Science versus politics

I’d written another essay that I’d planned to finish up and post today, but then woke up to this BBC news story about a new hydroxychloroquine trial. A month ago, the news was that researchers in Brazil had abandoned a high-dose chloroquine trial because of concerns for patient safety. All of this followed reports in March that malaria drugs and antivirals used to combat HIV were being looked at as possible treatments for this novel coronavirus—and President Trump’s immediate announcement that the FDA was fast-tracking use of hydroxychloroquine and other anti-viral drugs for COVID-19 patients.

More recently, we’ve all seen the video of President Trump announcing that he, along with many front-line workers, is taking hydroxychloroquine to prevent getting the virus.

We’ve also seen the cautious reaction from the scientific community, who are worried that people with contraindications may take it, or that people may take it in toxic doses, or that people will stockpile it and cause patients with a legitimate need for the drug to go without. So, when I heard that there was a new Oxford trial, which is testing the drug in front-line workers, my first thought to what might have been good news a month ago was, “Oh, no.” Because this is just a trial, and the people taking the drug or the placebo are in high-risk circumstances that make it more likely that they would contract COVID-19 without any intervention and they are being closely monitored. It’s not a vindication of the president’s announcement. But the reaction from the press and pundits to the president’s announcement went too far in the other direction. Chloroquinine, as the president rightly says, has been used to prevent malaria for half a century. Yes, there are “potentially serious side effects,” but anyone who has watched drug ads on US television knows that just about every drug comes with potentially serious side effects. No, people shouldn’t be self-prescribing, but it’s unlikely, unless they have some stockpiled from a previous trip to a place with malaria, that they’d be able to get it. No, people shouldn’t double their dose if a physician does prescribe it, but isn’t that true of every drug?

The problem is that this is how the news cycle goes now. People, most of whom are home with less than usual to keep them occupied, are hungry for any good news that comes out. When we were told about malaria and anti-viral drugs, it felt like maybe the disease would start to be more manageable as treatments proved effective. Donald Trump, desperate to reopen the economy and appeal to his base, jumped the gun initially by promising that the drugs would be fast-tracked for non-label uses. Scientists rightly said, “Whoa! Not so fast!” But then journalists took the scientific concern and ramped it up to show, once again, how dangerous Trump is. The problem is, this hysteria was no more accurate than the initial race to say there was a treatment. Over thirty years ago, my husband, in preparation for a trip to Thailand and Bali, went to the British Airways office in London and got his anti-malarial pills, along with shots for yellow fever and other diseases he doesn’t remember. He would not have been allowed to travel if he did not produce a record of having had those shots and pills. Obviously, times have changed and people are rightly more cautious about vaccines, and you’d have to go to your GP to get the shots and pills, but the fact that it was regular practice in an airline office to provide some sort of quinine pills means that people probably weren’t dropping like flies. So the hand-wringing and hysteria starts to look just as politically motivated as the initial statement. And that seems to be what Donald Trump thought, too, so he decided to raise the stakes. Either he really is taking the drug, under a doctor’s care, or he decided to announce that he was taking the drug to make the point that no matter what his critics said, taking the drug was a rational thing to do. He dug his heels in, so the pundits—and Nancy Pelosi—dug their heels in. Now, at least to Trump supporters, the pundits look a little stupid—or disingenuous, since there’s a trial from someone with no dog in the American fight, and hydroxychloroquine may just, at some point down the line, be recognized as a (relatively) safe and effective treatment.

Trump’s free-form mix of lying, truth, and conjecture certainly take the battle between political rhetoric and scientific research to a new level, but the same basic cycle is evident in the UK. Let’s look, briefly, at the decision to open schools in a phased reopening, starting with three grades, including some of the youngest students. Teachers’ unions reacted with some alarm, since the date was just two weeks off and they say they hadn’t been told in advance of Boris Johnson’s news conference what the plans were. Individual reactions were a mix of real concern and, again, what seems like over-hysteria about keeping children safe, since it’s widely known that children don’t typically seem to be getting sick from the virus. Of particular concern was the idea of starting with the youngest children, who would be almost impossible to keep at the recommended social distances. Pro-opening advocates pointed to research by Professor Saul Faust and Dr Alasdair Munro, suggesting that children do not generally spread COVID-19. This caused Professor Faust to correct the record once again, pointing out in an interview on the BBC that he actually agreed that more information and preparation was needed before schools open. His research had just been meant to calm fears that children were “super-spreaders” who would inevitably lead to a spread of the disease. Even in the pro-opening Express article cited here, Faust says opening needs to be done “carefully and with full surveillance,” going on to say that the important thing is—you guessed it—“track and trace.”

At least, the UK government seems to be on board now, ramping up their track and trace system, albeit with a few hiccups along the way. In the US, in contrast to pretty much the rest of the world, tracking and tracing people who have the virus is seen as unlikely to help much by a majority of Americans, and an infringement of rights by almost half the population, according to a PEW Research study. I’m not sure what that means for opening up going forward—or for when the rest of the world will feel comfortable with the US’s apparent choice not to know who has the virus—but it seems unlikely to change anytime soon. And so it goes.

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