Trump Uses Medical Quackery to Divert Attention from the Real Issues

Coronavirus Task Force, whitehouse.gov

In 1868, Pennsylvania’s Samuel L. Carter began to market a product called Carter’s Little Liver Pills. At various times, he claimed that his pills were good for increasing the flow of bile, curing headaches, treating “torpid liver,” and relieving “furred tongue,” among other real and imaginary ailments.  An apocryphal story claims that someone once asked Carter what his pills were good for, and he responded cynically by saying, “$100,000 a year” or some such claim. The pills are still on the market, although the FDA insisted that the word “liver” needed to be removed. 

Okay, well, in 1868, modern scientific medicine lingered in its infancy. But what excuse do we have today?

President Donald Trump, who surely passed a science course along the way to his bachelor’s degree from an Ivy League university, has been promoting a quick, unproven cure for the coronavirus, the malaria drug hydroxychloroquine. He may even believe in it. Rhetorically, however, hydroxychloroquine helps Trump create yet another diversion from – and maybe a good excuse about – his anemic response to the coronavirus pandemic. 

So, here is what Trump said during his opening speech at one of the many Coronavirus Task Force briefings that he held in March 2020:

“Now, a drug called chloroquine — and some people would add to it ‘hydroxy.’  Hydroxychloroquine. So chloroquine or hydroxychloroquine. Now, this is a common malaria drug. It is also a drug used for strong arthritis. If somebody has pretty serious arthritis, also uses this in a somewhat different form. But it is known as a malaria drug, and it’s been around for a long time and it’s very powerful. But the nice part is, it’s been around for a long time, so we know that if it — if things don’t go as planned, it’s not going to kill anybody.”

His odd comment that “some people would add to it ‘hydroxy’” convinces me that he knew very little about the drug’s pharmacology or chemistry.  (Hydroxychloroquine and chloroquine are chemically related but they’re not the same.) He was, I promise you, not finished. He also said:

“So, Regeneron, again, and — is some — is a company that’s done fantastically well, as I understand, with Ebola and some other things.  Great company.  And they’re looking at some very promising events also.  So you have remdesivir and you have chloroquine and hydro- — hydroxychloroquine.  So those are two that are out now, essentially approved for prescribed use.”

Now, first, President Trump was advocating an unproven cure for coronavirus. Second, Trump assured the American public that the drug was safe: “if things don’t go as planned, it’s not going to kill anybody.”

Both claims are dubious. Andrew Noymer, who is professor of public health at the University of California, Irvine, said that a study that Trump cited was "meaningless" because it lacked scientific controls. The CIA has quietly advised its personnel against using hydroxychloroquine for coronavirus: “At this point, the drug is not recommended to be used by patients except by medical professionals prescribing it as part of ongoing investigational studies. There are potentially significant side effects, including sudden cardiac death, associated with hydroxychloroquine and its individual use in patients need to be carefully selected and monitored by a health care professional.”

Public reactions have been predictable. Mr. Trump’s supporters are thrilled. Attorney General William Barr complained that the press was engaged in a “jihad” against hydroxychloroquine. Fox News’ Sean Hannity predictably touted hydroxychloroquine on his television show. My social media pages overflow with presumably responsible people praising hydroxychloroquine as a coronavirus cure and complaining bitterly that the mainstream press is unfair to the drug because they hate President Trump. The National Review, which is the closest that we have to a responsible conservative news outlet, complained earlier this month about the “Left’s Ugly Reaction to Hydroxychloroquine.”  This may be part and parcel of what Nobel Prize economist Paul Krugman notes is a long-standing relationship between America’s right wing and medical quackery. (For example, Alex Jones has hawked a nanosilver toothpaste to cure coronavirus while one of evangelist Jim Bakker's guests promoted a silver solution.)

Okay. I am a (retired) academic person, and so, when something like this happens, I want to ask – why? Why would the president of the United States devote so much energy to something so apparently silly? The answer? I think that Trump is advocating hydroxychloroquine, not just as a desperate attempt to give his supporters hope, but also to mitigate the criticisms against him. The hydroxychloroquine dustup diverts attention from Trump’s coronavirus failures.

Coronavirus-19, CDC image

Trump’s critics say that he was slow in responding to the coronavirus, that his administration has mishandled coronavirus testing and the provision of medical supplies, and that he has routinely made false promises that he was never able to keep. All that makes Trump look weak. It makes them look ineffective. He could get away with all of it, however, if hydroxychloroquine makes the coronavirus disappear like magic. And that is pretty much what Trump said later in the same press conference:

“THE PRESIDENT:  And I have to say, if chloroquine or hydroxychloroquine works — or any of the other things that they’re looking at that are not quite as far out — but if they work, your numbers are going to come down very rapidly.  So we’ll see what happens.  But there’s a real chance that they might — they might work.”

So, first, even if programs like testing, social isolation, ventilators, and economic stimulus programs failed to control the coronavirus pandemic, Trump will still look okay if an easy, inexpensive cure pops up and coronavirus fizzles away like magic: if “your numbers are going to come down very rapidly,” as he said. A quick, easy coronavirus cure would give him a Get Out of Jail Free card right out of a Monopoly game.

Second, while the Trump administration has had problems providing adequate testing and medical supplies to our hospitals, it’s much simpler to manufacture and obtain large quantities of hydroxychloroquine. And so, in a later Coronavirus Task Force briefing just a few days ago, Trump listed all of the things that he was doing, or pretended he was doing, to alleviate the coronavirus threat:

“On the medical front, the FDA — FDA has issued 47 emergency use authorizations for advancements and testing new ventilator designs, innovations, and personal protective equipment, and experimental medicines.  And Dr. Hahn is going to be talking about that.  We’ve cut through the red tape to give doctors and patients unprecedented freedom to make their own healthcare decisions, granting access to potential therapies and drugs. Since Monday, we’ve deployed two major shipments of hydroxychloroquine from our National Stockpile.  And it’s going to various cities.” [italics added]

Most of that was quite vague. New ventilator designs? When will they be available? What experimental medicines? When will personal protective equipment become available? How much benefit will we get from cutting “through the red tape?” (On a side note, Republicans have for decades complained that government red tape is our country’s main problem, so anything that cuts red tape surely appeals to Trump’s core voters.)

The one specific thing that Trump said in that passage is that the government had obtained “two major shipments of hydroxychloroquine” and was sending them “to various cities.” So, hydroxychloroquine gave Trump a simple, specific accomplishment that he could list to make himself look less inept. Maybe he was slow to confront the coronavirus. Maybe the government failed to establish a testing program. Maybe there are not enough ventilators. He can ignore all of that if a common, ordinary drug will solve the problem lickety-split.

Was Trump finished with hydroxychloroquine in March? No way! As recently as Monday, April 13, Trump said at yet another press conference:

“Furthermore, over the last seven days, my administration has deployed roughly 28 million doses of hydroxychloroquine from our National Stockpile.  We have millions of doses that we bought and many people are using it all over the country.  And just recently, a friend of mine told me he got better because of the use of that — that drug.  So, who knows?  And you combine it with Z-Pak, you combine it with Zinc — depending on your doctor’s recommendation.  And it’s having some very good results, I’ll tell you.”

So, here we have the president of the United States hawking the modern-day equivalent of Carter’s Little Liver Pills. And, while he was unable to provide real help for coronavirus patients, he was able to boast about distributing 28 million doses of an unproven medication. An April 14, 2020 White House fact sheet reiterated the same point: “28 million tablets of Hydroxychloroquine have been shipped across the country from the Strategic National Stockpile.”

So far, scientifically, Trump’s foray into pharmacology has not gone well. The scientific journal that published the first positive study about hydroxychloroquine has since cautioned that the study does not meet its usual standards. The publisher issued a statement that they believe "the article does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety”.

A clinical trial of the drug in Brazil was discontinued because of dangerous side effects. (It turns out, contrary to Trump’s promise, that this drug can be dangerous.) A study that started with 150 patients in China was discontinued because hydroxychloroquine failed to show enough benefits to justify continuing the experiment. The CDC quietly dropped its dosage instructions for the drug, now merely saying: “There are no drugs or other therapeutics approved by the U.S. Food and Drug Administration to prevent or treat COVID-19.” 

All the same, if Trump's supporters want to believe that hydroxychloroquine is a miracle cure that fails only because Deep State stands in the way, they have all the excuse they need to defend Trump's indefensible public-health actions.

Mostly, however, it looks as if Trump is promoting hydroxychloroquine as a diversion.While the public gets riled up about hydroxychloroquine, we might overlook worse things that he's doing. In the unlikely event that it worked, hydroxychloroquine would get Trump out of trouble. But it didn’t. This is not the first time that Trump has tried, with the skill of a stage magician, to divert attention away from his own failures. It will not be the last. Magicians often fool people into thinking they're seeing something real. So does Trump.


Elsewhere on my blog:  

Trump Uses Creative Confusion As a Persuasive Tactic 

Trump Creates a Magical Illusion That He Is Giving Proof


P.S. Trump and his supporters have other diversions up their sleeves and behind their magical hidden panels. I hope to write something about them in the future.