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The Politics of Hydroxychloroquine | In the Pipeline

I had not been planning to return to the topic of hydroxychloroquine so soon, but here we are. This will not be a calm, measured blog post – fair warning.

Yesterday, Dr. Rick Bright was pushed out of his post at HHS, where he was deputy assistant secretary for preparedness and response and director of BARDA, the Biomedical Advanced Research and Development Authority. This didn’t look good at the time, but now it turns out that Dr. Bright is not planning on going quietly. The New York Times reports this statement of his to their reporter Maggie Haberman:

“I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the Covid-19 pandemic into safe and scientifically vetted solutions. . .I am speaking out because to combat this deadly virus, science — not politics or cronyism — has to lead the way. 

. . .To this point, I have led the government’s efforts to invest in the best science available to combat the Covid-19 pandemic. Unfortunately, this resulted in clashes with H.H.S. political leadership, including criticism for my proactive efforts to invest early into vaccines and supplies critical to saving American lives. I also resisted efforts to fund potentially dangerous drugs promoted by those with political connections.

Specifically, and contrary to misguided directives, I limited the broad use of chloroquine and hydroxychloroquine, promoted by the administration as a panacea, but which clearly lack scientific merit. While I am prepared to look at all options and to think ‘outside the box’ for effective treatments, I rightly resisted efforts to provide an unproven drug on demand to the American public. I insisted that these drugs be provided only to hospitalized patients with confirmed Covid-19 while under the supervision of a physician. . .”

He’s asking the HHS inspector general to investigate the circumstances of his firing and political influence on BARDA, specifically pressure to fund what he terms “companies with political connections and efforts that lack scientific merit

This is a grenade. It was clearly meant to be one, and I have to applaud Dr. Bright for his refusal to shrug his shoulders and just walk off. These are really serious charges to make during this pandemic, and if his accusations have merit, this is just the sort of malfeasance that can’t be tolerated. Dead bodies are piling up, the economy is at a standstill, we are in a public health crisis the likes of which none of us have ever experienced, and the administration is making sure to take funding decisions out of the hands of career scientists so that cash can be steered to well-connected snake oil artists? We have to know the truth.

This of course comes just a couple of days after yet another look at the use of chloroquine and hydroxychloroquine (with and without azithromycin), this time from the VA health care system, that found that administration of these drugs to coronavirus patients actually increased the chances of death and of serious respiratory problems. That study by itself is not enough to prove that these drugs don’t work, of course: it has a standard-of-care control group for comparison, but it’s all retrospective, not an intentional blinded clinical trial. But it’s not meaningless, either, and when you add that in to the other studies that are showing no effect (at best), the ones that claim benefit are not enough for a person to say that anything is working. If Rick Bright was calling for these drugs to be administered under controlled conditions and to not declare them as great therapies for the epidemic, then good for him: those are the right decisions. And if he was fired for them and for similar calls, then there should be an investigation.

Unfortunately, the conduct of many members of this administration does not allow anyone to dismiss these allegations out of hand. I will resist the temptation to list details; they are abundant. The president’s fans will wave these aside as exaggerations or fabrications, and nothing I or anyone else can say will convince them otherwise. Every administration, every government has some of these people, though, and as far as I’m concerned we have a lot more than our share right now. Sadly, I find it completely believable that Trump administration officials could take this opportunity to grease campaign donors and reward their friends at the expense of the public health and at the expense of scientific evidence. Completely.

Don’t you? Look at the commentary of veteran industry observers like Steve Usdin of Biocentury, whose frustration comes through when he writes about this administration’s behavior during the pandemic. He’s not alone. Honestly, just step back a little and take a look at the whole DC landscape in light of the coronavirus: can you say that George Packer is wrong? Get to the bottom of this. Get to the bottom of it as quickly as possible. This is supposed to be a great nation, not a racket run by a bunch of smirking grifters.

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