Donald Trump: Hydroxychloroquine for Covid-19 Prophylaxis

Covid-19 and hydroxychloroquine
During the height of the covid-19 pandemic's first American peak, in spring 2020, Trump took a two-week course of hydroxychloroquine (HCQ) and zinc. His personal physician tersely stated: "After numerous discussions he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risks" SEE BELOW. Medical professionals widely criticized the action, owing to the absence of good quality evidence that the benefit of HCQ outweighed its non-zero risks.

Comment: The decision of Trump and his physician smells of panic. Apparently they judged the risk of the disease to be so high that they felt justified in exposing Trump to a medication that has well-documented significant side effects and (as known then) had only weakly suggestive benefit against the disease. Furthermore, time has shown that their judgment was wrong: subsequent studies demonstrate that HCQ offers no benefit against covid-19 1 2 3 4 5 6 7. Trump's admitted germaphobia would no doubt have contributed to any panic.

Conspicuously, Dr. Conley's note did not say that he or any other physician prescribed these agents. Comment: This is no defense. Conley could just as easily have written that Trump took the medications against his advice or that he (Conley) had no opinion and left it to Trump's decision. But he didn't. Moreover, if Conley believed at the time that the benefits outweighed the risk for his obese 73-year-old male patient with subclinical coronary artery disease, then why didn't he (and the administration) press for the rest of the obese men age 73+ with coronary disease in the United States to begin taking the medication? Conclusion: the White House physicians were either patsies or unethical or both -- there is no other possibility.

Vice President Pence did not follow suit 8.

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Source: 8

Cited Sources
  1. Boulware DR, et al. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19. New England Journal of Medicine. 2020; 383: 517-525.   Available on the web at: https://www.nejm.org/doi/full/10.1056/NEJMoa2016638
  2. Cavalcanti AB, et al. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. New England Journal of Medicine. 2020; 383: 2041-2052.   Available on the web at: https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
  3. Geleris J. Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. New England Journal of Medicine. 2020; 382: 2411-2418.   Available on the web at: https://www.nejm.org/doi/full/10.1056/NEJMoa2012410
  4. Mitja O, et al. A Cluster-Randomized Trial of Hydroxychloroquine for Prevention of Covid-19. New England Journal of Medicine. 24 Nov. 2020.   Available on the web at: https://www.nejm.org/doi/full/10.1056/NEJMoa2021801
  5. RECOVERY Collaborative Group. Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. New England Journal of Medicine. 2020; 383: 2030-2040.   Available on the web at: https://www.nejm.org/doi/full/10.1056/NEJMoa2022926
  6. Self WH, et al. Effect of hydroxychloroquine on clinical status at 14 days in hospitalized patients with COVID-19: a randomized trial. JAMA. 2020; 324: 2165-2176. DOI: 10.1001/jama.2020.22240
  7. Saag MS. Misguided use of hydroxychloroquine for COVID-19. JAMA. 2020; 324: 2161-2162. DOI: 10.1001/jama.2020.22389
  8. Caralle, Katelyn. Mike Pence says he is NOT on hydroxy despite Donald Trump claiming it is keeping him safe - as mystery over who prescribed the drug to the president deepens. (Published 19 May 2020. Downloaded on 2020-06-09.) Available on the web: https://www.dailymail.co.uk/news/article-8337159/Mike-Pence-says-NOT-hydroxy-mystery-prescribed-drug-Trump-deepens.html

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