First, the obvious: He is capricious when he needs to be thoughtful and careful, he has an incredibly thin skin and doubles down on statements rather than ever admitting he was wrong, he treats most interactions with the press as either campaign rallies or battles, and he’s generally continued this behavior for the whole of the Coronavirus crisis. This leaves people unclear about what the White House is actually thinking or doing and unsure what to believe when he talks. He behaves in the Coronavirus briefings with a combination of these behaviors. The long, rambling conversations about the virus sound as if he’s mistaken the conference for a cocktail party. This tendency has been satirized many times by people more creative than I (by Kylie Degnan in this video).
Obviously, all of Trump’s personality characteristics would make it more difficult to separate fact from fiction, and to give some of us confidence that his “scientific advisors” are giving their unfiltered, best opinions, rather than trying to avoid being in the line of fire or shown the door (see the suit by Rick Bright, for example, who says he was fired for disagreeing with the President over hydroxychloroquine).
I’m going to continue with the whole hydroxychloroquine incident, because I think it distills, in one incident, all of the problems with what’s currently going on. First, there was Trump’s announcement in March that the FDA was fast-tracking research into using the drug as a treatment for COVID-19.
The press conference was typical Trump, in that it started with a challenge to the press, made a political point about China, and touted the bright prospects for the stock market before going on to give himself a pat on the back (“there’s never been a president even close that’s been able to do what I’ve done”), but when he eventually got to the actual information, it really wasn’t that controversial. There are, of course, the usual inaccuracies: Chloroquine and hydroxychloroquine are not just two different things people call the same drug, rheumatoid arthritis is not just “strong arthritis,” and Trump’s statement that “it’s not going to kill anybody” was a little overstated, given what we now know about the risks. But he also is fairly even-handed about its likelihood for success. Most of the news stories, though, seemed less concerned about reporting what research was going on and more about highlighting the inaccuracies. Some of the headlines back then included: “Trump says his belief in one potential coronavirus drug is ‘just a feeling’,” “Hydroxychloroquine: how an unproven drug became Trump’s coronavirus ‘miracle cure’,” and one from CNBC that’s a little more positive, “Trump’s claim that malaria drug can treat coronavirus gives hope, but little evidence it will work.” This is the problem with the adversarial style that has become the hallmark of the Trump presidency. After the negative press, on May 18, Trump repeated his “feeling” about hydroxychloroquine in his now-famous press conference in which he claimed that he is taking the drug himself.
It’s again typical Trump, in that he starts by accusing “the guy who signed the application” (presumably Rick Bright, who has now filed the lawsuit discussed above) of being a Democrat shill. And I doubt his doctor and the scientists who surround him wanted him to announce that he was taking the drug. He obviously thought it gave his assertions more gravitas—these people are saying I shouldn’t be promoting unsafe treatment, but would I be taking it myself if it’s unsafe? So far, nothing is new about this. What is more interesting, though, is what happened after his announcement.
First, Nancy Pelosi discussed Trump’s taking the drug with Anderson Cooper, calling the President “morbidly obese.”
This started a flurry of news stories, mostly cheering Pelosi on for making the comment. There were a few stories, including this one from CNN, that comment on the veracity of the comment (no, he’s not morbidly obese, but he is obese). The thin-skinned Trump hit back at Pelosi, saying she had mental problems, and then a Politico reporter asked Pelosi if she thought, upon reflection, that she should have made the comment. Even though, by then, the CNN article and others made it clear that what she’d said was not accurate, Pelosi took a page out of Trump’s book and doubled down. Here’s the whole back-and-forth:
One commentator said that Pelosi had shown “genuine concern” for the President. Does anyone think that sounded genuine? I’m sure she’s genuinely concerned that he will prompt other people to take an unproven drug, and that’s what she should have said. Instead, she chose to deliver a low blow—twice. So, presumably, Michelle Obama’s advice “When they go low, we go high” has turned to “When they go low, we go lower, because we’re cleverer.”
What if the tables had been turned, Nancy Pelosi were taking hydroxychloroquine, and Donald Trump said he was concerned for her because she’s almost 90 and shouldn’t be taking the drug? (For the record, she’s 80 and Trump is 73, so his calling her “almost 90” would also be incorrect and designed to get under her skin.) The news would be awash in stories of outrage, pointing out the error and using it as yet another example of why he is unfit to lead. I think it would be awful, too. The difference is that I think what she said was inappropriate, and I think the fact that she thought it was fine to excuse herself by saying, “Well we know he says those kinds of things” is even worse. It was also a “gotcha” moment that detracted from the important thing she should have said, which was that she was concerned that the President of the United States was making recommendations to take unproven drugs, and she was worried that 1) there would be a shortage for the people that needed the drug, and 2) people who shouldn’t be taking it would somehow manage to get it and take it.
The other major problem with all of this is that there is legitimate research going on regarding this drug and it is now overshadowed by Trump’s announcement and the press’s desire to show how reckless he is. This tendency has even crossed the pond. UK healthcare workers are part of an international effort to test the effectiveness of using hydroxychloroquine and chloroquine as a preventative against contracting the disease. This is what Trump, quite prematurely, said he was doing. So far, there is no clear evidence that it is effective, but researchers must have thought it was a link worth exploring. The research is backed by the University of Oxford and the Wellcome Trust, two institutions that are generally thought to be trustworthy. Participating UK hospitals are the John Radcliffe in Oxford, Brighton and Sussex University Hospitals. This does not appear to be a drug company or other for-profit organization trying to push something to make money from it. Yet, after the announcement, someone posted an article about the trial from The Telegraph on Facebook. There were over forty comments, but here’s the flavor of the vast majority of them:
First, note that The Telegraph starts out referring to the drug as the “Donald Trump drug.” This sets up the comments that follow. Second, if you read the Guardian article , the research that is being conducted is quite different from other trials, because those all concentrated on people who were already in hospital with the disease, while in this trial, the people being given the drug are healthy, currently COVID-free people with the likelihood of high exposure to the disease—NHS front-line workers. Yet most articles after Trump’s announcement conflated two conditions. I told my son yesterday that I was in the middle of writing this article and he said, “Oh, did you hear, the WHO stopped that trial because people got sick and died?” I said, “I think that was a trial investigating treating people who were already quite sick.” He said, no, he didn’t think so, but he’d send me the article in the Independent. Of course, the article refers to a trial on people already sick enough to be hospitalized. Their organs and immune systems are already compromised. People who get that ill from COVID tend to be older, with pre-existing conditions. Most people, including people with the immune disorder lupus, tolerate the drug quite well, according to the WHO Director General, Tedros Adhanom Ghebreyesus. Yet I can’t blame my son for having been confused. The title of the article is “Hydroxychloroquine: WHO suspends clinical trial of drug touted by Trump as ‘coronavirus cure’ over safety fears,” with the subtitle “Move comes after a study found use of drug increased risk of death by 34 per cent and risk of serious heart arrhythmias by 137 per cent.” Anyone skimming headlines would assume, since Donald Trump is mentioned in the headline, that the trial was testing the use that Trump was touting.
Why does this matter? Facebook brings out all the self-proclaimed experts who base their opinions on very little information, so does it matter that people are relying on articles that are slanted in this way? If we were to ask Vincent Wood and Oliver O’Connell, the writers of the article, why they chose to invoke Trump’s comments when talking about research into a very different use for the drug, they might candidly say Trump sells papers. If they wanted to profess a more noble justification for slanted reporting, they might say that they wanted to warn the public against taking the drug without supervision, but that rings hollow, since it’s a prescribed drug.
It matters because knowing the facts is always more comforting than hearing conjecture and bias. In this case, NHS workers are already being asked to volunteer to take the drug. What if the press has been so negative that not enough people are willing to volunteer? Do we scrap the trial into a promising treatment, perhaps losing lives down the road as a result, because Donald Trump promoted it? And NHS workers are just the participants in the trial. If the drug proves effective in lowering the risk to people on the front lines, maybe it will eventually be used by other public-facing workers (bus drivers, train conductors), countries to start opening up without an increase in the numbers of infected people.
Hydroxychloroquine is just one example of a bigger problem. It matters more generally because we have asked people to make very great sacrifices to keep others, and themselves, safe. If they don’t believe what they are reading, if everything is a contest between the “It’s our right to open up now—without masks!” crowd and the “Not until there is a 100% guarantee that no one will die of COVID-19” crowd, we will never open up. A vaccine is a long way away, and may not be discovered. In order for businesses to succeed upon reopening, consumers have to have confidence that they have been given all the facts, and right now, I don’t think that’s happening. Everyone is so wed to a position, and in the US, the position is guided by how people feel about President Trump. That’s the real danger of having a lightning rod like Donald Trump at the helm during a crisis like this.
In my next post, I’ll discuss some of the other times when polarization and obfuscation have caused real damage during the pandemic.