For some weeks now, President Trump has been hyping the potential of the drug hydroxychloroquine to treat COVID-19. New York Governor Cuomo has expressed similar sentiments: “The president is optimistic about these drugs and we are all optimistic that it could work”. Yet only Trump gets slammed by the media for “peddling false hopes” by “touting unproven drugs”. For example:
The president’s belief in the possibility that hydroxychloroquine, an anti-malarial drug, might be an effective treatment for Covid-19 is not shared with his leading public health experts on the White House task force…On Fox News on Friday, infectious diseases expert Dr Anthony Fauci said: “We still need to do the definitive studies to determine whether any intervention, not just this one, is truly safe and effective. - “Trump touts unproven drug as Cuomo says New York is nearing apex “, The Guardian April 4, 2020
While public health officials are hopeful that the drugs will work against coronavirus, Trump's tone hasn't matched the science, which is extremely limited and anecdotal at this early stage…Trump's over-the-top optimism has been tamped down by the medical professionals on the White House task force handling the pandemic. Dr. Anthony Fauci, the nation's top public health official on infectious diseases, said the proof is only anecdotal. …Trump has repeatedly touted the drugs in recent weeks, even though there haven't been any clinical trials in humans proving that they work for coronavirus. Earlier this month, Trump tweeted that the drugs "have a real chance to be one of the biggest game changers in the history of medicine. - “Fact check: Trump again touts unproven drugs for coronavirus, and other misleading statements from Monday's briefing”, CNN March 30, 2020 [Italics in original]
Note that expressing optimism isn’t the same thing as stating a fact. Trump doesn’t say the drug “will work”, only that it might work (that’s what a “belief in possibility” is). To quote the President: "Let's see how it works, It may. It may not." Is that “over-the-top optimism”? How is such “touting” different from calling the drug “promising” or noting that it has “good potential”, as has been opined by plenty of scientists, e.g. “In combination with its anti-inflammatory function, we predict that the drug has a good potential to combat the disease” (Liu, J., R. Cao, et al., 2020).
Also note the use of “unproven” in The Guardian’s and CNN’s opinion pieces. Scientists are more likely to say something is “supported” than “proven” (a word I associate with toothpaste commercials). We may want scientists to make bold statements about what is the case, but they tend to express their professional opinions with a certain humility, with caveats and acknowledgement of knowledge gaps. When it comes to drug research, scientific confidence in a drug’s efficacy is something that builds gradually over multiple studies, a process that typically takes years. But there’s nothing wrong with being optimistic about a drug that shows promise in the studies to date, as in the case of hydroxychloroquine. To criticize Trump for such warranted optimism in this time of crisis is a cheap shot.
As for those studies to date, here’s what the New York Times has to say:
“The malaria drug hydroxychloroquine helped to speed the recovery of a small number of patients who were mildly ill from the coronavirus, doctors in China reported this week. Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug. The authors of the report said that the medication was promising, but that more research was needed to clarify how it might work in treating coronavirus disease and to determine the best way to use it… But the findings strongly support earlier studies suggesting a role for the drug, an [infectious disease expert] said.” The New York Times April 1, 2020
References:
Cortegiani A, Ingoglia G, Ippolito M, et al. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care 2020 Mar 10. [Epub ahead of print] PMID: 32173110 https://doi.org/10.1016/j.jcrc.2020.03.005 (“A search in trial registries shows that 23 clinical trials are ongoing in China.”)
Gao J, T Zhenxue, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends 2020;14(1):72-73. PMID: 32074550
Liu, J., R. Cao, et al. (2020). "Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro." Cell Discovery 6(1): 16. https://doi.org/10.1038/s41421-020-0156-0 (published March 20, 2020)
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Research 2020;30:269–271. PMID: 32020029
World Health Organization (WHO). Coronavirus: landscape analysis of therapeutics as of 17 Februrary 2020. Accessed March 16, 2020. Available on the World Wide Web at https://www.who.int/blueprint/priority-diseases/key-action/Table_of_therapeutics_Appendix_17022020.pdf?ua=1
Yao X, Ye F, Zhang M, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020 Mar 9. [Epub ahead of print] PMID: 32150618