Wednesday, April 08, 2020

TRUMP SNAKE OIL hydroxychloroquine





Trump's touting of unproven COVID-19 drug is unusual. We'll ...
https://www.cbc.ca › news › world › trump-drug-covid-hydroxychloroqui...

3 hours ago - ... Trump, a norm-smashing U.S. president facing the political fight of his life, is all-in on a malaria drug as a possible treatment for COVID-19.

Trump's touting of unproven drug for COVID-19 has its own ...
https://www.theglobeandmail.com › canada › article-trumps-touting-of-un...

19 hours ago - Dr. Robin Armstrong, the home's medical director, is treating nearly 30 residents of the nursing home with the anti-malaria drug ...

Doctors embrace drug touted by Trump for COVID-19, without ...
https://nationalpost.com › pmn › health-pmn › doctors-embrace-drug-touted...

2 days ago - Dr Vladimir Zelenko, a general practitioner in upstate New York, has claimed that a three-drug cocktail of hydroxychloroquine, azithromycin and ...

Trump Tells The Story Of A 'Miracle' Cure For COVID-19 ... - NPR
https://www.npr.org › sections › coronavirus-live-updates › 2020/04/07 › tr...

17 hours ago - President Trump continues to promote hydroxychloroquine, a drug that has not been proved to work against coronavirus and COVID-19


Dr. Donald: why the U.S. president keeps touting an unproven COVID-19 treatment

James McCarten
The Canadian Press

Published Wednesday, April 8, 2020



Is hydroxychloroquine effective?

WASHINGTON -- Americans and Canadians alike are used to seeing gauzy, pastel-coloured pitches for medicines, therapies and treatments on cable television. They're less accustomed to hearing them delivered live from the White House briefing room.

At times, Donald Trump's nightly news conferences have come to resemble infomercials as the country's pitchman-in-chief promotes hydroxychloroquine -- an anti-malarial drug more commonly prescribed for diseases like lupus and rheumatoid arthritis that the president seems convinced carries promise for COVID-19 patients.

Trump said the U.S. has stockpiled 29 million hydroxychloroquine tablets -- a strategy based on evidence that doctors, health care professionals, governors and infectious-disease experts across the country have described as inconclusive at best and downright dangerous at worst.

On Tuesday, he seized on the story of Karen Whitsett, a state Democrat from Michigan, who told Fox News this week that "she thought she was dead" before trying the drug, which she now credits with saving her life.

"I think she'll be voting for me now, even if she's a Democrat," Trump said. "I don't say that happens with everybody, but that's a beautiful story. There are many of those stories. And I say, 'Try it."'

That's precisely the sort of message Florence Tew doesn't want to hear.

Tew, who lives in Toronto, has been taking the medication for the last 12 years to help manage lupus, which can include debilitating joint pain, rash and kidney problems. She wants nothing more than the world to find an effective COVID-19 treatment, she said -- but not based on unproven theories that come at the expense of her own therapy.

"It's disheartening," said Tew, who described hearing stories online from other lupus patients being warned by their pharmacies that they wouldn't be able to refill their prescriptions -- and in one case, being told by a doctor's office that they would be denied the drug entirely.

"That's when I started to really panic," she said. "You've gotten to a point where you're taking this medication and you just -- you feel good, you're able to work, you're able to function, and then something throws a wrench into it."

Tew said she currently gets a monthly supply of her medication from PocketPills, a B.C.-based pharmacy service that fills, delivers and manages prescriptions online -- and that's beginning to notice warning signs about the drug's availability.

Demand for the drug spiked in North America in the early days of the outbreak, not long after the president began singing its praises, said A.J. Bassi, the company's director of pharmacy services. Oversight bodies like the Ontario Medical Association and the Registered Nurses of Ontario had to issue notices to discourage doctors from stockpiling it.

Since then, although manufacturers insist that the supply of the drug in Canada is currently at typical, pre-pandemic levels, vendors are using historical purchase trends to restrict pharmacies to a 30-day limit on how much they can purchase, he said.

"If I only historically purchased 500 tablets a month, because that's how much I dispense, then that's how much they're restricting that we can purchase," Bassi said. The coming challenge will be dealing with supply-chain problems where wholesalers are forced to use ground transportation to send shipments, leading to potential restocking delays.

"Everybody's going crazy buying toilet paper -- when you need some, you go buy two rather than one, because you're just -- you're afraid. And the same thing in pharmacy -- you're afraid for your patients, so you buy more."

So what's with the president's fixation on hydroxychloroquine?

Conspiracy theories abound, most of them revolving around Big Pharma's long-standing influence in U.S. politics and reputation as a generous campaign donor. The New York Times reported Tuesday that Trump has a small personal stake in Sanofi, a Paris-based drug maker that produces Plaquenil, the brand-name version.

"Hydroxychloroquine can cause serious adverse reactions and should not be taken without medical prescription or advice," the company says on its website. "Sanofi's hydroxychloroquine product is not indicated for use for COVID-19 in any country."

People close to Trump, including billionaire Larry Ellison, television doctor Mehmet Oz and former New York mayor Rudy Giuliani have all been pushing the president to expedite approving the drug for COVID-19, the Times reported. It's also been a popular talking point on Fox News, Trump's preferred cable-news indulgence.

And Peter Navarro, the White House trade adviser, has reportedly been so aggressive in promoting the hydroxychloroquine theory that he got into a Situation Room confrontation on the weekend with Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases and the face of the government's COVID-19 effort.

Navarro, citing his own research into anecdotal reports of the drug's effectiveness, has parroted the president's thinking.

"History will judge whether this was an efficacious drug," he told CNN. "Right now, in the fog of war, if that can save lives that's a good thing."

The Trump administration's enthusiasm for the drug is based on anecdotal studies conducted on a relative handful of patients, said Dr. Allen Zagoren, a surgeon and professor of public administration at Drake University in Des Moines, Iowa.

"When you have a disease that's affecting a million people, you need to have bigger numbers to project because that could be coincidental -- the disease is very unpredictable," Zagoren said.

"You need to have a big study to predict. When you start throwing stuff at the wall to see what will stick, that's garbled information -- it's garbage in, garbage out."

Then there's the issue of side effects, Zagoren noted: the drug carries a host of potential issues, particularly for people with pre-existing conditions, compromised immune systems, cardiopulmonary problems -- the very people who are most likely to be vulnerable to the severe effects of COVID-19 in the first place.

Hydroxychloroquine is also often administered with an antibacterial known as azithromycin that carries a heightened risk of death in patients with a pre-existing heart condition.

"If I was asked to review a case for a lawyer or the board of medicine that a physician decided to give a drug to the patient that had no proven efficacy off-label and the patient died, that's negligence," Zagoren said.

"Write the cheque, because you can't defend that."

This report by The Canadian Press was first published April 7, 2020.


Trump allies put unproven virus drug to work in Texas
Dr. Robin Armstrong puts on his face shield while demonstrating his full personal protective equipment outside the entrance to The Resort at Texas City nursing home, where he is the medical director, Tuesday, April 7, 2020, in Texas City, Texas. Armstrong is treating nearly 30 residents of the nursing home with the anti-malaria drug hydroxychloroquine, which is unproven against COVID-19 even as President Donald Trump heavily promotes it as a possible treatment. Armstrong said Trump's championing of the drug is giving doctors more access to try it on coronavirus patients. More than 80 residents and workers have tested positive for coronavirus at the nursing home. (AP Photo/David J. Phillip)

AUSTIN, Texas (AP) — When a coronavirus outbreak hit a Texas nursing home, Dr. Robin Armstrong reached for an unproven treatment: the anti-malaria drug hydroxychloroquine.

First, he needed to find a supply. But at a moment when President Donald Trump is heavily promoting the drug, Armstrong is no regular physician. He is a Republican National Committee member and GOP activist in Houston, and after calling Republican Lt. Gov. Dan Patrick, the Texas chairman of Trump’s presidential campaign in 2016, Armstrong soon had enough doses to begin treating 27 infected residents of The Resort at Texas City.


Armstrong, the medical director at the facility, said Tuesday it is too soon to tell whether the treatment will work. But his sweeping use of the drug at one nursing home along the smoggy Texas coastline illustrates how Trump’s championing of the medication is having an impact on doctors across the U.S., even as scientists warn that more testing is needed before it’s proven safe and effective against COVID-19.

“I probably would not have been able to get the medication had he not been talking about it so much,” Armstrong told The Associated Press.

Hydroxychloroquine is officially approved for treating malaria, rheumatoid arthritis and lupus, not COVID-19. But as Trump holds out promise for the drug in the face of a mounting death toll, he has often stated, “What have you got to lose?”

Now in Texas, political connections and Trump allies are helping push the drug into the hands of more physicians.

Republican Bryan Hughes, a Texas state senator, said he is helping organize a pipeline of hydroxychloroquine donations to other states through their GOP leaders. Hughes said he has spent recent weeks helping Louisiana, Mississippi, Arkansas and Georgia receive or expect shipments from Amneal Pharmaceuticals, a maker of the drug based in New Jersey. Last month, the company announced it had donated 1 million tablets to Texas.

Amneal did not return an email seeking comment Tuesday. The company has previously said it donated 2 million tablets to New York, and in Detroit, Henry Ford Health System announced it would lead a 3,000-person U.S. study to determine the effectiveness of the drug against COVID-19.

Small, preliminary studies have suggested the drug might help prevent the new coronavirus from entering cells and possibly help patients clear the virus sooner. But those have shown mixed results.

Armstrong, who emerged from the nursing home Tuesday donned in full protective gear and a face shield, said he knew it was a “ticking time bomb” once the virus started spreading through the facility in Texas City, a refinery town outside Houston. At that point, Armstrong said, the goal quickly became preventing older patients from getting so sick they would require a hospital transport.

“We thought maybe we should try treating these folks while they’re in the nursing facility, while we’re watching them,” Armstrong said.

Armstrong, who said he has used the drug before on COVID-19 patients at a hospital, said that in searching for the medication for the nursing home he called Patrick, a firebrand conservative who drew national attention last month for saying people over the age of 70 would be able to “take care of ourselves” in the pandemic and that the U.S. needed to reopen for business. In a statement, Patrick said Armstrong called him on Friday and that after putting him in touch with Hughes, the drugs were on their way the next morning.

Both Armstrong and Hughes said they had not discussed the drug with the Trump administration. As nursing home residents began receiving their first dose of the treatment Saturday, Armstrong said he sat for a previously scheduled interview with the Trump campaign for a series called “American Heroes.” Armstrong said the interview was conducted by Kayleigh McEnany, who was named the new White House press secretary Tuesday, but said he wasn’t invited on to discuss the drug.

Research studies are beginning to test if the drugs truly help COVID-19 patients, and the Food and Drug Administration has allowed the drugs into the national stockpile as an option for doctors to consider for patients who cannot get into one of the studies.

The drug can cause potentially dangerous side effects, including life-threatening irregular heart rhythms. Those risks are even higher in patients taking other medications that affect the heart.

More than 80 people in all tested positive at the nursing home, and Armstrong said about 30 infected residents were not good candidates for the treatment. He endorsed the need for more rigorous clinical trials, but defended Trump’s embrace.

“Obviously, I’m not getting my medical practice ideas from politicians,” he said. “What it’s done is allowed for more access to the medication.”

For most people, the virus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.

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