Study: Drug Trump Touted Made Coronavirus Patients More Likely To Die; Defense Chief Mark Esper: "Completely Confident" Vaccine Delivered By January; Schools Make Reopening Plans Ahead Of New Year.
JOHN KING, CNN HOST: Hello, everybody, top of the hour. I'm John King in Washington. This is CNN continuing coverage of the Coronavirus pandemic. All 50 states now open in some way this holiday weekend. The President's take is they should stay open even if Coronavirus cases begin to explode in the fall. In the here and now there are more states trending in the wrong direction. At least one of them Alabama worries of a possible shortage of critical care hospital beds. But we begin with another violent collision between what the President Thinks and say and the more disciplined world of science and data. For two months now President Trump has told that hydroxychloroquine is a game changer. He says it is a drug that saves lives. The President himself says he is finishing up a round of hydroxychloroquine treatment. Sales of the drug had doubled driven by the President's praise. But a new study published in the medical journal "The Lancet" today says the drug did not help hospitalized Coronavirus patients. Instead, that study says it made them more likely to die and it also increased the likelihood patients would develop an irregular heart rhythm that puts them at sudden risk the cardiac arrest. Let's get straight to CNN's Senior Medical Correspondent Elizabeth Cohen. Elizabeth, 96,000 patients across 6 continents hospital data studied, take us inside the study.</s>ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: John, let's take a look at these numbers. The study that was done and published in "The Lancet" today looked at patients in 671 hospitals with Coronavirus on six continents, nearly 15,000 hospitalized patients who received hydroxychloroquine or chloroquine, sometimes in combination with other drugs as well as patients who were in a controlled group. And what they found is that those who took those drugs or some combination of them, 33 percent to 45 percent more likely to die, and that is even after adjusting for the fact that there were some differences between the groups in terms of how healthy the patients were also patients who took the drug, 2.4 to 5 times more likely to develop heart arrhythmias. Point, I want to make here these are hospitalized patients. Trump said he is taking this preventatively. Those are two different things and we don't know what it does preventatively. Could it work? It's possible, but doctors I've been talking to say when you see these kinds of results that it actually hurt patients who were in the hospital and this is not the first study that's found this. There are other published studies that say the same thing. They wonder is it even worth studying as a preventative agent against COVID-19.</s>KING: Elizabeth Cohen, thank you so much a very important study. Let's continue to discuss it now with one of its lead author Dr. Mandeep Mehra is also Executive Director of Brigham Center for Advanced Heart Disease in Boston. Doctor thank you for being with us today. You looked through the study and I want to read you a principal finding from it. We were unable to find a benefit hydroxychloroquine or chloroquine when used alone or with -- on in hospital outcomes for COVID-19. Each of these drug regimens was associated with a decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment for COVID-19. Based on this should hospitals around the country and around the world just stop using this as a treatment?</s>DR. MANDEEP R. MEHRA, EXECUTIVE DIRECTOR, CENTER FOR ADVANCED HEART DISEASE AT BRIGHAM AND WOMEN'S HOSPITAL: Yes, that would be our strong recommendation, John. Our data has very convincingly shown that across the world in the real-world population that this drug combination, whichever way you slice or dice it, does not show any evidence of benefit, and in fact, is -- showing a signal of grave harm.</s>KING: So, there is a distinction in the sense that you are looking at hospitalizations of patients. This is not a live, clinical trial, right? That would be the gold standard of research. So, for anyone out there now, for the hydroxychloroquine promoters, who are going to say oh, wait a minute. Its elitist doctors trying to say the President of the United States is wrong. Make the distinction for me between your research and some of the clinical trials that are under way right now about the same drug?</s>DR. MEHRA: Yes. So, we looked at a very specific cohered of patients who were hospitalized with COVID-19. Now we all know that when you get hospitalized with COVID-19 it's a very chaotic situation with the lots of uncertainty. We know that patients who have underlying cardiovascular disease and underlying lung disease are particularly vulnerable to bad side effect of any medicine that's used in these patients at that time, and what our data is showing is in that chaotic circumstance of the hospitalized patients of COVID-19. And there's no question that there is a very clear signal of harm with these drug regimens. Now caution is advised in interpreting these findings for people who have not yet had COVID and are actually looking at trying to prevent COVID.</s>DR. MEHRA: It's in that group of patients that clinical trials are to be conducted and we would endorse conducting clinical trials in those patients. But even in those patients, the use of this drug regimen in an off-label capacity should be shunned and avoided notably because of these observed risks particularly in patients who have underlying cardiovascular illness and this is a very, very critical distinction to keep in mind.</s>KING: Well, so let's close on that point because the President of the United States is one of those people you just mentioned. He's outside he is not hospitalized. He says he wants to use this as a prophylactic. He says he keeps hearing despite studies like this from other people, as he likes to put it lots of people as he likes to say that this actually works. Here's one of the things you say in your research and your write-up of this. Nevertheless, a cause and effect relationship between drug therapy and survival should not be inferred. These data do not apply to use of any treatment regimen used in the ambulatory out of hospital setting. Randomized clinical trials will be required before any conclusion can be reached regarding benefit or harm of these agents in COVID-19 patients. That's where the President is, he is in an out of hospital setting, but from what you learned inside the hospital do you believe this drug should be restricted to only disciplined, protected clinical trials and not the kind of use the President of the United States says he just went through?</s>DR. MEHRA: I do agree with that statement, John. And in fact, when I finished medical school one of the most important principles that I kept in mind was what I was taught at the time I was graduating which was -- first do no harm. And when you see evidence of harm, you've got to be really, really careful using anything in any circumstance without a controlled clinical trial setting.</s>KING: But what would you say, sir, to someone who says I believe the President?</s>DR. MEHRA: Well, it's their belief, and I would personally disagree with that individual, but we all have a choice to make in our lives, and we can't push choice.</s>KING: Doctor Mehra, I really appreciate you joining us today. And of course, this as the article in "The Lancet" here is very detailed it is very thorough. It is worth a read, no matter what you view on this issue. Sir, I really appreciate your time.</s>DR. MEHRA: Thank you.</s>KING: Thank you. Let's bring in our CNN White House Correspondent, Kaitlan Collins. Kaitlan, you've been there at the White House most days through this. And the President let's listen from the very beginning has been a fan.</s>DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I had a two-week regimen of hydroxychloroquine. A lot of doctors are taking it. A lot of people swear by it. I get a lot of tremendously positive news on the Hydroxy. I really think it's a great thing to try. What do you have to lose? Take it. I really think they should take it. The hydroxychloroquine try it.</s>KING: Kaitlan, repeatedly promoting a drug that this new study says is harmful, it doesn't help with COVID and it is potentially harmful for people in the hospital. You heard the lead author there saying he doesn't think it is very helpful or at least until we get clinical study it should not be taken by people out of the hospital like the President any reaction at all from the White House?</s>KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: No reaction yet, but we know that this is a journal they quoted before. They quoted just last week when the President was threatening to withhold funding from the World Health Organization. So, they're well aware of what they've been publishing. But I think it is that sentiment that you heard there from the President at the end that has been the most concerning for medical experts. And that's the President not just taking it himself they say that's between the President and his doctor of course. But that he is pushing other people to take it and he's saying you know the sentiment of what do you have to lose? Well, based on this study people could have a lot to lose, so I think that's been the concern. And of course this study doesn't at all touch as Elizabeth noted on how the President is using it which he believes as a preventative even though the FDA says there is no evidence that it actually works to prevent you from getting Coronavirus. But we know that what the President has said matters? People like Senator Rubio have said they don't believe people are taking prescriptions based on what the President is pushing, but we actually know after the President started pushing hydroxychloroquine in March there was an uptick in prescriptions written for it because people were asking their private pharmacies and retail pharmacies were actually seeing a higher interest of request to use hydroxychloroquine. So, that's the question there. Is he encouraging other people to where they feel more comfortable using it? And so far they haven't responded. We should note, John that today is the last day for the President to be taking his own prescription of hydroxychloroquine according what he told us about two days ago.</s>KING: Kaitlan Collins live for us at the White House. Come back if you hear anymore from the White House or any of those people about this new study. Kaitlan, I appreciate it, thank you. And a big promise today from the Defense Secretary Mark Esper in the race for a vaccine, on NBC Secretary Esper says, come the New Year, every American will be able to get a vaccination.</s>MARK ESPER, U.S. DEFENSE SECRETARY: Absolutely it's possible and I've spoken to our medical experts about this. We are completely confident that we can get this done. We've been ahead of the curve and in the fight from day one and this is the next phase of this battle. And we will deliver on time the vaccines. I'm confident we'll get it.</s>ESPER: DOD has the expertise and the capability, of course, to get the manufacturing done and the logistics and I am confident that we will deliver.</s>KING: You heard a couple of confidence and a completely confident there but that would be a remarkable achievement in well ahead of what most scientists believe is probable. Even the former big Pharma Executive now leading President Trump's vaccine effort told "The New York Times" just last week 12 to 18 months for a viable vaccine "Is already a very aggressive timeline". A quick break when we come back as states reopen, as states drop more restrictions you're getting out of the house and moving about. We'll show you just how.