Press does the 'gotcha' dance over 'Trump-touted' NIH hydroxychloroquine non-recommendation, flunks basic reporting
For the press, it's quite the "gotcha" dance.
The National Institutes of Health's refusal to recommend the use of the common anti-malarial drug hydroxychloroquine in combination with the antibiotic azithromycin for the treatment of COVID-19, was proof positive according to the "science" that President Trump was wrong about the use of the drug, as well as an incompetent who was touting quack medicine, given that he noted the treatment as promising in one of his tweets.
They've finally got something to pin on him.
One problem: The headlines are distorted. First, Trump most certainly didn't tout the drug as a proven treatment; he called it a potential treatment with a "real chance" of being a good one and didn't rule out there weren't many.
HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents).....— Donald J. Trump (@realDonaldTrump) March 21, 2020
He also made several statements in the aftermath to clarify that more testing is needed and he wasn't calling this a panacea.
But that didn't matter to the biased media.
The Times went so far as to try to prove, badly, that the anti-malarial drug he cited was something he had a financial stake in and that he stood to make millions from promoting it. They found a negligible stake in some distant mutual fund holding of his through a trust he does not control and then touted that as proof that Trump was selling snake oil to turn a profit. It was so egregiously bad that the left-wing fact-checker Snopes called the claim "mostly false."
Second, the NIH didn't give the thumbs down to hydroxychloroquine at all as a treatment on its website. The NIH had concerns about the combination of the two drugs based on complications seen in some patients and decided to recommend against that combination outside clinical trials, but it also released a statement saying hydroxychloroquine itself, like every other treatment the NIH noted, simply needed more study to make a recommendation on. The NIH said there was "insufficient clinical data to recommend for or against" the use of the drug itself.
Here's the actual NIH wording:
At present, no drug has been proven to be safe and effective for treating COVID-19. There are no Food and Drug Administration (FDA)-approved drugs specifically to treat patients with COVID-19. Although reports have appeared in the medical literature and the lay press claiming successful treatment of patients with COVID-19 with a variety of agents, definitive clinical trial data are needed to identify optimal treatments for this disease. Recommended clinical management of patients with COVID-19 includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support when indicated. As in the management of any disease, treatment decisions ultimately reside with the patient and their health care provider.
- There are insufficient clinical data to recommend either for or against using chloroquine or hydroxychloroquine for the treatment of COVID-19 (AIII).
- If chloroquine or hydroxychloroquine is used, clinicians should monitor the patient for adverse effects, especially prolonged QTc interval (AIII).
- There are insufficient clinical data to recommend either for or against using the investigational antiviral drug remdesivir for the treatment of COVID-19 (AIII).
- Remdesivir as a treatment for COVID-19 is currently being investigated in clinical trials and is also available through expanded access and compassionate use mechanisms for certain patient populations.
- Except in the context of a clinical trial, the COVID-19 Treatment Guidelines Panel (the Panel) recommends against the use of the following drugs for the treatment of COVID-19:
- The combination of hydroxychloroquine plus azithromycin (AIII) because of the potential for toxicities.
And here's the kicker from the NIH, seen on its Introduction page:
Finally, it is important to stress that the rated treatment recommendations in these Guidelines should not be considered mandates. The choice of what to do or not to do for an individual patient is ultimately decided by the patient together with their [sic] provider.
The people running the NIH aren't forbidding it. They aren't giving a go or no-go on the use of hydroxychloroquine. They are issuing a non-recommendation for its use in a particular combination based on potential problems already seen, and only outside clinical trials. And Politico of all places has done a far fairer story about what the NIH report said, although that publication goes a little strong on the "Trump touted" narrative. Politico wrote this:
There is not enough data for or against the vast majority of the medicines, the panel said in its "living document", while warning against using some outside of clinical trials. Those included the combination of hydroxychloroquine and the antibiotic azithromycin, which President Donald Trump has repeatedly recommended, because of increased risk for heart problems, as well as Eli Lilly's Olumiant because it can worsen infections.
The panel also advised against a group of drugs known as interferons because of lack of efficacy data. And it warned that an HIV drug combination, lopinavir and ritonavir, did not show a clear benefit on mortality rates or length of hospital stays compared to standard of care in a randomized Chinese trial.
The experts added that there are conflicting results for hydroxychloroquine and chloroquine and advised physicians to monitor their patients with use. The drugs have been on the market for decades to treat malaria and more recently lupus and arthritis. The president has often touted hydroxychloroquine in particular, but has not mentioned it on the press briefing stage in nearly a week.
It's telling that in nearly all the press reports, the link to the NIH statement goes only to the front page, not the actual recommendations page. That sounds like a media spin effort to get a gotcha dance going, without benefit of precise facts.
Update: And a Twitter denizen named ScottFantasy has found that the press is making a concerted propaganda effort to claim, in lockstep, that the combination offers "no benefit, more deaths."
Fact is, Trump hasn't touted the matter as a panacea as the media claim he does, and based on his past statements calling for more medical knowledge, he would agree with the NIH recommendations such as they have called for more testing. Fact also: The NIH hasn't squelched the drug he cited, even if he had touted it as a cure-all.
It's all media spin designed to demoralize COVID-19 patients who might want to try the drug or who have no options other than right-to-try. Pinning the drug on Trump and then claiming that the NIH said "no" to him because he's such a quack is nonsense. Not a single thing in some of these reports rings true. Based on the current coverage, it's all spin to Get Trump.
Photo illustration by Monica Showalter with use of Pixabay public domain sources.