Zinc, Hydroxychloroquine, and How the Trump Dumpster Fire Engulfed Academic Research
Zinc is rather boring. We know it as an essential mineral, a nutrient in our bodies, the silvery grey chemical element in the middle of the periodic table. Have I lost you yet? Even the word is dull. Whatever excitement we get from the “Z” is immediately neutralized by what follows. Zinc is your mildly handsome neighbor who opens his mouth and has nothing to say. Hydroxychloroquine, on the other hand, is six syllables of fun for the tongue. It’s a Latin hip-shaker on Dancing with the Stars. The word is exciting. At first you can’t say it, and there’s building tension about whether you will be able to one day pronounce it correctly. When you finally do, you feel smart. Instantly. And just like that, you feel you have mastered all of science.
Perhaps this is why our public conversation about COVID treatment is in the state that it’s in: we think that how we feel about a treatment is what matters — whether it excites us, captures our attention, aligns with our political stripes, can withstand a Twitter storm. Whether or not we’re titillated is now key to how we regard science. And thanks to its puppet master, hydroxychloroquine continues to titillate. Maybe it’s a byproduct of ever-declining education in the U.S., a vanishing of critical thinking, or years of commercials teaching us to “ask our doctor” if a medicine is right for us, we believe we know better than the experts. The experts say that hydroxychloroquine is not helpful, even potentially harmful. But the President and his followers feel differently. As recently as Monday, the President continued to tout the miraculous effects of hydroxychloroquine from his daily bully pulpit, often saying he’s a “fan” of it, as if his affections have anything to do with its efficacy.
Worse, the President has been masterfully trained us, and our media, to keep our eyes on the shiny object. That object is usually him. A man who sits on a gold toilet and puts his name on every one of his buildings understands how to mesmerize. He is the main event, always, even during a pandemic— not the experts around him, not the scientists, not the doctors. There has only been one other star of The Pandemic Show, and it’s not Dr. Anthony Fauci. Trump will only share the spotlight with one other shiny object: hydroxychloroquine. The problem with shiny objects, though, is that they sometimes refract just enough light to spark a flame and start a fire that engulfs everything around them. Such is the case with the Trump dumpster fire. The latest pile of ashes? Academic research.
Consider the case of a recent study on zinc. On May 8, one of New York’s leading infectious disease specialists, Dr. Joseph Rahimian, MD, and his team at NYU Langone Medical Center, authored a study that found that a trio of drugs might prove effective therapy for coronavirus. They took a look back at 932 COVID-19 patients who had been treated at NYU hospitals in the months of March and April. In the acute phase of the pandemic in New York City and with no other hope in sight, the hospital doctors treated select patients with a combination of hydroxychloroquine and azithromycin. There had been very preliminary data suggesting the possibility that the combination may be helpful. Another group was treated with hydroxychloroquine, azithromycin, and zinc. Their observational study found that the addition of zinc helped. It increased the frequency of patients being discharged home, and it decreased the likelihood of death or transfer to hospice. Layman’s takeaway: with zinc, you might be less likely to die.
It looked as if zinc might be the hero of the story, not hydroxychloroquine. Why? Hydroxychloroquine is what’s called an “ionophore.” In this case, it helps a cell absorb more zinc, which could help stop the virus from replicating. Plainly put, hydroxychloroquine is not stopping the virus, but it may help zinc to stop it. Think of it as the assist. It’s not dunking the basket, it’s passing the ball to zinc to dunk. The words “might” and “may” are important here. The data showed the possibility that zinc is helpful, and the research was promising, but like all medical studies, the regiment was just beginning its journey from idea to accepted practice. That journey is one fraught with red tape, layers of peer review, and additional and expanded research and testing — as it should be. It also requires the one thing we have very little of: time.
And for Rahimian and his colleagues, time was of the essence. In order to make their findings immediately public and contribute to the worldwide project of finding effective treatments and/or a cure for the virus, the team submitted their study to what’s called a “preprint server.” There are various medical preprint servers in use, but by many reports they are all being overwhelmed these last few months with everything from quack theories to legitimately promising studies. The purpose of a preprint server is to distribute early findings that may be beneficial to other groups of researchers. Science is what politics is not: collaborative. As chemicals must work together to form an effective compound, so must doctors and researchers work together for the greater good. The preprint is just the first step to funding a larger study and continuing to research an idea.
But this is when the shiny object blinded us. We seem to no longer have any capacity in our public discourse to understand collaboration — not between doctors or politicians, nor even between chemicals. Trump has taught us that the flashiest singer is all who matters; the band is not worth the spotlight. We can only see that which mesmerizes. When Rahimian’s study hit the preprint server, it was pushed out over the preprint’s Twitter feed, and the Twitter vultures went to feast. The right used the study to prove that “Fauci lies!” — pointing to hydroxychloroquine as the game-changer that the President promised. No mention of Zinc. The left decried the doctors as doing the devil’s work, supporting a drug that did not clinically do much, the latest item branded with a Trump logo. Even on Rahimian’s personal social media accounts, the study was grossly misconstrued and interpreted as a commentary on Trump. “Trump would be proud!” read one comment. Again, no mention of Zinc. The Internet had missed the point.
Rahimian probably assumed the press would be more thoughtful in their approach. He was wrong. Television reports of the study, for which he was interviewed on-camera, distorted the findings, misinterpreted the takeaway, or simply couched the story in the larger narrative of, yep, you guessed it, the star of the show: hydroxychloroquine. The media wasn’t interested in legitimate findings, only in proving what they wanted to prove about hydroxychloroquine. No one seemed to understand that the study’s intent was to assess the efficacy of zinc. It had very little do with hydroxychloroquine. But that is all anyone talked about. Zinc went unnoticed.
And then came Dr. Stella Immanuel, who quickly burst on to the national scene last week when the President re-Tweeted a video of the Houston doctor standing in front of a small army of white coats, ranting about a cure. The miracle? Hydroxychloroquine, azithromycin, and zinc. And immediately the dumpster fire raged. The right defended the re-Tweet. To them, Immanuel was one voice of many singing the praises of hydroxychloroquine, and the video spread through the MAGA crowd like COVID at a Florida beach party. To the left, Immanuel became Dr. Demon Sperm, after videos surfaced of the doctor lecturing about topics that can only be described as bizarre: alien DNA, sex with witches, demon-dreaming. CNN’s Don Lemon asked his audience to mark their calendars to commemorate the day he had to say “demon sperm” on live television.
Lost in the circus of it all is the perfectly legitimate possibility that zinc may have beneficial effects for treating COVID-19. It may send patients home sooner or even save lives. But now we are likely to never know. Hydroxychloroquine, the six-syllable fascinator stole the show again, and Zinc, the boring back-up singer, never got the mic. Rahimian and his colleagues will continue their research, but zinc will now forever be linked in the public conversation with America’s shiny object du jour. As they navigate the red tape of academic research, their studies stand to get less attention and their research less funding, as the main actor in their work has suffered from guilt-by-association, and basic science has been obscured by unscientific opinion. In the end, we all stand to lose as scientific knowledge takes a back seat to political theater.