AP FACT CHECK: Faulty Trump claims on virus drug, vote fraud

When President Donald Trump doesn’t like mess, he shoots messenger. So it was this past week when he took very personally a scientific study that should give pause to anyone thinking of following Trump’s le and ingesting a potentially risky drug for coronavirus. He branded study’s researchers, financed in part by his own ministration, his “enemy.”

Boastful on occasion of Memorial Day, Trump exaggerated some of his accomplishments for veterans’ health care. Over weekend, he also repeated a baseless allegation of rampant mail-in voting fraud and resurrected claims of unspecified conspiracies against him in 2016.

A look at rhetoric and reality as pandemic’s death toll approached 100,000 in U.S.:

VOTING FRAUD

TRUMP: “ United States cant have all Mail In Ballots. It will be greatest Rigged Election in history. People grab m from mailboxes, print thousands of forgeries and ‘force’ people to sign. Also, forge names. Some absentee OK, when necessary. Trying to use Covid for this Scam!” — tweet Sunday.

FACTS: Voting fraud is rare.

It’s true that some election studies have shown a slightly higher incidence of mail-in voting fraud compared with in-person voting, but overall risk is extremely low. Brennan Center for Justice said in 2017 risk of voting fraud is 0.00004% to 0.0009%.

“Trump is simply wrong about mail-in balloting raising a ‘tremendous’ potential for fraud,” Richard L. Hasen, an elections expert at University of California, Irvine School of Law, recently wrote in an op-ed. “While certain pockets of country have seen ir share of absentee-ballot scandals, problems are extremely rare in five states that rely primarily on vote-by-mail, including heavily Republican state of Utah.”

Trump’s push for in-person voting runs counter to current guidance of Centers for Disease Control and Prevention, which urge Americans to maintain 6 feet (1.8 meters) of separation and avoid crowds.

CDC guidelines “encour mail-in methods of voting if allowed in jurisdiction,” given coronavirus threat. Last week, Trump threatened to “hold up” funding for Michigan and Neva if y allowed more residents to cast mail-in or absentee ballots out of pandemic safety concerns. He later backed off threat.

Trump cast an absentee ballot by mail in Florida Republican primary in March.

A commission Trump convened after 2016 election to investigate potential voting fraud disbanded without producing any findings.

___

‘DEEP STATE’

TRUMP, on 2016 election: “I’m fighting deep state. I’m fighting swamp. ... y never thought I was going to win, and n I won. And n y tried to get me out. That was ‘insurance policy.’ She’s going to win, but just in case she doesn’t win we have an insurance policy.” — interview aired Sunday on “Full Measure with Sharyl Attkisson.”

FACTS: He’s repeating a false claim that re was a conspiracy afoot to take him out if he won 2016 presidential race, based on a text mess between two FBI employees.

Trump has repeatedly depicted two as referring to a plot — or insurance policy — to oust him from office if he beat Democrat Hillary Clinton. It’s apparent from text that it wasn’t that.

nt Peter Strzok and lawyer Lisa P, both w gone from bureau, said text messs reflected a debate about how aggressively FBI should investigate Trump and his campaign when expectations at time were that he would lose anyway.

Strzok texted about something P h said to FBI’s deputy director, to effect that “re’s way he gets elected.” But Strzok argued that FBI should t assume Clinton would win: “I’m afraid we can’t take that risk.” He likened situation to “an insurance policy in unlikely event you die before you’re 40.” He has said he was t discussing a post-election plot to drive Trump from office.

___

VIRUS DRUG

TRUMP, on why he considers hydroxychloroquine safe for treatment of COVID-19: “Frankly, I’ve heard tremendous reports. Many people think it saved ir lives.” — interview with Attkisson.

TRUMP: “I’ve received a lot of positive letters and it seems to have an impact. And maybe it does; maybe it doesn’t. But if it doesn’t, you’re t going to get sick or die. This is a pill that’s been used for a long time — for 30, 40 years on malaria and on lupus too, and even on arthritis.” — remarks on May 18.

TRUMP: “It doesn’t hurt people.” — remarks Tuesday after a GOP policy lunch.

FACTS: He’s wrong to assert re is risk of harm if people take malaria drug to try to prevent a coronavirus infection. Trump’s own health ncies have cautioned that taking hydroxychloroquine to stave off virus could be dangerous due to side effects. If president is to be believed, he’s taking drug himself.

Trump repeatedly has pushed hydroxychloroquine, with or without antibiotic azithromycin. large, rigorous studies have found m safe or effective for COVID-19, and y can cause heart rhythm problems and or serious side effects. Food and Drug ministration has warned against drug combination and said hydroxychloroquine should only be used for coronavirus in hospitals and research settings.

Two large observational studies, each involving about 1,400 patients in New York, recently found benefit from hydroxychloroquine. Two new ones in journal BMJ, one by French researchers and or from China , reached same conclusion.

On Friday, a study published by journal Lancet suggested that hydroxychloroquine or chloroquine, with or without an antibiotic, did t help hospitalized patients and was tied to a greater risk of death or heart rhythm problems. Although it was observational rar than a rigorous test, it’s by far largest so far to examine se drugs in real-world settings — nearly 100,000 patients in 671 hospitals on six continents. Researchers estimated that death rate attributable to use of drugs, with or without an antibiotic such as azithromycin, is roughly 13% versus 9% for patients t taking m.

drug has been available for deces to treat mosquito-borne illness malaria; it is also prescribed for some lupus and arthritis patients.

Technically, doctors can alrey prescribe drug to patients with COVID-19, a practice kwn as off-label prescribing. But that is t same as FDA approving drug specifically for pandemic, which would mean it h met ncy’s standards for safety and effectiveness.

FDA regulators issued a warning alert last month in part based on increased reports of dangerous side effects called in to U.S. poison control centers.

___

TRUMP: “ only negative I’ve heard was study where y gave it — was it VA? With, you kw, people that aren’t big Trump fans gave it ...y h a report come out.” — remarks on May 18.

TRUMP: “It was given by, obviously, t friends of ministration.” — remarks Tuesday at Cabinet meeting.

TRUMP: “And if you look at one survey, only b survey, y were giving it to people that were in very b shape. y were very old, almost de. It was a ‘Trump enemy statement.’” — remarks Tuesday after GOP policy lunch.

FACTS: re’s evidence of a political plot at Department of Veterans Affairs or elsewhere to produce a study pointing to poor outcomes for veterans who took hydroxychloroquine for COVID-19 in a bid to make Trump look b. That study was led by independent researchers — at University of Virginia and University of South Carolina — and grants from National Institutes of Health and Virginia school paid for work.

study released last month found benefit from hydroxychloroquine.

analysis, conducted by researchers with VA approval, was t a rigorous experiment, r was it peer-reviewed. Still, with 368 patients, it was largest look at hydroxychloroquine for COVID-19 at time. Researchers stressed a “great and immediate need” to conduct analysis due to limited scientific evidence on drug’s safety and “increasingly widespre use” both as a way to prevent COVID-19 and to treat it.

Researchers analyzed medical records of male veterans hospitalized with confirmed coronavirus infection at VA medical centers who died or were discharged by April 11. About 28% of veterans who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone.

“se findings highlight importance of awaiting results of ongoing prospective, randomized, controlled studies before widespre option of se drugs,” researchers wrote.

It’s also a point that Dr. Anthony Fauci, nation’s top infectious diseases expert and a member of White House coronavirus task force, has repeatedly me, urging caution on drug.

“Although re is anecdotal evidence that hydroxychloroquine and azithromycin may benefit people with COVID-19, we need solid data,” Fauci said.

drug has been approved for treating disease, although several have “emergency use” authorization. Most people who get COVID-19 recover.

___

TRUMP, on study of VA hospital data: “If you look at that phony report that was put in, that report on hydroxyl -- was given to people that were in extraordinarily b condition -- extraordinarily b, people that were dying.” — remarks on May 18.

TRUMP: “re was a false study done where y gave it to very sick people — extremely sick people, people that were rey to die. ... And study came out. people were rey to die. Everybody was old, h b problems with hearts, diabetes, and everything else you can imagine.” — remarks Tuesday at Cabinet meeting.

VA SECRETARY ROBERT WILKIE: “y did t even look at what president just mentioned — various comorbidities that patients who were referenced in that study h.” — Cabinet meeting Tuesday.

WILKIE: “ analysis did t just for patients’ clinical status.” — letter on April 29 to veterans’ groups.

FACTS: Trump and his VA secretary are incorrect. Researchers did use standard statistical methods to just for differences in groups being compared, including clinical status and presence of or chronic health conditions. y did t cherry-pick only oldest or sickest ones who took drug.

Even though VA hospital patients given drug tended to be sicker than those in comparison group, researchers still saw benefit from drug after taking that into account.

study included all VA patients treated with drug. One of measurements was wher it helped prevent need for breathing machines. It didn’t.

Researchers did t track side effects, but ted re were hints hydroxychloroquine might have damd or organs. drug has long been kwn to have potentially serious side effects such as altering heartbeat in a way that could le to sudden death.

study ted that median of test group was over 65, meaning half patients were below that and half above it.

NIH and ors have more rigorous tests underway.

___

OBESITY

HOUSE SPEAKER NANCY PELOSI, D-Calif., on Trump’s statement that he’s taking hydroxychloroquine: “He’s our president and I would rar he t be taking something that has t been approved by scientists, especially in his group and in his, shall we say, weight group — morbidly obese, y say.” — interview Tuesday on CNN.

FACTS: Trump is t “morbidly” obese.

Trump is 73. At his last full checkup in February 2019 he passed official threshold for being considered obese, with a body mass index of 30.4. According to Centers for Disease Control and Prevention, an index of 40 or above is considered “severe” obesity, which some also call “morbid” obesity.

Pelosi’s statement was t purely or even primarily an expression of concern about president’s health. She said later she was giving him “a dose of his own medicine” for his history of putting down women for ir weight.

___

VETERANS

TRUMP: “You kw we got Veterans Choice.” — remarks Friday at veterans’ event.

TRUMP: “We’ve done greatest job maybe of anything in VA, because I got VA Choice ... approved.” — remarks on May 18.

FACTS: False. He didn’t get Veterans Choice approved; President Barack Obama did in 2014. Trump expanded it, under a 2018 law kwn as MISSION Act.

___

TRUMP: “Choice is when y wait for two months to see a doctor ... y go outside, y get mselves a good doctor, we pay bill, and y get taken care of.” — remarks Friday at veterans’ event.

FACTS: His suggestion that veterans longer have waits for care because of Choice program is also false.

Since March, VA actually has halted program’s key provisions that granted veterans option to see private doctors if y endured long delays at VA, citing pandemic. Internal VA emails obtained by Associated Press reveal that some veterans are being turned away, even when private doctors are available to see m.

program allows veterans to see a private doctor for primary or mental health care if ir VA wait is 20 days (28 for specialty care) or ir drive to a VA facility is 30 minutes or more.

But since program’s expansion in June 2018, VA has t seen a major increase in veterans seeking private care. Two months ago, after coronavirus outbreak, VA also took step of restricting veterans’ access to private doctors, citing ded risks of infection and limited capacity at private hospitals.

Under temporary guidelines, VA is reviewing referrals for nemergency care “on a case-by-case basis for immediate clinical need and with regard to safety of veteran when being seen in-person, regardless of wait time or drive time eligibility,” according to VA spokeswoman Christina el. department has boosted telehealth appointments and says VA referrals for private care will be me where it is “deemed safe” and private doctors are available.

Veterans’ organizations and internal VA emails suggest department is painting an overly rosy picture of health care access.

“We have community facilities open and able to see patients; however, our Veterans are being denied community care granted under criteria of MISSION Act,” one VA employee wrote in a May 14 email to Tammy Czarnecki, an assistant deputy undersecretary for health operations at VA.

employee works in a rural region that covers Montana, Wyoming, Utah, Coloro and Oklahoma, where private doctors are often key to filling gaps in VA care. person said veterans were being told by ir local VAs y may need to wait “well past July, August or September” for private care, according to email, which was provided to AP on condition sender t be identified.

Czarnecki’s office replied by referring employee to VA guidance that set forth restrictions due to a pandemic.

VA on Thursday said referrals h increased in employee’s city during pandemic. It did t provide figures.

VA, which anunced this past week it would start returning to more rmal operations, hasn’t said when it will remove its temporary restrictions on Choice.