Well, if Trump consulted with his physician, and his physician approved hydroxychloroquine for Trump, than I imagine some in the medical community might question that doctor’s qualifications to dispense prescriptions. We know Trump takes cholesterol medicine, which is a heart health medicine. We know hydroxychlorquine has heart attacks as a potential side effect. And we know Trump is the president of the United States. I suppose Trump could have just said “give me the damn medicine”, but that might still call into question the ethical standards of the physician in question. That doctor could have said “I can’t do that, Mr. President”.
For the public, it would seem to be fair to at least ask how is it a physician is giving Trump a drug that carries dangerous side effects. Are we expected to believe that physician concluded “those side effects most likely won’t apply to you, Mr. President”. Apparently, you think that must be the case. And all the medical professionals acting incredulous that Trump might be doing this are off base being incredulous.
And, is the outrage really over Trump taking it? Or is the outrage over the fact that it encourages Trump supporters to think it must be safe to take? Trump said many front line workers are taking it. Yet, the NIH cannot find evidence that they are. Would it be fair to be outraged over Trump’s buttressing his claims for this drug by making a false claim about all those front line workers taking it?
Here’s the outrage: rather than appear to have been mistaken, Trump will continue to tout a drug the medical community suggests should not be used to prevent or combat Covid-19 outside a hospital setting.
The ways in which cholesterol and hydroxychloroquine affect the heart are very different and not related. Elevated cholesterol is
correlated with an increased risk for atherosclerosis, which further down stream can
contribute to cardiac ischemia (problems of getting blood to the actual tissue of the heart). Hydroxychloroquine
can cause delayed repolarization of the heart (fundamentally an electrical conduction issue) that
can lead to a higher risk of arrhythmias that can be fatal. The idea that this is a deadly medication has been very overblown. But the issue here is taking it
prophylactically. I had argued previously that I very much doubt that there are many people (relatively) who were taking this
prophylactically. Prescribing it for that purpose has always been fairly discouraged (initially because of an access issue, in the same way common people wearing masks was discouraged because it would deplete the supply from people who actually needed it). But despite what television shows, the news, and our cultural views on science and medicine have taught us, medicine really isn't so black and white. There's a lot of grey area. Saying that you can find someone out there who would prescribe this prophylactically isn't a stretch. Those kinds of things happen all the time, and there are many times that a patient may suggest something that the physician otherwise wouldn't have done, but due to a number of variables arrive at a conclusion that they wouldn't have independent of patient preference. This happens often and for people of a much lower status than being president of a powerful nation. Hell, it happens regularly with people who have absolutely no institutional power, no job, and even no insurance. Though I've argued the amount of people getting this prophylactically has been small, I'm certain it's even much smaller now, and yes, he was prescribed [presumably] this because he's the president.
But I think this is a good example of what I've been harping on so many times, that the time and situation completely dictates what is and is not appropriate, and what acceptable burden of proof is. My arguments regarding hydroxychloroquine has always been to defer these decisions to treating physicians and minimize the public pressure and politicization of its application. Taking this in higher risk situations changes the risk/benefit analysis, and the fact that it's of time-limited duration makes the negative effects of it less concerning. In reality, the jury is still out on this, regardless of what people are saying [but don't conflate me saying the jury's out with me saying I have an opinion on this or think that it works -- I've stated that, if anything, it probably doesn't have benefit -- but in reality the jury is still out]. But its use prophylactically is a different question all together. To use it prophylactically requires a larger burden of proof. Especially at this point in time, where (in absence of having some specific exposure), your risk of being exposed to this now really isn't that much different from a week from now, or two weeks from now, or a month from now. So taking it in a time-limited fashion makes less sense. I mean, I suppose you could take it indefinitely, but that would require an even larger burden of proof that doesn't exist.
Tl;dr if anyone who, like the rest of the population, had never heard of hydroxychloroquine until Trump mentioned it, but now believe a number of perceived certainties regarding this from their intense study of news articles, believes that this is as deadly and dangerous as everyone has assumed, then they can sit back with the upmost assurance to watch his inevitable fatal demise.