From the WebMD Archives
By Alan Mozes
WEDNESDAY, April 29, 2020 (HealthDay News) -- When the President of the United States offers medical advice, many Americans will heed the call. Never mind that the recommendations may be unfounded and potentially dangerous.
That's the cautionary finding of an analysis published April 29 in JAMA Internal Medicine.
Researchers examined Google search patterns following President Donald Trump's public embrace of the malaria medications hydroxychloroquine and chloroquine as treatments for COVID-19.
"We monitored all Google searches indicative of shopping for chloroquine and hydroxychloroquine in the U.S. between February 1 and March 29," explained study lead author Michael Liu, a masters candidate in social policy and intervention at Oxford University in the United Kingdom.
The team then split the search time frame into two parts. The first ran up until March 16. That's the date that billionaire Elon Musk -- CEO of the electric car company Tesla, Inc. -- first took to Twitter to endorse another malaria drug, chloroquine, as another unproven treatment for COVID-19.
The second time period ran from March 16 onwards. It covers Musk's endorsement, Trump's first televised endorsement of hydroxychloroquine on March 19, and also news reports of fatal poisonings stemming from off-label use of such drugs.
The team saw interest in purchasing both drugs skyrocket after both endorsements, but most notably after Trump's.
"We found that Google searches indicative of shopping for chloroquine and hydroxychloroquine were 442% and 1389% higher following these endorsements, respectively," said Liu.
"Even after deaths attributed to unsupervised consumption of chloroquine-containing products were reported, these searches remained 212% and 1167% higher, respectively," he added.
Even though hydroxychloroquine or chloroquine are not approved by the U.S. Food and Drug Administration as a treatment for COVID-19, "the position of President of the United States offers one an immense amount of influence," Liu said. "So, when President Trump endorses potential therapies on national television, people will listen and seek them out."
The misuse of presidential influence -- particularly in the context of a health crisis -- is a "gross mismanagement of power," said Tom Kolditz, founding director of Rice University's Doerr Institute for New Leaders, in Houston.
"I am an independent," stressed Kolditz, who is also a retired Brigadier General and the former head of behavioral science and leadership at the West Point United States Military Academy. "I am not interested in being political," he said.
"But what I am interested in is the critical role of moral obligation when it comes to leadership, regardless of party," Kolditz added. "Because when you are in a position of leadership, such as the president, you have a moral obligation to the people you lead who will follow your motivation, your directives and your guidance. And during a health crisis -- or any crisis -- leaders don't have the right to get it wrong."
And that, in and of itself, can pose a public health risk, said Liu.
"Chloroquine and hydroxychloroquine are both potentially hazardous and should not be taken without medical supervision, especially if an individual has certain pre-existing conditions," Liu said. "Moreover, these drugs are FDA-approved to treat such conditions as lupus and rheumatoid arthritis. The surge in demand has led to shortages of these drugs across the country for patients who actually need them for legitimate health reasons."
Also, the FDA last week warned that these drugs are too dangerous for general use because they may trigger potentially fatal heart rhythm problems in COVID-19 patients.
As for Trump's now infamous April 23 conjecture regarding the injection of disinfectants as a COVID-19 treatment, Liu suggested that might pose even greater risk given the relative ease with which the public can access Lysol or bleach, compared with prescription medications.
What can be done?
But if the President insists on sharing unsafe advice, what can be done?
"That's what we have the free press for," said Kolditz. "And journalists have an obligation not to participate in the silliness, and to confront bad leadership when they see it."
The good news? "I do think that the facts are out there, and the American public is really pretty well informed," Kolditz said. "And people are paying attention to medical experts." However, he cautioned that those medical experts also have an obligation to tell truth to power.
Liu added that "COVID-19 has caused enough suffering already. We do not need misinformation to further exacerbate the current public health crisis."