Trump's bad habit of overpromising and underdelivering
Why the president's claims about convalescent plasma should be met with skepticism
President Trump keeps making a rookie political mistake: overpromising and underdelivering. He did it again Sunday, making the "truly history announcement" that the Food and Drug Administration had given emergency use authorization to allow doctors to treat COVID-19 patients with convalescent plasma — basically, an infusion from patients who have recovered from the virus.
Convalescent plasma is a "powerful therapy," Trump said. "It has an incredible rate of success."
"This is a major advance in the treatment of patients," Health and Human Services Secretary Alex Azar said. "This is a major advance."
There are reasons to be skeptical. A preliminary Mayo Clinic study does show improvements in the death rate for coronavirus patients who receive this treatment soon after their diagnosis. But the study is missing a key component for sound scientific research: It doesn't include a placebo group for comparison. And even if the treatment is effective, the supply is limited because it relies on recovered patients donating their plasma. For now, that's a relatively small group. As such, some top government health officials, including Dr. Anthony Fauci, last week argued against authorizing the treatment. As with so many things related to COVID-19, there is still a lot experts simply do not know with certainty.
But that didn't stop Trump from recklessly promising that convalescent plasma will save "countless lives." The president has offered similar assurances before during the pandemic: Remember when he said that hydroxychloroquine would prove to be a miracle drug? Or that Americans would be back in church by Easter? Or that the virus would go away on its own? Of course, none of these assertions ever came to fruition.
Such high expectations and subsequently dashed hopes is bad for public health. "I worry that engendering false hope will cause complacency that will deprive us of the time needed to find a lasting solution," H. Holden Thorp, the editor of Science journals, wrote in March. "And I worry about lasting damage if science overpromises."
So why does Trump keep doing this? Surely, some of it comes down to habit. The president is a salesman (some would say a conman) whose entire public history is full of gold-plated hyperbole. He often seems to genuinely believe that his failures are accomplishments — on Sunday he lamented to reporters about "the success we have that people don't talk about" during the pandemic, once again incorrectly saying the U.S. coronavirus fatality rate is the lowest in the world. And Trump's tendency to overpromise might stem from a lifetime of avoiding accountability for his failures. There has always been a bankruptcy court, a reality show producer, or a rich father to pick him up and dust him off when things go wrong.
There is evidence, too, that the president believes he can simply speak success into existence. Trump's biographers have noted his affinity with Norman Vincent Peale, the author of The Power of Positive Thinking and, literally, an evangelist for self-confidence. "Have faith in your abilities!" Peale exhorted. As my colleague Damon Linker has noted, Trump's tendencies fit perfectly within a Republican Party whose leaders long ago rejected the "reality-based community" in favor of their own vision. In such cases, hopefulness often curdles into hubris.
Of course, Trump also has a November election to win, and he has shown he will do just about anything or say anything to win it. That is why he was impeached, after all, and it is also why he is reportedly trying to fast-track approval of a COVID-19 vaccine before the election, despite fears that doing so might cut necessary corners.
Voters seem to be on to Trump's "the boy who cried success" routine. Polls show two-thirds of Americans are dissatisfied with his handling of the pandemic. The president may lament that he doesn't get credit for his accomplishments, but this isn't the media's fault. His failures are easily seen in America's mounting death toll, unemployment rate, and rising evictions. The skepticism has been amply earned.
Perhaps this time will be different. Perhaps Trump — and Americans — will get lucky, and convalescent plasma will prove to be the miracle he says it is. But the president might be better served if he dealt more humbly and honestly with the massive challenge presented by COVID-19.
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