President Donald Trump blocked top infectious disease expert Dr. Anthony Fauci from discussing the president's hype of an unproven drug treatment for the new coronavirus at Sunday's White House press briefing.
"Would you also weigh in on this issue of hydroxychloroquine?" CNN reporter Jeremy Diamond asked Fauci, the director of the National Institute of Allergy and Infectious Diseases. "What do you think about this?"
"Didn't you just ask that question?" Trump snapped back before Fauci had a chance to respond. Diamond had asked Trump about the drug — but not Fauci. "Fifteen times."
"He's a doctor," Diamond responded.
"You don't have to answer the question," Trump told a dumbfounded Fauci. "I answered that question 15 times."
Fauci never answered the question, and the briefing continued. The exchange came after Fauci repeatedly called any evidence that the drug is effective against the coronavirus "anecdotal."
The briefing came after Fauci and economic adviser Peter Navarro got into a heated argument about the drug at Saturday's task force meeting, according to Axios.
Navarro brought out a stack of folders, which he said contained studies from "mostly overseas" that "show clear therapeutic efficacy," the outlet reported.
Fauci pushed back, arguing that there was only "anecdotal" evidence the drug worked.
The remark "set Peter off," a source told Axios, who insisted the studies proved otherwise.
"That's science — not anecdote," Navarro said, starting to "raise his voice," according to the report. The adviser also accused Fauci of opposing Trump's travel restrictions on China.
Vice President Mike Pence and adviser Jared Kushner were reportedly forced to intervene.
"It was pretty clear that everyone was just trying to get Peter to sit down and stop being so confrontational," one of the sources told Axios. "People speak up and there's robust debate, but there's never been a confrontation. Yesterday was the first confrontation."
"There has never been a confrontation in the task force meetings like the one yesterday," another source said.
The following day, Trump promoted the drug in the strongest terms yet.
"What do you have to lose?" Trump repeatedly said during Sunday's briefing. "I want them to try it, and it may work and it may not work. But if it doesn't work, there is nothing lost by doing it. What I want is to save lives, but I don't want it to be in a lab for a year and a half."
Demand for the drug has spiked since Trump began hyping it at briefings, leaving patients who use the drug for off-label uses to treat lupus and arthritis worried about shortages.
The American Medical Association and top pharmacist organizations issued a joint statement last month warning about the purchase of "excessive amounts of these medications in anticipation of potentially using them for COVID-19 prevention and treatment."
"The organizations strongly oppose these actions," the statement said, warning of "grave consequences for patients with conditions such as lupus or rheumatoid arthritis if the drugs are not available in the community."
The president was undeterred.
"I'm not acting as a doctor," he said Sunday. "I'm saying, 'Do what you want, but there are some good signs.'"
Trump added that the country does not have time to "go and say, 'Gee, let's take a couple years'" to study it.
"We have this medicine tested for many years. So it's a very strong, powerful medicine. But it doesn't kill people," Trump argued. "What do I know? I'm not a doctor. I'm not a doctor, but I have common sense."
Trump previously claimed that he may take the drug himself, though he dodged questions about doing so on Sunday.
Last month, an Arizona man died after ingesting a form of the chemical called chloroquine phosphate after hearing Trump discuss the drug at his briefings. The nation of Nigeria also issued a warning about the drug after recording poisonings following Trump's endorsement.
A 2018 review article warned that the drug could cause neurological side effects. The drug's side effects also include heart problems, nausea, abdominal cramps and vomiting. Longterm side effects include liver failure, hearing loss and muscle paralysis.
"Chloroquine phosphate, when used without a prescription and supervision of a healthcare provider, can cause serious health consequences, including death," the Centers for Disease Control and Prevention said last month. "Currently, these medications are being studied and evaluated as treatment for COVID-19; however, their efficacy to either prevent or treat this infection are unknown."
The Food and Drug Administration issued an emergency approval for the drug to be used as an experimental coronavirus treatment, but the Department of Health and Human Services warned that clinical trials were necessary to "provide scientific evidence that these treatments are effective."
Dr. Megan Ranney, an emergency room physician and researcher at Brown University, told ProPublica that she would not use the drug unless it was proven to be effective.
"This drug has major side effects," she said, "including paranoia, hallucinations, suicidal thoughts, suppression of your blood counts, so you became more susceptible to infections. It can cause severe cardiac arrhythmias that can even cause death. Now, these are not common side effects, but they're common enough that they should not be taken just willy-nilly. It is not like water. It is not harmless."
Trump cited a French study that involved just 40 patients and drew skepticism from researchers at Sunday's briefing. Another study in China, which involved just 30 patients, did not find any significant differences in outcomes for patients that took the drug compared to those who did not.
Dr. Luciana Borio, a former National Security Council official under Trump who served as the top scientist at the FDA under President Barack Obama, said the drug had led to disappointing results in the past.
"Hydroxychloroquine has been studied as a possible antiviral therapy for many decades," she told The New York Times. "Despite showing evidence of activity against several viruses in the laboratory, it never showed success in randomized clinical trials."
Though Fauci was cut off at Sunday's briefing, he has similarly sought to downplay the president's hype.
"We've got to be careful that we don't make that majestic leap to assume that this is a knockout drug," he told Fox News on Friday. "We still need to do the kinds of studies that definitely prove whether any intervention is truly safe and effective."
"The data are really just at best suggestive," he later told CBS News. "I think in terms of science, I don't think we could definitively say it works."