As President Trump wades haphazardly into the worlds of public health and medicine with his daily coronavirus briefings, it appears he skipped the “do no harm” lesson of the Hippocratic oath. On Thursday, the president boasted of the potential for the drug hydroxychloroquine to treat the virus, saying that there’s been “very, very encouraging results” and that “we’re going to be able to make that drug available almost immediately.” When Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said that the drug was not an effective treatment for the coronavirus, Trump disagreed. “I feel good about it,” he said. “That’s all it is, just a feeling, you know, smart guy. I feel good about it.” On Twitter, he later added that the drug — taken with a Z-Pak (a course of the antibiotic azithromycin) — could be “one of the biggest game changers in the history of medicine.”
After the press conference, the Food and Drug Administration immediately sought to deflate Trump’s claims, stating that hydroxychloroquine has not been approved to treat the coronavirus. And in the days following the president’s elevation of the drug, researchers have expressed great doubt in its efficacy. But the public attention Trump brought to the drug has been a game changer for lupus patients, according to a ProPublica report that states that Americans suffering from lupus — an autoimmune disease in which the immune system attacks healthy tissue — are now having trouble accessing hydroxychloroquine:
Lupus patients [and] those with rheumatoid arthritis [are] suddenly confronting a lack of medication that safeguards them, and not only from the effects of those conditions. If they were required to take stronger drugs to suppress their immune systems, it could render them susceptible to more serious consequences should they get COVID-19.
The shortages have caught the attention of the Lupus Foundation of America, which said it is working “to take steps that ensure people with lupus will be protected from a disruption in access to critical medications.”
Speaking with ProPublica, California resident Anna Valdez, who lives with lupus, explains what happens if she does not have access to hydroxychloroquine. Following Trump’s speech, pharmacies in Santa Rosa were not able to fulfill her prescription owing to increased demand by people who may have heard Trump’s speech and stocked up on the unproven treatment.
“I am likely going to go into a flare or I am going to have to increase other, more dangerous medicines to keep me out of a flare. I take a bunch of medicines to keep my immune system from working so it doesn’t harm me. If I have to replace it by increasing my CellCept, which is a more powerful immune suppressant, I am basically putting myself at a higher risk. I am basically increasing my risk of having very serious complications of coronavirus. I already have that risk.
“When I think about the other people out there with lupus and other autoimmune disorders, we’re all really scared right now. I haven’t left my house in nine days. I’m working completely remotely. If I get coronavirus, unlike someone else my age, almost 50 years old, who is likely to recover and will be fine, I will likely end up in the ICU.”
According to the Wall Street Journal, it’s not just Americans who need hydroxychloroquine who are facing shortages after the president’s speech: People in South Asia and Africa — regions that deal with malaria on an annual basis — rushed to stockpile the anti-malarial drug following Trump’s misguided advice. Pharmacies carrying the drug have been emptied in cities including Lagos, Kampala, and Karachi, while several patients have been hospitalized in the Nigerian capital for self-medicating. (Side effects of hydroxychloroquine range from diarrhea and dizziness to hypoglycemia and, more rarely, symptoms of heart failure.)
Speaking on Sunday, Trump still did not appear concerned about the possibility that his misunderstanding of drug-development procedures could have real-world consequences. While discussing treatments that have not been proved to be effective and have the potential to harm patients, he asked, “Why should we be testing it in a test tube for a year and a half when we have thousands of people that are very sick, and we can use it on those people and maybe make them better?”
While researchers remain hopeful that extensive clinical trials could prove the effectiveness of chloroquine, unsupervised usage has already proven fatal. On Monday, the day the World Health Organization announced the drug would be part of a global clinical trial testing for coronavirus treatments, a hospital system based out of Phoenix announced that a man died and his wife is in critical care after the two “ingested chloroquine phosphate, an additive commonly used at aquariums to clean fish tanks.”