A4 eZ re the washington post.monday, april 6 , 2020
the coronavirus pandemic
BY ROSALIND S. HELDERMAN,
JOSH DAWSEY,
AND JON SWAINERudolph W. G iuliani, who was i n
the center of the impeachment
storm earlier this year a s an unpaid
private attorney for President
Trump, has cast himself in a new
role: as personal science adviser to
a president eager to find ways to
short-circuit the coronavirus pan-
demic.
In one-on-one phone calls with
Trump, Giuliani said, he has been
touting the use of an anti-malarial
drug combination that has shown
some early promise in treating
covid-19, the disease the novel
coronavirus causes, but whose ef-
fectiveness has not yet been
proved. He s aid he now spends his
days on the phone with doctors,
coronavirus patients and hospital
executives promoting the treat-
ment, which Trump has also pub-
licly lauded.
“I discussed it with the presi-
dent after he talked about it,”
Giuliani said in an interview. “I
told him what I had on the drugs.”
Giuliani’s advice to Trump
echoes comments the former New
York mayor has made on his pop-
ular Twitter feed and a podcast
that he records in a radio studio
installed at his New York City
apartment, where he has repeat-
edly pushed the drug combina-
tion, as well as a stem cell therapy
that involves the extraction of
what Giuliani termed “placenta
‘killer cells.’ ”
He is part of a chorus of promi-
nent pro-Trump voices who at
first downplayed the severity of
the virus and then embraced pos-
sible cures — worrying health
experts who fear such comments
undermine efforts to slow the
virus’s spread and downplay the
risks of the unproven treatments.
Giuliani’s comments have
helped him regain a bit of the
prominence he had during
Trump’s impeachment — last
week, he was back in the spotlight
when Twitter briefly locked his
account for promoting misinfor-
mation about covid-19.
“ He’s been out of the news and
out of the limelight since the end
of the impeachment drama,” s aid
Andrew Kirtzman, a Giuliani bi-
ographer who is writing his sec-
ond book about the former New
York mayor. “What you’re seeing
is an effort to regain relevance.”
The White House did not re-
spond to a request for comment
about the president’s conversa-
tions with Giuliani.
Giuliani’s name has not come
up during meetings of the admin-
istration’s coronavirus task force,
according to two members of the
group, who spoke on the condi-
tion of anonymity to describe in-
ternal dynamics.
However, Giuliani said he has
spoken directly to Trump “three
or four times” about a potential
coronavirus treatment, describ-
ing to him the results of an initial
small-scale study in France that
suggested the anti-malarial drug
hydroxychloroquine may help
treat covid-19. Giuliani said he
has not spoken to other White
House officials about his views.
“There are obviously other peo-
ple around him who agree with
me,” Giuliani said.
The drug combination has
been touted on Fox News and One
America News Network, a cable
favorite of the president, a nd New
York Gov. Andrew M. Cuomo (D)
has said there is a “good basis” to
believe the treatment could work
and said the drugs were in the
pipeline for New York patients.
At his daily briefings, Trump
has praised the drug combo, say-
ing it could be one of “the biggest
game changers in the history of
medicine.”
Last week, the FDA issued
emergency authorization for the
use of the anti-malarial drug for
some covid-19 patients.
FDA spokesman Michael Fel-
berbaum said the decision was
made by expert career staff mem-
bers, after extensive discussions
with officials at o ther government
agencies and based on the scien-
tific evidence available.
“The known and potential ben-
efits to treat this serious or life-
threatening virus outweigh the
known and potential risks when
used under the conditions de-
scribed in [the order],” he said.
On Saturday, Trump said that
the drug had passed the “safety
test” and that he had seen results
that were positive.
“I hope they use it, because I’ll
tell you what, what do you have to
lose?” the president said, adding:
“I may take it. I’ll have to ask my
doctors about that.”
‘Looking at a slaughter’
In his newly fashioned role,
Giuliani — who was widely
praised for steering New York City
with a steady hand through the
2001 terrorist attacks — has solic-
ited medical tips from a contro-
versial Long Island family doctor
with a following in the conserva-
tive media, as well as a former
pharmacist who once pleaded
guilty to conspiring to extort the
actor Steven Seagal.
“Got lots of positive reports on
hydroxy and Zithromax,” Giuliani
tweeted on March 26.
It w as one of at l east 14 m essag-
es Giuliani posted during the past
three weeks referring to the com-
bination of the anti-malarial drug
and the antibiotic azithromycin.
“The Hydroxy treatment, first
introduced by POTUS, appears to
be working so far!” he tweeted two
days later. Another message blast-
ed the “demented left” h e claimed
wished to ban the therapy.
Giuliani said that while he is
hoping to turn his podcast into a
moneymaking venture, he is not
working for any of the companies
involved with the treatments he
has promoted. He said he last
worked for medical companies a
decade ago, when he represented
Pfizer and Purdue.
“I’m not trying to get a dime out
of this,” he said.
Some doctors say the anti-ma-
larial treatment has appeared an-
ecdotally to help some covid-
patients, but it has not yet been
proved effective in valid clinical
trials.
Anthony S. Fauci, the White
House task force’s infectious dis-
ease expert, has repeatedly coun-
seled caution until more research
is completed. Fauci warned on
“Fox and Friends” on Friday that
there is not yet any “strong” evi-
dence t hat it is effective in treating
covid-19, and he has been aggres-
sive in making that argument in-
ternally, officials said.
Giuliani said that he has not
discussed the treatment with Fau-
ci, but that Trump agrees with
him. “I’m sure he thinks I am an
ignoramus,” he said of Fauci.
“They’ve thrown cold water on
it because they are academics,” he
said of scientists like Fauci. “ ‘You
can’t b lind test it.’ I know you can’t
blind test it. But we’ve got thou-
sands of people dying, sweet-
heart. And by the time you blind
test it, we’ll have 100,000 people
who are dead. Why don’t w e get in
the real world of being a doctor
instead of being an academic?”
“We’ve got to take a little risk,god dammit, if we want to save
lives,” he added. “We are looking
at a slaughter.”
Giuliani said he knew the med-
icine had side effects, but he said
that even if it is “marginally”
helpful, it should be used.
Joel F. Farley, a professor at the
University of Minnesota College
of Pharmacy, said it concerned
him to hear prominent political
figures publicly advocate for FDA
action on any specific covid-
treatment.
“It worries me that political
pressure could be applied and
potentially distract from other
possible treatments,” Farley said.
The avid promotion of the un-
proven treatment by nonmedical
experts has worried scientists,
who are concerned they down-
play some known side effects of
the medications and could lead to
hoarding of drugs used to treat
other ailments, such as lupus and
rheumatoid arthritis.
“You should be listening to
credible scientists, ideally physi-
cians and researchers who ap-
proach this issue with a respect
for the scientific method. Rudy
Giuliani i s the opposite of that
kind of person,” s aid David Juur -
link, an internist and head of the
division of clinical pharmacology
at the University of To ronto.
Juurlink said that some of Giu-
liani’s “statements are dangerous
and are not to be believed.”
On March 27, Twitter locked
Giuliani’s account until he delet-
ed one of his messages that indi-
cated the treatment had been
“100 percent effective” i n treating
covid-19, part of an effort to crack
down on misinformation about
the virus on the platform, a com-
pany spokeswoman said.
Giuliani said he “didn’t think”
he knew of the action by Twitter.
He said that he has been consult-
ing widely with medical profes-
sionals on the treatment and that
at least 20 have told him they are
enthusiastic about its promise.
While some doctors in China
and France have said they have
used hydroxychloroquine on pa-
tients with covid-19 and seen im-
provements, Juurlink said the
studies have been small and con-
tradictory.
And the medicine does in rare
cases have serious side effects,
including lethal cardiac compli-cations. Its interactions when
used in combination with azithro-
mycin, as Giuliani has promoted,
are particularly not well under-
stood, he said.
“The issue is that these are
powerful medications that may or
may not work for the desired
efficacy but nevertheless have a
side-effect package,” s aid Michael
Ackerman, a genetic cardiologist
at the Mayo Clinic who published
an article last week in the Mayo
Clinic Proceedings warning
health-care providers about hy-
droxychloroquine’s cardiac side
effects.
Still, he said it may not hurt for
figures like Giuliani and Trump to
share their enthusiasm over the
early reports the medicine has
helped some people.
“Hope is a powerful medicine,”
he said, cautioning against draw-
ing political battle lines over
treatments that could work.Changing his focus
Many of Trump’s allies had
hoped Giuliani’s influence over
Trump might end with the im-
peachment crisis — a drama he
helped spark with his efforts to
find damaging information about
Democratic presidential candi-
date Joe Biden in Ukraine.
Two Giuliani associates who
assisted in the project were ar-
rested and charged with cam-
paign finance violations. Late last
year, federal prosecutors in New
York sought information that in-
dicated they were scrutinizing
Giuliani’s consulting and legal
work on behalf of foreign clients.
He has not been charged, and
Giuliani has denied wrongdoing.
In early February, when Trump
was acquitted by the Senate of
charges he had abused his office,
Giuliani declared vindication. (“Ac-
quitted for life!” he tweeted just
after the vote). He then spent weeks
continuing to press his case against
Biden in his podcast “Common
Sense,” which debuted in January.
By March, as the virus spread
across the globe, Giuliani
changed his focus to the growing
crisis — at times calling for unity
and comparing the moment to
how the United States pulled to-
gether after the 9/11 attacks and at
other times issuing biting attacks
against Trump’s perceived ene-
mies.In early March, he posted a
sobering interview about the vi-
rus with Joe Lhota, a former may-
oral aide who now serves as a top
executive at New York Universi-
ty’s L angone Health center. Lhota
explained that researchers in-
creasingly believed that people
with no symptoms could be
spreading the deadly virus.
“They may not even know they
have it?” Giuliani responded, ex-
claiming, “Oh my goodness!”
But days later, like other Trump
supporters who at the time said
the virus was being exaggerated
by Democrats to hurt the presi-
dent’s poll numbers, Giuliani ap-
peared to play down the threat.
On March 10, he tweeted statis-
tics from the Centers for Disease
Control and Prevention showing
how many people die of various
ailments in the United States each
year. “Heart Disease: 635,260;
Cancer: 598,038,” the list began,
followed by four other common
causes of death, including the flu.
“Likely at the very bottom, Coro-
navirus: 27,” he wrote.
On March 26, he tweeted a
quote from prominent Trump
supporter Candace Owens: “A p-
proximately 7500 people die ev-
ery day in the United States.
That’s approximately 645,
people so far this year. Coronavi-
rus has killed about 1,000 Ameri-
cans this year. Just a little per-
spective.”
Giuliani said his tweets were
referring to the fact that only a
small percentage of people who
contract the coronavirus will die.
“I was right,” he said. He did not
address projections that more
than 100,000 people in the United
States could die from the virus.
His messages echoed argu-
ments made at t he time by Trump,
who repeatedly compared the
coronavirus to the flu and played
down its severity as he resisted
efforts to shut down the economy.
Among those with whom Giu-
liani has consulted about the vi-
rus are Vladimir “Zev” Zelenko, a
family doctor from Monroe, N.Y.,
who has repeatedly been featured
in conservative media after re-
porting he successfully treated
hundreds of suspected covid-
patients with what he called a
cocktail of hydroxychloroquine,
azithromycin and zinc sulfate. Ex-
perts say his results are anecdotal
and need to be validated through
controlled scientific studies.
“We text,” Zelenko said in an
interview when asked about his
communication with Giuliani.
Zelenko has also been in touch
with White House officials, in-
cluding Trump’s n ew c hief of staff,
Mark Meadows, as The Post p revi-
ously reported.
Giuliani said he met the New
York doctor through a rabbi and
now speaks with him several
times a day to compare notes.
Appearing on Giuliani’s podcast
last week, Zelenko said that no
one under 60 should be given the
medications because they would
overcome infections from the cor-
onavirus without them.
“Your immune system is strong
enough. Statistically, it’s been
proven. You will recover,” Zelenko
said.
While younger people are less
at r isk, Juurlink said, it is “just not
true” that people under 60 all
recover.‘The right channels’
On March 27, Giuliani hosted
Robert Hariri, a doctor and chief
executive of a New Jersey biotechfirm, Celularity, that has been
experimenting with using stem
cells harvested from placentas to
treat various forms of cancer.
Hariri said the treatment could
be effective with covid-19. Giu-
liani pressed to know when
Hariri’s firm would get approval
to administer the experimental
treatment to covid-19 patients.
“The general reputation of the
FDA — and I don’t mean to be
critical at a time like this — but
that it’s very slow,” Giuliani said.
“I’ve represented pharmaceutical
companies in very, very difficult
situations, and it was my o bserva-
tion that they just took forever.”
Hariri told Giuliani he expect-
ed to hear from the FDA on a
request for an early clinical trial
within days. Five days later, the
firm announced the FDA had ap-
proved a study using the therapy
in up to 86 covid-19 patients.
Felberbaum, the FDA spokes-
man, said the agency cannot by
law comment on pending applica-
tions, but he said they are subject
to “internal scientific review” to
determine whether it is “reason-
ably safe to move forward with
testing the drug in humans.”
Through a spokeswoman,
Hariri declined to comment.
He told the New York Times
last week that he has known Giu-
liani for years. He described the
podcast appearance as “a friendly
chat between people who know
each other and who share a com-
mon interest in this particular
response to this disease.” He said
Giuliani had no financial rela-
tionship with him or his company.
Another recent podcast guest,
Julius R. Nasso, who runs a com-
pany that supplies medical equip-
ment to the shipping and cruise
industries, used his March 25 ap-
pearance to pitch U.S. and state
authorities on his idea for them to
lease empty cruise ships to care
for covid-19 patients.
“You can’t h ave any higher than
the president’s p ersonal attorney,”
Nasso said in an interview. “He’s
the one that basically gets it to t he
right channels.”
Nasso said he had been in
touch with federal officials about
his idea. He also credited himself
with prompting Trump’s March
26 suggestion that cruise compa-
nies repatriate their holdings
from tax havens to receive state
aid. “That was all a result of my
interview with Rudy Giuliani,”
Nasso said. He declined to pro-
vide additional details.
Giuliani denied connecting
Nasso with the White House, but
“I did put him on my p odcast, and
I know people there listen.”
The White House did not re-
spond to a request for comment.
On the broadcast, Giuliani
praised Nasso’s cruise ship idea.
“Frankly, a lot of these people
are not that sick. It’d be kind of a
nice environment for them, too,”
Giuliani said, adding: “Could they
use the pool?”
The former mayor described
Nasso as a Brooklyn-raised phar-
macist and shipping industry fig-
ure who was “another one of those
great American success stories.”
In August 2003, Nasso pleaded
guilty to conspiring to extort Sea-
gal, the actor, and was sentenced
to a year in prison. In 2008, he
received a payment from Seagal
in a civil legal settlement to re-
solve a business dispute.
The year before he was indict-
ed, Nasso launched a film-pro-
duction company whose board
members included Paul
Manafort, the political strategist
who would chair Trump’s presi-
dential campaign. Manafort is
serving a 7^1 / 2 -year federal prison
sentence for financial crimes.
In a telephone interview, N asso
said he’d known Giuliani 35 years
but they had no business relation-
ship. Nasso declined to comment
on his criminal conviction.Waiting out the crisis
Before the pandemic, Giuliani
would spend long hours with
friends at e xclusive cigar bars and
traveled the world tending to for-
eign clients.
These days, Giuliani said, he
“keeps up with the six-foot thing”
but spends time with his usual
“six or seven people around him,”
including Denny Young, his for-
mer chief counsel at c ity hall, who
is now living with him.
The former mayor says he goes
on drives every other day to in-
spect New York. When he records
his podcast in his apartment, am-
bulance sounds often intrude.
“I don’t think the Grand Ha-
vana Room is open,” he said of one
of his favorite cigar haunts in New
York City. “If it was open, nobody
would be there. I can dream of it
coming back. That’s what I did
after 9/11. I dreamed of all the
things coming back.”
rosalind.helderman
@washpost.com
[email protected]
[email protected]Giuliani, still a Trump confidant, touts unproven drugs
Jeenah Moon/reuters
Former New York City mayor Rudolph W. Giuliani was on hand when the USNS Comfort hospital ship arrived in Manhattan on March 3 0.Jabin botsford/the Washington Post
President Trump listens as others speak with coronavirus task force members at the White House on
Thursday. Trump said he’s seen positive results of treating the coronavirus with an anti-malarial drug.