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Reporting Indicates Heated Disagreement Within Trump White House Over Efficacy Of Hydroxychloroquine To Treat COVID-19. Aired 8- 8:30a ET
Aired April 6, 2020 - 08:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JONATHAN SWAN, NATIONAL POLITICS REPORTER, "AXIOS": But Trump has made clear that when he disagrees with him, he's just going to overrule him. He is making that very clear publicly. It's not like you need private reporting to draw that conclusion.
JOHN BERMAN, CNN ANCHOR: Jonathan, it's interesting, because the president's belief in this seems to be more than just based on science. He seems to be leaning into this for political reasons, as well? What is your reporting on why he's putting so much stock in this?
SWAN: Look, President Trump talks about this -- I think this is of a piece with other comments he's made with respect to coronavirus, which is he's wanted to provide hope and optimism, and he has sometimes done that in the face of evidence and facts. He's done that and had to walk back with respect to his desire to reopen the economy by Easter and have these scenes of flourishing churches by Easter. So I think it sort of fits into that category of commentary.
And he's also, frankly, hearing from people that he likes, like Sean Hannity, the FOX News opinion host, and Rudy Giuliani, and others, and he's hearing stories from certain individual doctors that are reinforcing this hope that this drug will be a game changer, in Trump's words, with the virus.
BERMAN: All right, Jonathan Swan, stand by, if you will, for us now, because joining us, I think, from the White House is Peter Navarro. He is the director of the office of trade and manufacturing policy and a White House economic adviser. We've been hearing this reporting, Peter, if you can hear me, about what appear to be a disagreement with Dr. Anthony Fauci that you had inside the situation room over hydroxychloroquine. Explain to me the nature of this disagreement.
PETER NAVARRO, DIRECTOR, WHITE HOUSE OFFICE OF TRADE AND MANUFACTURING POLICY: Anybody there?
BERMAN: Peter Navarro, it's John Berman in New York. Can you hear me?
NAVARRO: Brother John. How are you, my friend?
BERMAN: I'm very well, Peter. Thanks so much for being with us. Look, we've been listening to reporting and reading it all morning long about a disagreement in the Situation Room between you and Dr. Anthony Fauci about the efficacy of hydroxychloroquine. Can you explain to me the nature of this disagreement?
NAVARRO: We're off the air now, right?
BERMAN: No, we're on air, Peter.
NAVARRO: Oh, we're on air. Sure. So let me focus on the issue at hand. Does hydroxychloroquine work? That was the subject in the task force meeting this Saturday. The facts of the matter are the following. First of all, FEMA has 29 million tablets sitting in a warehouse, that's number one.
Number two, John, at the task force meeting there was unanimous agreement that FEMA would immediately begin surging hydroxy into the hot zones to be dispensed only between a doctor and a patient decision, not the federal government. So that's number two.
Number three, you may find this interesting in the city that you live in, in New York, in the New York health and hospitals system, virtually every patient now that comes in presenting COVID-19 symptoms is given a cycle of hydroxychloroquine. and when I discussed this last night with Mitch Katz, who is the head of that system, I asked him, are you doing that because the federal government is telling you or because you think it may work? And he said quite clearly that it may work.
NAVARRO: The fourth fact I want to say, and then we'll get to the politics of this, the fourth fact I want to say is that there's now numerous scientific studies that indicate potential efficacy, including, John, and this is important, the study that was just published in the last few days from Wuhan --
NAVARRO: -- which is one of the first randomized studied with a control group, and it showed very clearly that 80 percent in the control group did very well versus 50. So there was that discussion --
BERMAN: Listen --
NAVARRO: -- on Saturday. And if we didn't have disagreement or debate in the Trump administration, this administration would not be as strong as it is.
BERMAN: Let me just say one thing. I'm not interested in the politics of it. I'm only interested in the science of it. When you talk about that study out of Wuhan, we should not, yes, that was the only study we've seen so far with a control group.
Hang on, but it wasn't double blind, which means that the doctors who were using it knew who was getting it. It was also with only moderately ill patients. Finally, again, on the science of it, I want to play you something that Dr. Anthony Fauci has said about hydroxychloroquine. Listen.
NAVARRO: Sure. Sure.
(BEGIN VIDEO CLIP)
DR. ANTHONY FAUCI, NATIONAL INSTITUTES OF ALLERGY AND INFECTIOUS DISEASES: The data are really just at best suggestive. There have been cases that show there may be an effect, and there are others to show there's no effect. So I think in terms of science, I don't think we could definitively say it works.
(END VIDEO CLIP)
BERMAN: So why is Dr. Anthony Fauci, the lead infectious disease doctor in the country wrong about this, in your opinion?
NAVARRO: I'd let him speak for himself, John, but I would have two words for you -- second opinion. And in terms of the studies that exist, I think you would grant me that there are numerous studies on this which show preliminary therapeutics.
BERMAN: I know three. Hang on, Pete. I have to ask the question. I let you go to four points in the beginning. I just want to follow-up.
NAVARRO: Sure. Sure.
BERMAN: You're saying a second opinion here. What are your qualifications to weigh in on medicines more than Dr. Anthony Fauci? Why should we listen to you and not Dr. Fauci?
NAVARRO: Let me suggest, John, that later in the day, you have William Grace on, another famous doctor in the city of New York. He can talk eloquently about this. But John, doctors disagree about things all the time. My qualifications in terms of looking at the science is that I'm a social scientist. I have a Ph.D., and I understand how to read statistical studies, whether it's in medicine, the law, economics, or whatever.
BERMAN: I'm sorry, that doesn't qualify you to treat patients. You know it doesn't qualify to you treat patients.
NAVARRO: Hang on, John, John, John, John. John, all I'm asking for you to understand, John, is that right in your city, in the New York health and hospital system, virtually every patient getting COVID, presenting with COVID-19 symptoms is given hydroxy. Now, you -- talk to Mitch Katz, talk to William Grace, and I simply present that. And you can -- I think this is important for your viewers. There are downsides to this. There can be in some cases --
NAVARRO: -- negative effects.
BERMAN: Deadly. NAVARRO: Yes, that's true. And it's related to heart and related to
vision, and that's why the task force was very clear in its decision that it had to be the patient-doctor relationship that would prescribe the drug. But John, let's do this --
BERMAN: Hang on, Peter. It's may turn. Let's take turns here.
BERMAN: I've spoke to Dr. Rob Gore who is on the front lines treating patients inside a hospital in Brooklyn, and as you said, yes, they are giving patients hydroxychloroquine. When I asked him whether he works, he said we don't know.
BERMAN: They simply don't know. I asked Dr. Daniel Varga in New Jersey, are you giving hydroxychloroquine to patients. He said yes. I asked him does it work? He said we don't know. The difference here, the difference that you are making and the difference that you are taking, the additional step you are taking is as a social scientist with no medical training is you are now saying that you think it works while Dr. Anthony Fauci, who is an infectious disease doctor who has been running the top infectious disease agency for decades, says we don't know if it works.
NAVARRO: May I respond?
BERMAN: My question to you again --
NAVARRO: Lengthy. Go ahead.
BERMAN: You were lengthy, too. Why should we listen to you and not Dr. Anthony Fauci?
NAVARRO: So you presented a false case there. Basically, what I have said and the only thing I have said is that the scientific studies that I have seen point to the possibility that it has both therapeutic efficacy as well as possible prophylactic efficacy.
And one thing is would ask you to do, John, is you speak to these doctors and nurses and other people at the front lines, ask how many of them are taking hydroxy as a prophylactic in warzone. So I'd appreciate here, John, this is a situation where this drug could save lives, and I think there needs to be a debate.
And you're right that I'm not the arbiter of this, but there's a lot of doctors out there who are on one side and there's a lot of doctors on the other side. There's science going on. We are at war here, and what we're trying to do is make sure as few people die as possible.
And I look at a study, just this latest one, I read it, from Wuhan, and there's a controlled group where 80 percent do well and only 50 percent don't. You could be a plumber and read that and come to the same conclusion, John. I don't know why you're so hard about this. Would you take it if you got sick? BERMAN: Would I take it if I got sick?
NAVARRO: Yes, would you take it, knowing what you know now?
BERMAN: I would listen to my doctor about whether or not I should take it.
NAVARRO: Good, That's exactly what you should do. that's exactly what you should do. That's all we're asking you to do.
BERMAN: I would not consult someone involved with trade policy.
NAVARRO: We're taking 29 --
BERMAN: I would not consult someone involved with trade policy.
NAVARRO: I agree. I'm not prescribing anything. I'm not prescribing anything. I'm not prescribing anything.
BERMAN: And my question, do you want a doctor? Do you want a medical doctor, an internist, do you want an internist striking trade deals?
NAVARRO: Touche. Touche.
BERMAN: That's my point.
NAVARRO: But you're setting up a false narrative here.
BERMAN: I'm not. I swear to God I'm not. You had a debate inside the Situation Room with the nation's top infectious disease doctor, the man who is in charge to a certain extent of the nation's medical response to this, and all he said -- he wants this to work. Everyone wants this to work. All he has said is, let's let the testing and the science decide. What you seem to be saying is, I've read a study out of Wuhan, and I decided.
NAVARRO: That's so unfair, John. In that meeting, I had over 100 pages of numerous studies that --
BERMAN: I know three. I know three.
NAVARRO: Oh, there's many more, and I'll get them to you today, John. But here is the thing. The issue wasn't about me offering my medical opinion. The question was whether we should take the 29 million doses in the FEMA storehouses and surge them into the zones. And it was unanimous, John, in that task force meeting to do so on the advice of patient to his doctor. So that's the only question I posed.
BERMAN: But see, look --
NAVARRO: All you're doing is reading --
BERMAN: No, I want to ask you a different question here. Dr. Anthony Fauci was asked at the briefing yesterday to weigh in on the efficacy of hydroxychloroquine, and the president wouldn't let him. So shouldn't we hear from the scientist on this at the briefing?
NAVARRO: Look, John, that's just an unfair question to ask me, OK? It's like if CNN wants to set up Dr. Fauci as the only authority on medicine and only rely on him, that's one set of facts. What I'm saying is doctors disagree all the time, and I would talk to -- I have William Glass on your program today, would you do me that favor? Have Mitch Katz on.
BERMAN: Do you have reason to doubt the analysis of Dr. Anthony Fauci?
NAVARRO: I agree with the analysis of Dr. Fauci in this sense -- we don't have definitive, 100 percent science to say that this absolutely works, and we don't know what degree that is does work. That's not inconsistent with the idea of using it as they do in all 11 hospitals in the New York health and hospital system as a therapeutic at this time, when we are in basically at war with the virus, and it appears at least in some studies, to have therapeutic efficacy, John.
And I get back to you, John. God help it if you get COVID, but if you go into a hospital and have that choice, you're going to have to make that choice. And you're going to make that choice with the discussions with your doctor and as an educated man, you'll probably read all of the studies that are out there. And you'll make that choice.
BERMAN: I've read the study out of China, out of Wuhan, which again, is the first one with a control group, but it's not a double blind.
NAVARRO: Have you read all the all others?
BERMAN: I saw the ones from Europe as well which had no control groups.
NAVARRO: Yes, but there's --
BERMAN: The previous studies, the previous studies, Peter, that I have seen or know of, are of hydroxychloroquine dealing as an anti-viral in general, not specifically to COVID-19, and those also have mixed results. This is not a new drug. People have been leaning on this for a long time.
NAVARRO: Sure. Sure.
BERMAN: -- hoping it would cure viruses. The question is, once again, as you are not prescribing this, but suggesting its efficacy to the American people as President Trump asks, what's the harm? What do you have to lose? Hang on, what do you have to lose?
NAVARRO: You're keep putting words in my mouth here. You weren't at the meeting.
BERMAN: When the president says what do you have to lose? You know as a social scientist who has read the studies that there are potential side effects. There is, in fact, something to lose potentially, correct?
NAVARRO: Well, look, you can take any drug right now in America and read the side effects, and every single thing you take has some potential side effects that can harm you. You've seen the commercials. I love the commercials, like they show kids at play and people going out and having a great time, and then that voice underneath says this thing can kill you in six different ways.
But in this particular case, this drug has been around for many, many decades. It has recognized side effects, but some doctors judge that the risk is relatively low relative to the risk of dying of COVID. And all my role has been in this is to suggest that we have this in the stockpiles, and that we may have -- we should have that discussion about whether we should surge it.
And the task force, who included the surgeon general, Fauci, Steve Hahn, and others, unanimously agreed that we should surge that to the hot zones, and let the doctor-patient relationship determine who takes it.
And John, that's a really good outcome. And history will judge whether this was an efficacious drug, but right now in the fog of war, if that can save lives, that's a good thing.
BERMAN: We all want the same thing, which is people to get better.
NAVARRO: I'm not sure we do sometimes.
BERMAN: What are you talking about? Hang on. Hang on.
NAVARRO: Well, you're really -- you're setting this up kind of as a false dichotomy between you know, this doctor over here and --
BERMAN: Peter, I respect you and respect -- don't you dare for a second suggest that I don't want people to get better from this. I've got two friends -- I've got two friends in bed right now recovering from this.
NAVARRO: No, no. That's not what I said, John. Don't put those words in my mouth. But when you say that we -- you know, when we come on here, and we say we all want the same thing, there is this political overtone, this battle between, you know, you trying to give this false dichotomy between the President and --
BERMAN: There is no false dichotomy. We want people to get better.
NAVARRO: We do. Then let's do this, in the spirit of friendship, John --
BERMAN: We absolutely want people to get better and I appreciate your efforts to do so, I appreciate it, but don't suggest that my point is anything other than trying to figure out what the science is behind this and the efficacy.
NAVARRO: Fair enough, John. I really enjoyed talking to you and you know, you're an honorable man, and if I offended you in any way, it wasn't my intention, but you did not let me finish my sentence, so I wasn't guilty of that.
NAVARRO: But anyway, let's -- I mean, look, John, people are dying here. This is war. This is an important debate to have. And I think it was a wise decision in the form of the Taskforce to move forward with this and let doctors and patients determine.
I really would urge you to have people like William Grace on, talk to Mitch Katz, have them on. Talk to some of those doctors at the front line who are taking hydroxy as a prophylactic, and let's see what happens. I mean, we're working overtime.
BERMAN: I got you and I know you are, Peter, I know you're also working on the supply chain issues, getting supplies out to the states into the hospitals. And I do want to talk to you about that. Hopefully, we can have you back tomorrow or very soon to have that discussion.
NAVARRO: I'll come back soon.
BERMAN: Peter Navarro --
NAVARRO: Anytime, John.
BERMAN: Thank you very much.
NAVARRO: Thank you very much. Be safe.
BERMAN: I appreciate it -- Alisyn?
ALISYN CAMEROTA, CNN ANCHOR: Fascinating interview, John. Thank you very much.
Let's bring in CNN's chief medical correspondent, Dr. Sanjay Gupta. Also back with us is national political reporter for Axios, Jonathan Swan, who has done the reporting that Peter Navarro was just commenting on.
Sanjay, first to you. So I want to know what you heard from Peter Navarro. What I heard was him saying they don't want to wait for the clinical trials. They want to get this into the bodies of patients and the hands of doctors right now, what was your impression?
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: It's a total clash, you know, here, Alisyn. On one hand, understandably, and I think John made this point very clearly, of course, everybody would love for a therapeutic to get out there and to work.
I mean, you know, when I say everyone, I mean, everyone on the planet, it wants something to work at some point.
The fact of the matter is, we don't know if hydroxychloroquine works. We don't even know if maybe it works for some people and not others. Could it make some people worse? Small example. This is a medication that seems to suppress your immune system. That's why it works for patients, for example of autoimmune diseases. Now, if you're somebody who needs a strong immune system, because you're elderly and your immune system has not been working well, would you really want to suppress that person's immune system? Probably not. I don't know.
Nobody knows, that's sort of the point and someone who has an overreaction of their immune system to this, maybe it might work. We don't know. You want to do the studies here.
Could it be harmful to some people? Possibly. That would be obviously a terrible outcome. We don't know the dosing that should be given. We don't know the duration that should be given. John was quite right in terms of how he characterized the studies.
They've been -- really, these studies have involved mild patients with mild disease. Now, why is that important? That's important because thankfully, most patients do still recover from coronavirus.
So if you have two groups, all -- you know, in one group, they have mild disease, the other group has mild disease. One group gets the medication, the other group doesn't get the medication. They're both very likely to improve. How do you really make sense of that sort of data, especially when it's a really small trial?
Look, I'm trying to give a little bit of the reasoning behind why trials are done. You don't want to harm people. There is a real potential here for that so that it is not, you know, can't hurt might help, why not situation. It just isn't.
I want there to be a therapy. You want there to be a therapy. John, everybody wants there to be a therapy. But we've got to be sure, and it can happen quickly. But why wouldn't we do that? Why wouldn't we actually do the trials?
BERMAN: And who wouldn't -- you know, everyone is okay with it being this therapy if it's proven to work, but if 200 million people are going to take it, for whatever reason?
GUPTA: That's right.
BERMAN: You have to make damn well sure that there aren't side effects or something doesn't go wrong. Jonathan Swan, just quickly. It's rare that you have someone basically just come on and publicly say, yes, we had that disagreement and this is what it was about. Peter Navarro basically just did that.
SWAN: Well, I give him credit for not lying. He didn't deny what happened in the room, and I think you saw in your very interesting interview, you got a little taste of what happened in the situation room, you know. You got the flavor of the kinds of arguments that Peter Navarro was making in the Situation Room.
That was a slice of what was described to me, exactly what you saw play out on CNN, you know, five to ten minutes ago. [08:20:10]
CAMEROTA: Sanjay, I know that from where you sit as a renowned doctor, of course, you want the clinical trials to happen first, but it sounds like they're actually bypassing it. I mean, it sounds like what Peter Navarro just told us was that they all agreed that they are going to hit the National Stockpile of the 29 million doses of hydroxychloroquine and they are going to surge it into the hotspots.
And he told John that doctors in New York are already routinely giving it to patients. So it sounds like they're already bypassing the preferred process that you would like to see.
GUPTA: Some of that is happening, Alisyn. I mean, I think there's several things that are happening, but being interpreted a little bit differently. First of all, you know, increasing the production, allowing some looser regulations so you can import this medication from other countries, in part is happening because, you know, there's this this this idea that look, if it does pan out, we want to be ready. You could make an argument that makes sense.
You also want to make sure that people who are legitimately taking this medication are really dependent on it right now. Don't go without as a result of what's happening right now.
I think that if you talk to doctors within these hospitals, you know, and there are hospitals who have this as part of their protocol for patients who have later stage illness of the COVID-19. They'll say, look, we're still conducting this as a trial. You know, we're still trying to collect the data here, figure out what dosing to give, what duration.
You know, again, the only studies have really been done in in mild cases, and yet the protocols are in severe cases because they don't know whether or not to give it to someone who has a mild case.
The last thing these doctors want to do is make somebody worse as a result of this. A mild case that would have likely -- and when I say likely, I mean eight times out of 10 likely resolved on its own, to give something that potentially could make that person worse is a real problem.
And again, let me just explain this. This is an immunosuppressant drug. That's how they believe it might work -- suppress the immune system. Why would you suppress the immune system with someone who has an infection? While, it might make sense if the immune system is overreacting that could be happening in a population of patients and it could be that overreaction of the immune system that could be making people critically ill and even causing death.
But in someone who doesn't have an overreacting immune system, it could make things worse. Again, I don't want to dive too much into the weeds here. But that gives you a little bit of a sense of what clinicians are trying to debate, what they're trying to figure out.
Am I dealing with an overreacting immune system? Am I dealing with a virus that is replicating and causing multiple system organ failure? What exactly is happening here? I have no other options. Maybe I should just try this. Perhaps that is happening sometimes in the form of a clinical trial, but this is a confusing thing to just basically say, can't hurt might help, why not? That's not true. It could hurt in certain situations.
BERMAN: Please dive into the science of it, Sanjay. We like hearing about the science of it. The science is what matters here. So thank you for that you. Just, Sanjay, Peter Navarro did ask a question. He said -- he asked me, he said, would you want it if you got COVID-19 and we're in the hospital?
My answer was I would talk to my doctor, what would your answer be?
GUPTA: Well, I am a doctor, and I wouldn't know -- there's not the data to support that right now. I would basically, if I was to have a conversation with a family, I would say that, look, we don't have a lot of great options. This is something that obviously, we have, you know, you've heard a lot of news about lately. It's something we can try, but I have no guarantees.
What I would say though, is that if the person had a heart rhythm problem, the person had a kidney problem. If the person had a liver problem, if I had evidence that look, suppressing their immune system could actually make them worse, I'd probably advise them no.
So to some extent, it is a case by case basis. But there are things to me just as a clinician that I would start to actually dive down with these patients as opposed to just saying across the board, yes. Give it to anybody with COVID-19. I absolutely wouldn't say that.
And frankly, you know, as you might imagine, John, all I do is talk to clinicians and scientists around the country. That is -- that is what I hear. You know, he was quoting somebody today, William Grace. I didn't know who this doctor was. I just looked him up during your interview and apparently he used to work at Lenox Hill. I don't think he works there anymore.
There's a lot of opinions out there, John. I think we've got to give a little bit of -- you know, talk about Anthony Fauci in this regard. This guy has been doing this for, you know, a long time. He's the Head of the Infectious Disease, sort of, you know, community in this country. I don't think that we should be sort of dismissing him the way he seems to have just been dismissed as just another opinion on the matter here. He's been looking into this.
BERMAN: It's a great point, Sanjay. Sanjay, thanks very much. We want to get back to you in a little bit. Jonathan Swan, thank you very much for being with us. And thank you for your reporting and helping us analyze what Peter Navarro had to say.
A government watchdog just released a report on how supply shortages and lack of testing are affecting America's hospitals right now. We'll discuss next.
(COMMERCIAL BREAK) BERMAN: All right, developing this morning. A new report from a government watchdog group about hospital response around the country to the coronavirus.
Joining us now to discuss this is Ron Klain. Ron Klain was in charge of response to Ebola during the Obama administration, and I should note he is an adviser to the Biden campaign.
Ron, thanks very much for being with us this morning. Let me throw up on the screen because I'm only seeing it now for the first time what this H.H.S. Inspector General has found.
Severe shortages of testing supplies and extended waits for results, widespread shortages of PPE, difficulty maintaining staffing hospital capacity, anticipated shortage of ventilators, and inconsistent guidance.
Hold off on that last one. We're going to get to more on that in a second. But in terms of supplies and response, what's your reaction to this Inspector General finding?
RON KLAIN, COORDINATED WHITE HOUSE RESPONSE TO EBOLA UNDER PRESIDENT OBAMA: Well, you know, this is kind of what a lot of us have been saying for five or six weeks that as things got very bad as the disease progressed, we see these critical shortages in the hospital.