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did not receive the drug. When Trump called hydroxychloroquine “a game-changer” on March 19, many researchers considered his enthusiasm premature and possibly dangerous. Practitioners started stockpiling the drug, and doctors worried they would not to be able to provide it to autoimmune-disease patients who relied on it. On March 28, the F.D.A. approved the emergency use of chloroquine and hydroxychloroquine in treating patients with Covid-19, but European regulators are awaiting more data.
As for Kaletra, a study in March in The New England Journal of Medicine found it did not help patients suffering severe illness related to coronavirus, though researchers left open the possibility that it might be more effective earlier in the course of treatment.
Arad knew at the time that neither drug had been through extensive clinical trials or had F.D.A. approval. She listened patiently to Hall and expressed her concern that his suggestions did not conform to standard medical procedure or C.D.C. guidelines.
Hall understood the need for evidence-based medicine as well as she did, he told her. But this was life and death. Under those circumstances,
sometimes you don’t wait for standard procedure, he said. If it came to it, he was sure Cai would assume the risk. Hall sure Cai would assume the risk. Hall suggested that he could provide Arad with a full translation of the guidelines, which had not yet been published in English; Arad, Hall said, took him up on the offer.
Lying in bed that night, Cai feared that he would close his eyes and never wake up — that he would slip away, essentially drowning in his sleep. He was being given oxygen, but even still, he saw his numbers trending downward — in the 80s. Concerned, he messaged a WeChat group that included his father and a doctor his father knew in Shanghai, who had been advising that Cai be put on a high-flow nasal oxygen cannula, a device that allows for a more intensive and stable delivery of oxygen into the lungs. Cai requested that treatment, but the nurses on duty said that they didn’t have the clearance to make that decision. Cai called Hall to ask for help in getting a doctor’s attention. Hall contacted a prominent local doctor, Henry Chen, who oversaw a sprawling network of community-health doctors in New York, in the hope that he could get in touch with someone at the hospital. Chen says he was told that because he did not have admitting privileges, he would not be put through.
Cai had never felt more alone. He repeatedly called for the nurse, and when she arrived, he spoke as harshly as he ever had to a fellow medical professional. “I am not going to sleep until I see a respiratory therapist,” he told her. He wanted closer monitoring; and he wanted the expert care of someone who could provide a higher level of oxygen dis-
"But this was life and death. Under those circumstances, sometimes you don’t wait for standard procedure, he said."