It would be a terrible blow to the liberal media if between now and the election, hydroxychloroquine were shown to be a safe and effective treatment for COVID-19. Not only would that validate President Trump's advocacy of the drug, it would also reduce the COVID deaths that the MSM likes to trumpet.
And so, when a prominent professor of epidemiology makes the case that hydroxychloroquine does indeed significantly improve outcomes in a large group of patients [high-risk outpatients] he and his assertions must be discredited by all means necessary.
Thus it was that CNN's John Berman went to war on this morning's New Day against Dr. Harvey Risch, who has written a Newsweek column making the case for hydroxychloquine, and which includes these lines:
"I . . . have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment [hydroxychloroquine] that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily."
The nub of the argument between Berman and Risch was Berman's contention that only "random, placebo-controlled trials" of a drug are valid. Berman used the phrase no fewer than 11 times during the interview. Risch made the case that such trials are by no means always employed before a drug is approved for use. He pointed out that: half the chemotherapy drugs; the common antibiotic amoxicillin; and drugs for sepsis have all been approved without such trials.
Despite being a layman, Berman was frequently snide and condescending to Dr. Risch, causing Risch to have to correct him. One example: when Risch referred to 12 studies demonstrating the effectiveness of hydroxychloroquine, Berman snidely said: "When you wrote in the Newsweek article it was seven, now it's twelve." In fact, reviewing the Newsweek article linked above, Risch did indeed cite 12 studies. If Berman's going to attack someone, he should at least have his facts straight.
And CNN sought to undermine Frisch by displaying a chyron during the interview reading [emphasis added]: "Yale Epidemiologist Insists, Against Evidence, Hydroxychloroquine Works."
Despite frequently misstating Risch's position, Berman did have a battery of facts and figures at his disposal. It was obvious that he and his staff had made a major effort in preparing for battle with Dr. Risch -- an indication of the importance CNN placed on attempting to discredit him.
When the interview was over and Dr. Risch no longer available to defend himself, Berman brought on two other people to agree with his take. The first one to speak, Prof. Jeanne Marrazzo, immediately congratulated Berman on his "masterful" handling of Dr. Risch.
Here's the transcript.
7:49 am EDT
JOHN BERMAN: New this morning: the administration official in charge of testing, Admiral , with a decisive split from the president on the use of the drug hydroxychloroquine to treat coronavirus. The admiral--also a pediatrician--says the studies do not show it works, and it's time to move on.
. . .
DR. HARVEY RISCH: So, as of now, there are 12 studies that show that hydroxychloroquine plus zinc other companion medications, when used early in high-risk outpatients convey significant and substantial benefit at reducing the risk of hospitalization and mortality.
. . .
BERMAN: When you wrote in the Newsweek article it was seven, now it's twelve. None of those studies which you just cited are random, placebo-controlled trials, what Dr. Anthony Fauci refers to as the gold standard . . . The random, placebo-controlled trials, none of them have shown efficacy, correct?
RISCH: That's not actually correct. The problem with those randomized controlled trials is they were trials done on the wrong people. They were trials done on low-risk people who have very, very low risks of hospitalization and mortality. So you don't do a study of prostate cancer in women to prevent prostate cancer in women because nobody is going to get the outcome. And that's what the studies did.
BERMAN: To that argument, again, your paper in Newsweek goes on to suggest the problem is they're not being tested, hydroxy is not being tested, on outpatient people, not hospitalized people. So a little shift in your argument there from what you wrote in Newsweek already. The fact of the matter is --
RISCH: No, I didn't. I'm sorry. That's a misstatement. I think that's a misstatement of what I said.
BERMAN: The fact of the matter is, there are no random, placebo-controlled trials, that show a benefit, correct?
RISCH: No. You're misstating what I said.
. . .
BERMAN: Again, the question is why haven't any random, placebo-controlled trials shown benefit, and isn't that a problem for an epidemiologist?
RISCH: No. In fact, the FDA has a huge history of drugs going into widespread use in the medical community for decades that have not been established on the basis of randomized, controlled trials. Half of the chemotherapy drugs used in cancer were used without randomized, controlled trials. The antibiotics, amoxicillin, for example, that parents use with their children all the time, day in, day out, was never established with a randomized, controlled trial before it was used.
. . .
BERMAN: I've been speaking to a number of epidemiologists over the last few days who also are frankly shocked that you've moved the bar so much on random, these randomized, placebo-controlled trials. Let me just read something, what someone wrote me. He said while I can't dismiss this out of hand, in in other words, he can't dismiss out of hand that maybe there is some benefit to some subgroup, for you to discuss it is irresponsible at this point without the public evidence provided by a random, placebo-controlled trial.
. . .
The benefit to these random, placebo-controlled trials, is that there is a built-in bias, or can be, in any trial that's not random. Randomized, placebo-controlled trials, which Dr. Fauci does refer to as the gold standard, are so useful. And I know you know that. And that is also what the --
RISCH: No, please don't speak for me. Don't speak for me.
BERMAN: That's what epidemiologists -- I'm not disputing that you have cited these other studies --
RISCH: Yes, you are. I think you should let --
BERMAN: I'm not disputing that you have cited these studies which show a benefit in subgroups. But the problem is --
RISCH: No. This is not a subgroup.
BERMAN: When put up against the random, placebo-controlled trials, none of which have shown a benefit, there is a conflict there which has caused the FDA pause.
RISCH: I'm sorry, but you actually have four, three or four wrong statements in what you said.
. . .
BERMAN: The issue is the conflict between the studies you're citing, some of which, people need to know, are a little sketchy. For instance --
RISCH: None of them are sketchy.
. . .
The FDA has no data on outpatient use, and yet it put a black letter warning against it. That to me is just unconscionable, that they could do that and allow 45,000 deaths in the month of July alone because of blocking a medication they had no data on.
. . .
DR. JEANNE MARRAZZO: John, you were masterful in that discussion. You clearly have read what we consider to be the gold standard for evidence regarding hydroxychloroquine. And indeed, that is the randomized, placebo-controlled trials.