What Mr. Trump Said
“You’d be surprised at how many people are taking it, especially the front-line workers before you catch it. The front-line workers, many, many are taking it.”
— at a round table with restaurant executives on Monday
“Hydroxychloroquine is used by thousands and thousands of front-line workers, so that hopefully they don’t catch this horrible disease or whatever you want to call it.”
— in a cabinet meeting on Tuesday
This lacks evidence. It is certainly possible that some doctors and health care workers are still taking hydroxychloroquine as a preventive treatment, but there is little support for the president’s repeated suggestion that the practice is widespread.
The American Medical Association said in a statement that it “does not know of any tracking or surveys examining personal use of hydroxychloroquine among health care workers.”
The American Nurses Association was more emphatic, saying that it “has not received reports from nurses or other front-line health care workers utilizing hydroxychloroquine as a preventative treatment for Covid-19. Furthermore, to date, research has not shown clear evidence that hydroxychloroquine has a preventative effect for Covid-19.”
In March, The New York Times and other news organizations reported that some doctors were prescribing themselves and their family members hydroxychloroquine and hoarding supplies, according to pharmacy boards across the country.
That behavior, however, appears to have declined after a warning from the Food and Drug Administration that the drug could cause serious heart problems for coronavirus patients, studies questioning its efficacy and a series of regulations from states and medical boards restricting its use.
“We have not received from the state boards of pharmacy any new concerns regarding the continued stockpiling of hydroxychloroquine,” said Al Carter, the executive director of the National Association of Boards of Pharmacy.
“Once states began implementing emergency limitations and guidelines on the amount of hydroxychloroquine that could be prescribed and dispensed for acute use, the complaints from pharmacists and state boards of pharmacy decreased significantly,” Mr. Carter added.
Mr. Trump may have been referring to front-line workers who are participating in clinical trials on the efficacy of hydroxychloroquine in preventing Covid-19 infection. Thousands are currently enrolled in these trials, and many are still recruiting eligible volunteers. Participants in these trials, however, represent a tiny fraction of the health care and front-line workers across the country. There are over one million active doctors and nearly three million registered nurses alone.
Researchers conducting these trials also said that interest in taking the drug, even in a clinical setting, had waned recently.
One of the largest trials coordinated by Duke University School of Medicine and the Patient-Centered Outcomes Research Institute, a nonprofit established by the Affordable Care Act that funds clinical research, has enrolled 550 health care workers, out of a goal of 15,000. Among a larger group of 12,000 front-line workers who have been sharing their experiences through the school’s website, two-thirds were previously interested in participating in the hydroxychloroquine trial, but that is down to about half “since the media hype,” said Dr. Adrian Hernandez, who directs the Clinical Research Institute at Duke.
Another doctor conducting a clinical trial who spoke on the condition of anonymity said many colleagues had stashes of hydroxychloroquine in their offices and used it as a preventive measure in the early days of the pandemic. Use is continuing but is no longer as widespread, the doctor said, especially after the F.D.A. warning and as supplies of personal protective equipment became less scarce. The doctor’s clinical trial, too, has lost recruitment because “people got scared,” the doctor said.
Dr. H. Michael Belmont, a professor of medicine at New York University, said his study had recruited 125 participants out of a capacity of 350, partly because of strict eligibility requirements, partly because cases in New York had decreased and partly because studies showing the drug’s ineffectiveness “reduced somewhat the enthusiasm.”
Taking hydroxychloroquine as a prophylactic should really be done only in a research setting, Dr. Belmont emphasized. “You do it outside a clinical trial, you lose the opportunity to answer scientific questions,” he said.
What Mr. Trump Said
“And if you look at the one survey, the only bad survey, they were giving it to people that were in very bad shape. They were very old, almost dead. It was a ‘Trump enemy’ statement.”
— in remarks to reporters on Tuesday
False. Mr. Trump was referring to a study of 368 Veterans Affairs patients — all male with a median age over 65 — hospitalized with Covid-19 infections. It found no evidence that hydroxychloroquine reduced patients’ chances of being put on a mechanical ventilator and that the drug was associated with “increased overall mortality.”
Frequently Asked Questions and Advice
Updated May 20, 2020
How many people have lost their jobs due to coronavirus in the U.S.?
Over 38 million people have filed for unemployment since March. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Is ‘Covid toe’ a symptom of the disease?
There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.
Can I go to the park?
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
How do I take my temperature?
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
How can I help?
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
But he was wrong that it was the “only bad survey” that threw cold water on the efficacy of hydroxychloroquine.
When Mr. Trump dismissed the study of veterans this month, The Times noted that the current body of research was limited to a few studies criticized for methodological errors and was insufficient to support the use of hydroxychloroquine and chloroquine, another malaria drug, as treatments.
What Mr. Trump Said
Reporter: “The F.D.A. has said hydroxychloroquine should not be used outside of a hospital setting or outside of a research study.”
Mr. Trump: “No, that’s not what I was told. No.”
— in the cabinet meeting
False. The F.D.A.’s warning, issued in late April, specifically states that it “cautions against use of hydroxychloroquine or chloroquine for Covid-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems.”
The agency did authorize the use of the drugs “for treatment of the virus in hospitalized patients when clinical trials are not available, or participation is not feasible.”
Mr. Trump seemed aware of the warning just an hour before he denied its existence.
“The F.D.A. warned that hydroxychloroquine could cause serious side effects, especially with the heart, with your heart,” a reporter told the president, after a luncheon with Republican senators.
“Yeah. Yeah,” he responded.
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