had started a clinical trial of 2000 patients to test the hydroxychloroquine-azithromycin combination.
When Mr Trump first started hyping hydroxychloroquine in March, Australia’s Therapeutic Goods Adminsitration (TPA) issued its own warning.
“Clinical trials are underway around the world examining the potential to treat COVID-19. However, these medicines pose well-known serious risks to patients, including cardiac toxicity (potentially leading to sudden heart attacks), irreversible eye damage and severe depletion of blood sugar (potentially leading to coma),” the TPA said.
“Given the limited evidence for effect against COVID-19, as well as the risk of significant adverse effects, the TGA strongly discourages the use of hydroxychloroquine at this time other than in a clinical trial setting or in a controlled environment in the treatment of severely ill patients in hospital.”
US ‘STUNNED’ BY TRUMP’S REVELATION
The most immediate reaction to Mr Trump’s revelation came from Fox Business host Neil Cavuto, who was rather flummoxed by the whole thing.
“That was stunning,” Cavuto said as his network cut away from the White House.
He cautioned his viewers not to follow the President’s example by taking hydroxychloroquine “casually”, reeling off a list of studies with worrying results.
“The fact of the matter is, when the President said what have you got to lose, in a number of studies, those – certainly, vulnerable in the population – have one thing to lose. Their lives,” Cavuto said.
One of the studies in question looked at 368 military veterans who were hospitalised with the virus. Some were treated with hydroxychloroquine. Some received both hydroxychloroquine and azithromycin. The rest got neither drug.
The rate of death was higher among those who did take the drugs.
“Those with vulnerable conditions, respiratory conditions, heart ailments – they died,” Cavuto told his viewers.
Mr Trump actually addressed the study during his media event today, calling it a “very unscientific report”.
“The only negative I’ve heard was the study where they gave it – was it the VA? With, you know, people that aren’t big Trump fans,” he said.
“The VA study to which the President alluded wasn’t a loaded political one. It was a test on patients there. And those who took it in a vulnerable population, including those with respiratory or other conditions – they died,” Cavuto argued.
“I want to stress again. They died. If you are in a risky population here and you are taking this as a prevantative treatment to ward off the virus, or in a worst case scenario you are dealing with the virus, and you are in this vulnerable situation – it will kill you.
“I cannot stress this enough. This will kill you.
“This is a leap that should not be taken casually by those watching at home, or assuming, ‘Well, the President of the United States says it’s OK.’ Even the FDA was very cautious about this unless in a clinical trial, safely and deliberately watched.
“I only make this, not to make a political point here, but a life and death point. Be very, very careful.”
Over on sister channel Fox News, anchor Bret Baier spoke to the network’s top medical contributor Dr Manny Alvarez.
“Why would the President be taking hydroxychloroquine?” Baier asked.
“I don’t know. Your guess is as good as mine,” Dr Alvarez said.
“I found it to be highly irresponsible for the President to have come out and made that statement. And I would like the White House physician to come out tomorrow and explain to me what has changed in a week-and-a-half or two weeks for the President to take this medication, when all the data that has been coming out very repetitively has shown that there’s really not a major benefit.”
On CNN, resident medical expert Dr Sanjay Gupta worried that Mr Trump’s remarks would cause “a lot of confusion” for regular Americans.
“He shouldn’t be taking it,” Dr Gupta said.
“His own FDA has said this is still something under investigation, it should not be taken outside of a clinical trial, only hospitalised patients should be getting it.
“What he said about the fact that it’s been used for malaria prophylaxis for decades is true. What we’ve found more recently is in people who already have COVID-19, already have this disease, that there are some real concerns. Concerns about impact on the heart.”
Dr Gupta did concede that most hydroxychloroquine trials so far have investigated its effect on patients who already had the coronavirus, rather than its effectiveness as a prophylactic (preventative) drug.
There remains a “lingering question” of whether it could be used to “prevent the virus from entering cells in the first place”.
“There’s no evidence to suggest that,” he added, saying the trial examining that question was ongoing – but Mr Trump wasn’t eligible for it.
“It’s for healthcare workers who have significant exposures, and obviously President Trump doesn’t fit either of those categories,” said Dr Gupta.
“This is one of those things that I think is going to cause a lot of confusion in people.”
He also stressed that the President should be “careful”, given his medical history.
“I don’t know who presribed this for him. It is a prescription drug. I hope, given that he has a history of heart disease, that he is being monitored in some way so he doesn’t develop a problem,” he said.
“I’m not suggesting that he would, as a prophylactic drug, but he obviously has to be careful.
“He shouldn’t be taking it. He doesn’t qualify to be taking it. There’s no evidence that this works in this way.
“There is, right now – to be clear – no evidence that it works to treat this disease, there’s no evidence that it works to prevent this disease, and there are some potential side effects.”