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This Time, Hardly Anyone Followed Trump’s Lead on Virus Drugs This Time, Hardly Anyone Followed Trump’s Lead on Virus Drugs
(3 days later)
Newly compiled prescription data shows that President Trump’s decision to take an antimalarial drug to ward off the coronavirus did not inspire many Americans to do the same, reflecting the fast-changing landscape surrounding the virus and efforts to treat it.Newly compiled prescription data shows that President Trump’s decision to take an antimalarial drug to ward off the coronavirus did not inspire many Americans to do the same, reflecting the fast-changing landscape surrounding the virus and efforts to treat it.
First-time prescriptions ticked up by only several hundred the day after Mr. Trump mentioned at a White House event on May 18 that, as a preventive measure, he was taking one of two antimalarial drugs he had touted, according to nationwide data analyzed by The New York Times.First-time prescriptions ticked up by only several hundred the day after Mr. Trump mentioned at a White House event on May 18 that, as a preventive measure, he was taking one of two antimalarial drugs he had touted, according to nationwide data analyzed by The New York Times.
That increase paled in comparison to the tens of thousands of first-time prescriptions that poured into retail pharmacies after Mr. Trump first promoted the two medications during a White House telecast two months earlier.That increase paled in comparison to the tens of thousands of first-time prescriptions that poured into retail pharmacies after Mr. Trump first promoted the two medications during a White House telecast two months earlier.
The drugs, chloroquine and hydroxychloroquine, have not been proven to treat Covid-19 and have been fiercely debated as a potential cure or prophylactic measure, despite warnings from medical experts about their efficacy and possibly dangerous side effects.The drugs, chloroquine and hydroxychloroquine, have not been proven to treat Covid-19 and have been fiercely debated as a potential cure or prophylactic measure, despite warnings from medical experts about their efficacy and possibly dangerous side effects.
First-time prescriptions of the drugs in retail pharmacies have remained higher than usual since the pandemic began, averaging about 2.25 times their previous weekday rate, according to the analysis.First-time prescriptions of the drugs in retail pharmacies have remained higher than usual since the pandemic began, averaging about 2.25 times their previous weekday rate, according to the analysis.
By the evening of March 19, the day the president first praised the drugs on television, the rate of first-time prescriptions had surged to more than 46 times the weekday average, the highest level to date. By contrast, on May 19 — the day after Mr. Trump revealed in the late afternoon that he had begun taking one of the drugs — the rate changed comparatively little: rising to about 2.8 times the average, the equivalent of about 400 prescriptions. The level remained slightly elevated for most of the week.By the evening of March 19, the day the president first praised the drugs on television, the rate of first-time prescriptions had surged to more than 46 times the weekday average, the highest level to date. By contrast, on May 19 — the day after Mr. Trump revealed in the late afternoon that he had begun taking one of the drugs — the rate changed comparatively little: rising to about 2.8 times the average, the equivalent of about 400 prescriptions. The level remained slightly elevated for most of the week.
The stark difference could be explained in part by the timing of the two announcements, said Dr. Walid Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.The stark difference could be explained in part by the timing of the two announcements, said Dr. Walid Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.
By May, the initial wave of fear and uncertainty about the virus had lessened, he said, and more was known from scientific studies about the questionable benefits — even possible harm — of taking the two drugs.By May, the initial wave of fear and uncertainty about the virus had lessened, he said, and more was known from scientific studies about the questionable benefits — even possible harm — of taking the two drugs.
Even the president taking one of the medications might not be enough to counter those developments.Even the president taking one of the medications might not be enough to counter those developments.
In addition, Dr. Gellad said, the pool of people inclined to take the drugs may have been depleted by May. “People who were going to do this already did it,” he said. “They already have it in their cabinet.”In addition, Dr. Gellad said, the pool of people inclined to take the drugs may have been depleted by May. “People who were going to do this already did it,” he said. “They already have it in their cabinet.”
The prescription data analyzed by The Times was compiled by IPM.ai, a subsidiary of Swoop, a company in Cambridge, Mass., that specializes in health care data and analytics based on artificial intelligence. The data did not include the identities of the prescribers or the patients.The prescription data analyzed by The Times was compiled by IPM.ai, a subsidiary of Swoop, a company in Cambridge, Mass., that specializes in health care data and analytics based on artificial intelligence. The data did not include the identities of the prescribers or the patients.
Last week, the White House press secretary Kayleigh McEnany said Mr. Trump reported “feeling perfect” after taking hydroxychloroquine and suggested he would take it again if exposed to the virus. The president has said he took a short course of the drug because two people in the White House had tested positive for the virus.Last week, the White House press secretary Kayleigh McEnany said Mr. Trump reported “feeling perfect” after taking hydroxychloroquine and suggested he would take it again if exposed to the virus. The president has said he took a short course of the drug because two people in the White House had tested positive for the virus.
Since Mr. Trump’s enthusiastic backing of the drugs, warnings about them have popped up with considerable regularity, including from within his administration.Since Mr. Trump’s enthusiastic backing of the drugs, warnings about them have popped up with considerable regularity, including from within his administration.
In late April, the Food and Drug Administration cautioned against using the drugs outside a hospital or clinical trial because they could lead to serious heart rhythm problems in coronavirus patients.In late April, the Food and Drug Administration cautioned against using the drugs outside a hospital or clinical trial because they could lead to serious heart rhythm problems in coronavirus patients.
At least 40 states have restricted the medications’ availability in some way, for instance barring pharmacists from dispensing them unless the prescription includes a diagnosis of a condition the drugs are proven to treat. (Hydroxychloroquine was developed to treat malaria and is frequently prescribed for lupus and other autoimmune diseases like rheumatoid arthritis. It is closely related to chloroquine, which is also used to treat malaria.)At least 40 states have restricted the medications’ availability in some way, for instance barring pharmacists from dispensing them unless the prescription includes a diagnosis of a condition the drugs are proven to treat. (Hydroxychloroquine was developed to treat malaria and is frequently prescribed for lupus and other autoimmune diseases like rheumatoid arthritis. It is closely related to chloroquine, which is also used to treat malaria.)
Updated June 5, 2020 Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Early in the pandemic, reports from doctors in China and France that the drugs might help coronavirus patients fueled interest in scientific and medical communities in the United States. Some people have suggested that taking the drugs prophylactically could guard against infection or lessen its severity, although a study published this week in The New England Journal of Medicine found that hydroxychloroquine did not prevent Covid-19 in 821 people who had been exposed to patients infected with it.Early in the pandemic, reports from doctors in China and France that the drugs might help coronavirus patients fueled interest in scientific and medical communities in the United States. Some people have suggested that taking the drugs prophylactically could guard against infection or lessen its severity, although a study published this week in The New England Journal of Medicine found that hydroxychloroquine did not prevent Covid-19 in 821 people who had been exposed to patients infected with it.
In March, more than 40,000 health care professionals were first-time prescribers of the drugs, which are typically prescribed by doctors from a narrow band of specialties, like rheumatology. But it expanded to include cardiologists, dermatologists, psychiatrists and even podiatrists, according to the prescription data.In March, more than 40,000 health care professionals were first-time prescribers of the drugs, which are typically prescribed by doctors from a narrow band of specialties, like rheumatology. But it expanded to include cardiologists, dermatologists, psychiatrists and even podiatrists, according to the prescription data.
State pharmacy boards reported then that doctors had been writing prescriptions for themselves and their family members, which some doctors explained as prudent given their interaction with patients.State pharmacy boards reported then that doctors had been writing prescriptions for themselves and their family members, which some doctors explained as prudent given their interaction with patients.
The data analyzed by The Times both in March and May did not include drugs prescribed to patients in hospitals, where some doctors have administered the medications, or those released to hospitals from the Strategic National Stockpile. The data is anonymized and based on insurance claims filed for about 300 million patients in the United States, representing approximately 90 percent of the country’s population.The data analyzed by The Times both in March and May did not include drugs prescribed to patients in hospitals, where some doctors have administered the medications, or those released to hospitals from the Strategic National Stockpile. The data is anonymized and based on insurance claims filed for about 300 million patients in the United States, representing approximately 90 percent of the country’s population.