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Study Shows, Drug Touted And Taken By Trump Is Linked To Increased Risk Of Death In Coronavirus Patients; Hotspots Emerge As Country Heads Into Holiday Weekend. Aired 10-10:30a ET

Aired May 22, 2020 - 10:00   ET



JIM SCIUTTO, CNN NEWSROOM: The study analyzed nearly 1,500 patients on six continents who were treated with the drug in some form.

POPPY HARLOW, CNN NEWSROOM: That's right. And this is the same drug that the president says he took despite not having tested positive for coronavirus. We're also learning that sales of this drug have been soaring, doubling from March of 2019 to more than 50 million in March of this year. That worked thanks to our investigative unit.

Let's begin with this new study. Elizabeth Cohen, our Senior Medical Correspondent, is with us now. Is this the most telling study yet on the ineffectiveness and the danger of hydroxychloroquine for COVID patients?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Poppy, the experts I'm talking to say yes, because it is by far the largest. This is much, much larger than the studies that have already been published in the Journal of the American Medical Association, the New England Journal of Medicine. Those studies were damning enough of hydroxychloroquine. This new study is much larger.

Let's take a look at what exactly these folks did. So this study was looked at patients in 671 hospitals on six continents. Nearly 15,000 patients in the hospital received hydroxychloroquine or chloroquine or azithromycin, some combination that involved hydroxychloroquine or chloroquine. Now, what they found is that the folks who took these drugs were 33 to 45 percent more likely to die. And that's after for adjusting for all sorts of differences between these patients. They were still 33 to 45 percent more likely to die. They were also between 2.4 and 5 times more likely to develop heart arrhythmias.

I talked to a doctor about the earlier studies and he felt like it was pretty much like the nail in the coffin. Now, doctors are telling me this really looks like the nail in the coffin for hydroxychloroquine for hospitalized patients. That's not the same as taking it preventatively, but there hasn't been any evidence that it works preventatively either.

SCIUTTO: Okay, and that's a question we'll ask the doctors too, an important distinction. We're also learning more results from vaccine studies, and that follows a string of results this week, NIH study, AstraZeneca study. What are we hearing and what should we take from this all together?

COHEN: What's different about this study, Jim, is that this is a study in humans that has been published in the medical literature, again, in The Lancet. So that's different. It means that doctors and experts looked at this and sort of put their stamp of approval that this was a study that was well done and needed to be published.

So these are folks in Beijing. This is a Chinese vaccine trial. And what they found is that when they gave their vaccine that it elicited these neutralizing antibodies that we've been talking about, meaning that the antibodies glommed onto the virus and disabled it so that couldn't infect human cells.

Now, the authors themselves said, hey, let's interpret this cautiously. The experts I'm talking were saying, it's unclear whether it's at a high enough level that it neutralized these antibodies to a high enough level to confer immunity. So that's something that we need to look at. As the three of us have talked about many times, this is a marathon, not a sprint. This is not a, yes, this vaccine worked, this is a, yes, let's keep proceeding.

HARLOW: Thank you, Elizabeth, yes, on all those fronts, for sure. We appreciate it.

COHEN: Thanks.

SCIUTTO: Let's go now to the White House. CNN's John Harwood joins us there with more. Of course, John, the president has touted this drug over and over again. He revealed just a few days ago he's taking it as a preventative measure. The president, of course, has been reluctant in the past to admit error. Do we expect a definitive statement from the White House now saying the president has a different view?

JOHN HARWOOD, CNN WHITE HOUSE CORRESPONDENT: No, definitely do not expect that. I've not gotten a response from the press office about the new study. President Trump, at the time I got in front of the camera, had not tweeted about it. But let's remember the context.

The president started touting hydroxychloroquine at the depths of this crisis when people were the most alarmed and he felt the need to offer them some hope. He has continued to tout the drug even as subsequent research has come in suggesting that it either has no benefit, or in very ill, hospitalized patients, it's associated with increased likelihood of death, and that's what this Lancet study found.

The president himself has cast the criticism of this promotion of the drug as a partisan thing, saying that people are targeting hydroxychloroquine simply because they don't like it. Take a listen.


DONALD TRUMP, U.S. PRESIDENT: I think it gives you an additional level of safety, but you can ask many doctors who are in favor of it. Many frontline workers won't go there unless they have the hydroxy. And so, again, this is an individual decision to make, but it's had a great reputation, and if it was somebody else other than me, people would say, gee, isn't that smart.


HARWOOD: It has not had a great reputation. There is some truth to the idea that, in a polarized environment, a president like Donald Trump associating himself with something will repel a lot of people.


But the contact here is that, from downplaying the pandemic initially to discouraging mask-wearing, to talking about disinfectant from the White House podium, this is a president who has increasingly showed his disdained for science, and science is what the American people are looking for to help protect them in this pandemic, guys.

HARLOW: 100 percent they are, and that's what they need and deserve from the commander in chief. John Harwood, thank you. Have a nice weekend.

Let's talk more about all this. Joining us now is Epidemiologist and CNN Medical Analyst Dr. Larry Brilliant. Doctor, we are so glad to have you.

You've taken hydroxychloroquine before as an anti-malarial drug, which it was created for. What do you make and what do the American people take away from this new huge study on the dangers of it?

DR. LARRY BRILLIANT, CNN MEDICAL ANALYST: Good morning, Poppy. Good morning, Jim. Yes, I lived in India for ten years looking to eradicate small pox, and malaria was our constant companion, our constant fear. So many took chloroquine and then later, hydroxychloroquine. And it's a good drug for malaria, and Malaria is a very bad disease, you want to take it.

Before I comment on the study, I want to say to those people out there that are taking hydroxychloroquine for lupus, under physician's prescription, keep taking it. If your doctor tells you to take it for the disease that you have, the drug is far better than the disease.

The issue of this study is this is a huge study. 96,000 cases, almost 100,000 cases on every continent except for Antarctica finding that taking hydroxychloroquine is associated with a one-third, 45 percent, increase in death is a huge finding. This has got to be taken very seriously.

I will note, this is a retrospective study, which means if you look at case results, you're not giving it to people and not to the other (INAUDIBLE) prospectively, which is the gold standard. So that should be done and is being done right now by the WHO as part of a multicenter study.

But this should take away the idea that this drug is something that we should be jumping to, hoarding it, keeping it for COVID, and I think that the FDA should really take a look at revoking the emergency approval that it's given to this drug, because it's a terrible result for this drug for this purpose.

SCIUTTO: Let me ask you, because, as you said, this deals with patients who were given hydroxychloroquine after being infected as a treatment. It does not deal specifically with people who take it as a preventative, as the president says he has done. Does this mean, in your view, that that's still okay or should they also be concerned about the risks?

BRILLIANT: No. The fact that you take it for a prophylactic or for a treatment doesn't make any difference. What we're looking at right now are the cardiac side effects of this drug, creating arrhythmia.

I heard earlier one of the justifications why the president could take this drug was because he had a 24-hour standby physician in case he developed arrhythmias. That's not a very good recommendation for a drug like this that you should be so worried about it that you had to have your own doctor on call all the time.


SCIUTTO: Yes, and most of us don't, of course.

HARLOW: Right. Doctor, if you could just put in context for people all the developments we've heard about these vaccines this week, because -- and I think Jim has been ahead of the game on this, warning about the fact that it's just sort of like, as The Washington Post op- ed said this week, publication by press release. It's not peer reviewed, it's not like the SEC overseeing company's financial results as they're put out. There's sort of no checks on what these companies are saying they can do.

BRILLIANT: Well, welcome to the world of making vaccines. It's really difficult. It often takes ten years to make a vaccine. If you think about what it took to make the polio vaccine, what we did to make the Zika vaccine, the difficulty we had, the impossibility of making HIV/AIDS vaccine. So these are baby steps. We are, of course, blowing them out of proportion because we're desperate. It's natural that if you get a vaccine that creates any neutralizing in an antibody, we're going to get really excited about it.

But that excitement is usually confined to a small room inside of a lab. It isn't on the front page of the newspaper. We are so -- I look at this as an indicator of how bad COVID is and how frightened we are and how desperate we are to get a vaccine.


I don't necessarily think these are stumbling blocks on the production of a vaccine. I do agree with Dr. Haseltine, that science is not done by press release, science is done by peer review, their way of doing it. And I think that some of the manufacturers are getting ahead of the game, but that does not speak to the good news or the bad news of the --


HARLOW: Dr. Brilliant, thank you on all of those fronts and have a nice weekend.

BRILLIANT: Thank you.

SCIUTTO: Well, we on this broadcast have asked Dr. Anthony Fauci a number of questions on the latest COVID news. While we wait and answer from the White House on whether he can join our show, here are his answers to our questions in writing.

So on the positive results from early vaccine trials out this week, Dr. Fauci tells CNN, and I'm quoting, these results are very encouraging since they indicate that the vaccine can induce neutralizing antibodies to a level that you would predict would be protective against infection with the coronavirus. This is merely the first step in a multi-step process. Now, if all goes well, Dr. Fauci says, we could have a vaccine widely available in this country by the end of this year, if all goes well.

On reopening, he tells us, quote, almost certainly you will see small blips in cases. That is inevitable, he says. The critical issue is how we handle these to prevent the blips from becoming resurgences.

On another question we get frequently on this show, the danger to children from this multi-symptom inflammatory syndrome that we have seen, Dr. Fauci says the following. It seems to be rare, but we are just at the beginning of understanding it. He does say this. I do not think that it should significantly affect our approach to reopening schools or sports. That's notable.

Finally, on the question of this anti-malarial treatment. Should members of the public take hydroxychloroquine as a preventative treatment? His answer, quote, there are no data to indicate that the general public should be taking hydroxychloroquine as a preventative intervention. Clear statement there from Dr. Fauci. Of course, he is welcome to join the program at any time.

HARLOW: So newsworthy. Jim, thank you for getting those answers.

Still to come, the president says new guidelines are coming soon to help churches reopen despite state restrictions. We'll speak with a pastor in California who plans to reopen his church next Sunday no matter what.

SCIUTTO: And more on the rising numbers in Alabama that have the state capital of Montgomery warning that its ICU beds are almost full.



HARLOW: Well, states reopening in one way or another but hot spots still emerging in Alabama, concerning uptick in cases. Officials in the state capital now warning that they are basically out of ICU beds. SCIUTTO: Dr. Karen Landers joins us. She is the Assistant State Health Officer for the Alabama Department of Public Health. And, Dr. Landers, great to have you.

I asked Dr. Fauci about these small outbreaks, if you can call them that, as reopening happens. He said, listen, they're inevitable. It's all how you respond to them and do you keep them under control. Is Alabama able to keep these new hotspots under control so they don't spread further?

DR. KAREN LANDERS, ASSISTANT STATE HEALTH OFFICER, ALABAMA DEPARTMENT OF PUBLIC HEALTH: Yes, In Alabama it's very important to remember that throughout our state, we require our hospitals to report in to our Alabama Incident Management System twice daily so we can coordinate with our hospitals and ensure what our bed capacity is.

Now, specifically, when we look at hospitals, again, hospitals have their surge plans, so they exercise these surge plans. And in situation such as what Montgomery is experiencing right now, hospitals are able to look within their hospital to where they can expand but also look to other hospitals where there is the ability for an MOU or mutual aid to be exercised in order for these patients to be taken care of.

HARLOW: So, one of the big concerns with this that Jim and I have been talking about now for months on this show, Doctor, is that when you do have areas that are not a big city like New York City, for example, like the more rural areas of your state, how concerned are you that what's happening in Montgomery with not enough ICU beds is going to be even worse if there are hotspots that emerge in the rural parts of the state?

LANDERS: Well, absolutely. It's extremely important as we are looking at our cases of COVID-19 to have robust testing opportunities in our rural counties as well as our urban counties so we can rapidly pick up cases of COVID-19, do our contact tracing, do our investigation to be able to reduce those numbers of cases and, additionally, have our hospitals in our areas that are actually have hospitals located reporting into our aimed systems so that when people need a hospital bed or when they need to be referred to a hospital bed, we can know where the capacity is in the State of Alabama.

There are a number of counties in Alabama that do not have hospitals, so we rely on our counties who have hospitals open, as well as our urban centers to provide more advanced level of care for patients who need ICU care, for example.


SCIUTTO: Understood. Dr. Landers, thank you so much for joining the program. We wish you and the people of Alabama the best of luck.

HARLOW: Yes, we certainly do.

LANDERS: Absolutely. Thank you.

HARLOW: Thank you, Doctor.

As we prepare to mark the unofficial start to summer this holiday weekend, safe travel, if you're going to travel. Obviously, it's top of mind for you.

SCIUTTO: CNN's Chief Medical Correspondent, Dr. Sanjay Gupta, joins us now. Dr. Gupta, it's a question I think all of us have. Can we fly safely? If we choose to do so, how best to make it safer? What's the answer?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: I think it's the second way you put it right, Jim, I mean, safely versus safer. I mean, those things that you can do that may be surprising and well within your control to try and mitigate or lower your risk.

I think for the most part, it's got to be essential travel, like most things in life, a risk/reward relationship. I decided to sort of navigate my way through and learn as best I could. Here is what I learned.


GUPTA: Things are going feel a lot different the next time you go to the airport. First of all, it will be less crowded, that's for sure. Certain precautions are in place, like plexiglass at the counters, telling people to keep their distance when they're in line. Let's go see what security is like.

Traveling in the age of coronavirus is all about averting risk. For airports, like here at Hartsfield Jackson and Atlanta, which is the world's busiest, it's about focusing and keeping things clean and distanced.

UNIDENTIFIED MALE: And, once again, thank you for the spacing.

GUPTA: For travelers, it's about masks and touching as few things as possible, whether at check-in -- don't forget to put your boarding pass on your phone ahead of time, less surfaces to touch.

We're going through security.

UNIDENTIFIED MALE: Okay. Put that into the machine, sir.

GUPTA: One thing to keep in mind, try and count how many surfaces you touch throughout the whole process.

UNIDENTIFIED MALE: I need everything out of your pockets, please.

GUPTA: One study found that the biggest germ hotspots for respiratory viruses in the entire airport, these security bins.

One thing I do want to show you is how I pack nowadays. I've got my hand sanitizer. So this is when I do a little hand sanitizer, put that back in, make sure everything is back in the bag and I could be on my way. Constantly washed the hands.

Also, look, they're cleaning the bins back there. That's a good idea.

One of the big concerns is always going to be those sorts of train rides. Right now, things aren't that crowded. But as airports start to pick up, you may want to allow extra time so that you can walk to the concourse instead of ride.

Bill Leintsch is one of the few people who has kept flying.

How do you quantify that for somebody who says, look, I don't know if I should fly or not right now, I'm not sure if the risk and the reward balance makes sense?

BILL LEINTSCH, CHIEF CUSTOMER EXPERIENCE OFFICER, DELTA: It might feel a little awkward the first time you get on board an airplane to see only 60 percent load factors, all the middle seats blocked, everyone wearing a mask. But after a while, that becomes very comfortable.

GUPTA: Delta is not the only one. Other major carriers are doing similar. Road Warrior Brian Kelly, you may know him better as The Points Guy, doesn't think social distancing in the sky is going to be permanent.

BRIAN KELLY, FOUNDER, THE POINTS GUY: Financially, it's just not possible. And I don't believe it's good for consumers to do that because we're going to pay for the cost of all of those empty seats.

GUPTA: In a statement, the International Air Transport Association said that while they support the use of masks by passengers and crew, they don't support mandating social distancing measures that would leave middle seats empty. To reduce risk, many airlines like Delta are wiping down more frequently and misting the entire planes with disinfectant.

Everyone is going to decide whether or not it makes sense to fly. It's the sort of risk/reward proposition. One thing I'll tell you is that separating yourselves out, obviously important. That's the distance. But think about the duration. Shorter flights are obviously going to be better as well.

One thing you'll see here at Delta is that they are boarding from the back of a plane first, ten people at a time, we hear.

Now, when you get to your row, a couple things to keep in mind. Try and touch as few surfaces as possible. When I sit down, I'm actually going to try and choose a window seat. And the reason being, that I'll just have less contact with people who are walking by the aisle.

Here is another tip. You open this, which is called the air gasper, and you turn it up as high as you can and feel the air there right in front of you. That's going to cause some turbulent air flow in front of you and possibly break up any clouds of virus. It's a small tip. It might make a difference, easy to do, could be worth it.


GUPTA: Now, one thing I will point out, most airlines, including Delta, will mandate masks when you're actually flying on the plane.


A lot of times they'll even hand out those masks at some point in the boarding area or on the plane itself.

Also keep in mind, you have to think about where you're traveling. If you go to Norway, for example, right now, once you land, you've to go into a mandatory 14-day quarantine. There are actually two states now in the United States, Hawaii and Massachusetts, that's the same issue there as well. So if you're flying to these places, think about where you're going, how the virus is circulating in those areas as well, and what you might be mandated to do when you land.

SCIUTTO: Yes, a lot of promises from those airlines to keep those middle seats empty have not borne out as we've seen air travel go. That's key. Dr. Gupta, thanks so much for showing us how it works.

Well, more than 1,200 pastors are set to defy California's order on holding church services in person. I'm going to speak with one of those pastors, next.