white house

Trump's drug surprise triggers a White House playbook: Defend and clean up

Some officials worked to justify the president’s decision to take hydroxychloroquine, while other aides debated whether they needed to update government guidelines about the drug.

Donald Trump

White House aides were as surprised as everyone else when President Donald Trump mentioned he was taking a controversial drug to help ward off the coronavirus.

Quickly, the administration assumed its typical posture for unexpected presidential proclamations — in this case, that the president had been using the anti-malaria drug hydroxychloroquine.

Officials defended the president’s decision while artfully addressing whether it is wise for the country's leader take an unproven coronavirus treatment that some research has shown could have serious side effects. Other aides scrambled to see if they could handle a potential surge in public requests for the drug. And there was discussion among health officials about whether the Centers for Disease Control and Prevention should issue additional guidance on using the approved drug, updating an existing government warning against taking the drug for coronavirus outside of a hospital setting or a clinical trial, according to a Republican close to the White House.

Trump’s unsolicited announcement reflected the president’s personal concerns about the coronavirus, a threat he spent months publicly downplaying only to see it infiltrate his inner circle in recent weeks. He started taking the drug around the same time two White House staffers tested positive for the coronavirus. The decision also showed Trump’s penchant for bucking the establishment — in this case, an alarmed medical community that has been skeptical about hydroxychloroquine’s effectiveness in helping combat coronavirus.

“I think that most people kind of expected he was on this or some other kind of prophylactic from the beginning,” said Jason Miller, a senior communications adviser for Trump’s 2016 campaign and co-host of the podcast “War Room.” “You’ve got people in the White House who have got it, he’s shaking a number of hands, you look at someone like [British Prime Minister] Boris Johnson having it, and the fact that the president has been so healthy through this, people probably suspected he was on something.”

Many of the key questions about the president’s use of hydroxychloroquine remained unanswered Tuesday: How much he’s taking, how long he planned to take it and how it would interact with his existing heart medication. Trump's physician said only that he and the president had made the decision together.

Instead, throughout the day, Trump simply defended his use of the drug, saying he believed hydroxychloroquine “gives you an additional level of safety” and “doesn’t hurt people,” and said “people are going to have to make up their own mind” regarding the drug’s efficacy. The White House declined to comment beyond Trump's remarks.

“This is an individual decision to make,” Trump told reporters after meeting with Republican senators on Capitol Hill. “But it’s had a great reputation, and if it was somebody else other than me, people would say, ‘Gee, isn’t that smart?’”

Yet recent research on the drug has not given it a great reputation for treating or preventing the novel coronavirus that has raced around the world, infecting upward of 1.5 million Americans and killing more than 90,000 of them so far.

In observational studies, the treatment has shown limited or no benefits for coronavirus patients, and may even cause heart problems like arrhythmia. And there are only limited results from studies on whether hydroxychloroquine could be effective as a prophylactic measure. More extensive studies are currently in the works.

Still, Trump has promoted the drug for weeks, encouraging Americans to take it. His proselytizing has led to a hydroxychloroquine shortage, which has had serious ramifications for people who have long used the drug to treat lupus, rheumatoid arthritis and other autoimmune diseases.

On Tuesday, Trump even dismissed one downbeat study about hydroxychloroquine as a “Trump enemy statement.” The study, partially funded by the government and released in April, found hydroxychloroquine provided no benefit and led to a potentially higher risk of death for coronavirus patients at U.S. veterans hospitals. The research has not been peer reviewed and was not a clinical trial.

Trump called the research a “false study,” arguing “it was given by obviously not friends of the administration,” even though it was a study of government data about treatments given at government facilities.

“If you look at the one survey, the only bad survey, they were giving it to people that were in very bad shape,” he added. “They were very old. Almost dead.”

There’s no conclusive evidence that hydroxychloroquine is more effective in healthier patients, however.

Health officials inside the administration were floored when Trump blurted out that he was taking hydroxychloroquine, said the Republican close to the White House. Aides had no idea he had been personally taking a drug he’d been touting for weeks, senior administration officials said.

The same Republican said the surprise among White House staffers was not unusual, since they are not privy to the president’s personal medical treatment.

A second senior administration official said the president’s statement was a “deliberate one” and that even if aides did not have first-hand knowledge of his use before Monday, the president had been talking to many people who had used it and not suffered.

White House trade adviser Peter Navarro, who has been working on global supply chain issues during the pandemic, argued the reaction to Trump’s decision was political posturing.

“The drug has been used relatively safely for years for malaria, lupus and rheumatoid arthritis, and close to 40 studies have signaled possible efficacy as a prophylactic and therapeutic,” he said. “It is false skepticism based on a few bad studies and a partisan knee-jerk reaction to anything Trump. These people hate Donald Trump more than they are concerned about the health and safety of American citizens.”

Vice President Mike Pence said he was not taking the drug himself, but added: “I would never begrudge any American taking the advice of their physician.”

“Hydroxychloroquine is a drug that’s been around for more than 40 years for treatment of malaria,” he said in a Fox News interview. “But, early in this process, the FDA approved what’s called off-label use where physicians could prescribe hydroxychloroquine in terms they deemed appropriate. So my physician has not recommended that, but I wouldn’t hesitate to take the counsel of my doctor. Any American should do likewise.”

When asked on Monday whether anyone else in his administration or family was taking the drug, Trump said “no.”

“But I wouldn't be surprised,” he added. “I don’t want to ask them because that's a personal decision as to whether or not you want to say. I just want to be open with the American public because, you know, I happen to think it's good.”

It was news the president seemed eager to share on Monday. After a question about government whistleblowers, Trump launched into a typical tirade about his political enemies. Then he casually tacked on that he happened to be taking hydroxychloroquine.

“A lot of good things have come out about the hydroxy,” Trump said. “I happen to be taking it.”

Reacting to the visible shock in the room, the president added: “I was just waiting to see your eyes light up when I said this, but — you know, when I announced this.”

Outside the White House, Trump allies said the response was overblown.

Trump’s critics, said Fox News host and Trump friend Sean Hannity, were acting as if the president’s “hope and optimism about the drug were some type of mortal sin.”