President Trump’s promotion of the anti-malarial drug chloroquine as a possible treatment for COVID-19 had dire consequences on Monday when an Arizona man died after ingesting it. He and his wife took a form of chloroquine that’s used to clean fish tanks in an attempt to immunize themselves from the coronavirus. “Trump kept saying it was basically pretty much a cure,” said the woman, who survived but was hospitalized.
Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Disease and a member of the White House Coronavirus Task Force, knows that he must walk a fine line, as his ability to reach a large audience with factual information is dependent on his showing respect for the president, even when he must correct Trump’s inaccuracies. Last Thursday, Trump declared chloroquine a “game changer” in the effort to develop a cure for COVID-19 and announced the drug had been “approved” by the Food and Drug Administration. Fauci pointed out that the drug had only been approved for testing for coronavirus and that reports of it being used to treat it were “anecdotal,” indicating that Trump’s enthusiasm could be misplaced. Trump had the last word: “I feel good about it. And we’re going to see. You’re going to see soon enough.”
Trump has hundreds of millions of fans who trust and admire him, in this country and in many others throughout the world where combating the global pandemic has become an all-consuming challenge. Trump reminds us frequently that he is a very smart man, yet he could not explain a principle of epidemiology, “double-blind verification,” a universal procedure to ensure the efficacy of a medical treatment.
It is certain that those suffering the symptoms of COVID-19 will feel better after enthusiastically taking the pharmaceutical form of chloroquine. Equally certain is that those who visit the Sanctuary of Our Lady of Lourdes to genuflect at the shrine do feel better, with some even living a bit longer based on the emotional boost. This is the beneficial side of the “placebo effect,” but there’s also vast harm done by widespread belief in a nostrum, or any procedure that has no curative value.
Meanwhile, the “blessing” of this medication by President Trump will divert his acolytes, which are not a small group, to view this untested medication as a cure for COVID-19. With large swaths of the public on virtual house arrest, the emotional distress, the loneliness, and the actual difficulties of acquiring necessities of living are no trivial matters, and false promises can lead to disastrous actions.
There is another devastating dimension to all this. Indeed, Trump’s introduction and enthusiasm for chloroquine is already causing shortages for those with diseases that this medication actually helps.
The president knows nothing about epidemiology, but ignorance about a subject has never deterred him from asserting expertise that transcends that of anyone whose views are based on scholarship, research, and a lifetime of working in the field. This only works for a king—or a prince such as Trump was in the real estate kingdom founded by his father, Fred Trump. This characteristic is so embedded in his psyche that it is unreachable for him to conceptualize, much less redress. He has preserved it by avoiding bringing into conversations those who have spent their careers delving into complex areas, examples being global climate change, the technology of evolving military weaponry, or colonization of our planetary system. This is what makes Dr. Fauci’s continued presence at the White House coronavirus briefings so interesting (and nerve-wracking for fans who worry one day he’ll push Trump too far and be banished).
The brief effort by President Trump to unite our country against a common enemy, proudly stating on multiple occasions, “I’m now a war president,” is only a fragile conceit, as he doesn’t seem to understand the very concept.
The ancient Hippocratic Oath of physicians is most closely associated with the phrase, “First, Do No Harm.” This must not be breached, especially by a president who is asserting his role as “Physician in Chief” in a war that he can’t begin to understand.