The temptation here is to say, “It’s a really small study. It might be wrong.” True. But the French study in which everyone’s placed their hopes was also very small, about the same size as this one. And allegedly methodologically flawed, as I noted yesterday.
Anyway, it’s silly to keep posting about the hypothetical benefits of hydroxychloroquine at a moment when New York City hospitals are approaching capacity. Doctors there will have a firsthand sense soon of whether the drug works or not.
The study, published in the Journal of Zhejiang University and first reported by Bloomberg, involved 30 patients diagnosed with COVID-19, who were randomly split into two groups. Both received five-days of conventional treatments, including bed rest, oxygen inhalation and antiviral drugs, but one group was also administered 400 milligrams of hydroxychloroquine—a derivative of chloroquine used in the treatment of malaria and arthritis.
According to the study, there was no statistical difference between the two treatment plans after seven days. In fact, the recovery of patients in the hydroxychloroquine group fared marginally worse than the controls. Fourteen of the non-hydroxychloroquine group tested negative for COVID-19 at the end of the experiment, versus 13 of the people treated with hydroxychloroquine.
Differences between the two groups in terms of the time it took for body temperature to return to normal and the length of hospital stay were also negligible.
Even the researchers behind this study called for a wider study to double-check their findings. Those are in the works right now in various places. Meanwhile, Nevada is taking drastic action to preserve the availability of hydroxychloroquine for people who rely on it to treat other ailments, like lupus:
Nevada’s governor on Tuesday banned the use of anti-malaria drugs chloroquine and hydroxychloroquine to treat coronavirus patients.
Democratic Gov. Steve Sisolak’s executive order came after President Trump touted the medication as holding promise for combating the illness…
His order also limits a prescription of the medicines — which are also used to treat illnesses like lupus and arthritis — to a 30-day supply to ensure it’s available for “legitimate medical purposes” and so people don’t stockpile the drug.
If I’m reading the regulation correctly, Nevada doctors can still use it on inpatients at the hospital. What Sisolak and his advisors are worried about is doctors writing scrips for family and friends who aren’t sick yet so that they can hoard the drug, just in case. Although I suppose anyone who really, really wants it could collude with a doctor to claim that they’re suffering from arthritis or whatever and need the drug to treat a rheumatological condition. If you’re going to be underhanded in the interest of hoarding, might as well go all the way.
The mass public interest in hydroxychloroquine is of a piece with the rash belief that it’ll be safe enough to let most of the country to get back to work in a few weeks. Each is a means of coping with reality at a moment when reality is overwhelming>. Maybe there’s an escape hatch from the pandemic in the form of a miracle drug; maybe there’s an escape hatch from an economic depression if we all collectively just want it bad enough. It makes sense that both would appeal to Trump, since what president would want to manage many months of a grinding double-barreled crisis like this? It’s natural to crave an exit from this gruesome timeline. But if he’s going to keep touting unrealistic quick fixes, he also has to drop the “wartime president” posture. FDR wasn’t telling people in December 1941 that there might be a quick fix to defeating the Japanese. Nor did he immediately try to dispatch troops to Europe after the Nazis declared war. There was a strategy, and that strategy would take time.
One of the basic tasks of a wartime president is to galvanize the public to show the resolve needed to see the strategy through. It’s likely that the only thing that’ll get us to a better place in the short-term is to keep physically distancing ourselves from each other. That’ll require discipline and sacrifice. The more he touts miracle cures, the more he inadvertently gives people a reason to relax that discipline, the harder it’ll be to turn this around. “Let’s just go back to work. If I get sick, they’ll give me hydroxychloroquine.”
His job approval is up lately because people like seeing a president take action in a crisis. A week ago he affirmed the need for social distancing; he and his team have also been scrambling to get masks and ventilators to New York. There’s also a “rally around the president” effect to some degree. (See, e.g., Bush 43’s approval rating shortly after 9/11.) But if he insists on nudging people outside hot spots to go back to work soon, that may change:
The number who trust Trump versus the number who don’t is just what you’d expect, right in line with his traditional job approval rating. The interesting numbers on that graph aren’t Trump’s, though. They’re the numbers for medical and health professionals and state governors. If Trump tries to encourage people to go back to work and he meets all but universal opposition from more trusted authorities, his bid to restart the economy just isn’t going to work. What does he do then?