President Donald Trump on Tuesday blasted Speaker Nancy Pelosi as a ‘sick woman’ with a lot of ‘mental problems’ after she called him ‘morbidly obese’ and he claimed academic research showing the dangers of hydroxychloroquine was done by his enemies.
‘Pelosi is a sick woman she’s got a lot of problems, a lot of mental problems,’ President Trump said during a visit to Capitol Hill where he had lunch with Senate Republicans.
Pelosi said the ‘morbidly obese’ president was putting his health at risk with his daily dose of hydroxychloroquine in an interview with CNN Monday night.
President Donald Trump blasted Speaker Nancy Pelosi as a ‘sick woman’ with a lot of ‘mental problems’ after she called him ‘morbidly obese’
President Trump was on Capitol Hill to have lunch with Republican senators – Senators John Barrasso and Mitch McConnell stand behind him wearing masks
Speaker Nancy Pelosi said the ‘morbidly obese’ president was putting his health at risk with his daily dose of hydroxychloroquine in an interview with CNN Monday night
The president defended his taking of the drug, which has government warnings about its side effects, saying the study on the drug that showed those results was a ‘Trump enemy statement.’
The president was referring to an April study from veterans’ hospitals that showed a higher rate of death among those who received the drug.
‘Well I’ve worked with doctors and if you look at the one survey – the only bad survey – they were giving it to people that were in very bad shape. They were very old, almost dead. It was a Trump enemy statement,’ he said.
An April study of 368 male patients at Veterans Affairs hospitals nationwide found hydroxychloroquine was linked to higher rates of death for those hospitalized with the coronavirus.
More than 27 per cent of patients who received the drug died and 22 per cent of patients who were treated with a combination of hydroxychloroquine and the antibiotic azithromycin – known as z-pack – also died.
The death rate for those who did not receive the drugs was 11.4 per cent.
President Trump claimed many of those working on the front lines of the coronavirus pandemic are taking hydroxychloroquine.
‘A lot of our front line workers take it because it possibly and – I think it does but you know these people are going to have to make up their own mind. Plus, it doesn’t hurt people. It’s been out of the market for 60 or 65 years for malaria, lupus and other things,’ he said during brief remarks after his lunch with senators on Tuesday.
‘I think it gives you an additional level of safety, but you can ask many doctors are in favor of it. Many front line workers won’t go there, unless they have the hydroxy. And so again this is an individual decision to make, but it’s had a great reputation. And if it was somebody else other than me, people would say gee isn’t that smart,’ he added.
The president has come under heavy criticism from doctors, Democrats, media commentators and foreign countries after his shocking announcement on Monday he is taking a daily dose of hydroxychloroquine even as he test negative for the coronavirus.
Vice President Mike Pence told Fox News on Tuesday he is not taking hydroxychloroquine but he wouldn’t ‘begrudge’ anyone who was
China claimed Trump was using ‘witchcraft’ to lead during the coronavirus pandemic after he admitted to taking hydroxychloroquine.
Hu Xijin, editor-in-chief of China Communist Party’s official publication, Global Times, blamed Trump for the high number of U.S. deaths from coronavirus, claiming the White House would be ‘burned down’ by the public if it were China.
‘President Trump is leading the US’s struggle against pandemic with witchcraft, and as a result, more than 90,000 people have died,’ Hu wrote Tuesday in a now-deleted tweet. ‘If it were in China, the White House would have been burned down by angry people.’
The editor of the governing publication is close with Chinese leadership.
Vice President Mike Pence told Fox News on Tuesday he is not taking hydroxychloroquine but he wouldn’t ‘begrudge’ anyone who was.
”I’m not. But I would never begrudge any American taking the advice of their physician. Hydroxychloroquine is a drug that’s been around for more than 40 years for treatment of malaria. But, early in this process, the FDA approved what’s called off-label use where physicians could prescribe hydroxychloroquine in terms they deemed appropriate. So my physician has not recommended that, but I wouldn’t hesitate to take the counsel of my doctor. Any American should do likewise,’ he said.
White House Press Secretary Kayleigh McEnany said the president shared his personal health information because he wants to be ‘transparent’ with Americans.
‘The president just wanted to be transparent about his personal health decision that he made in consultation with his doctor,’ McEnany told Fox & Friends Tuesday morning, adding others should only take the anti-malaria drug if they are prescribed it by their doctors.
President Donald Trump revealed during a round table discussion with restaurant executives Monday that he’s been taking hydroxychloroquine for around two weeks. On Tuesday he touted aid for farmers at the White House
At the White House: Donald Trump appeared at the White House with first daughter Ivanka Tuesday fresh from the revelation he is on hydroxychloroquine
Hu Xijin, editor-in-chief of China Communist Party’s official publication, Global Times wrote in a now-deleted tweet that Donald Trump is governing during the coronavirus pandemic by using ‘witchcraft’ after the president revealed Monday he is using hydroxycloroquine as a preventative measure to contracting the disase
White House Press Secretary Kayleigh McEnany told Fox & Friends Tuesday morning that Trump shared his personal health information so he could be ‘transparent’ with the American people – she also warned people only take the drug if they are prescribed by their doctor
Hu blamed Donald Trump for the deaths of more than 90,000 Americans from coronavirus due to his handling of the pandemic – and claimed that if he were doing the same thing in China, the ‘White House would have been burned down by angry people’
‘First, let me emphasize strongly that any use of hydroxychloroquine has to be in consultation with your doctor – you have to have a prescription,’ she said. ‘That’s the way it must be done.’
‘That being said, I talked to the FDA commissioner this morning, Stephen Hahn, he said hydroxychloroquine has been approved for three other uses, we have a lot of information about the safety of this drug,’ the new press secretary noted. ‘Though, ultimately, you make that decision with your doctor.’
McEnany slammed networks other than Fox News for ‘misreporting’ that hydroxychloroquine is too dangerous to take as a treatment for coronavirus.
‘So some of the misreporting on other networks… ignore the fact that tens of millions of people around the world have used this drug for other purposes, including some people in my communications office who used it for malaria prophylactics before traveling to other parts of the world,’ she argued.
In fact it was not other networks, but Fox News, which had raised the alarm first.
On Monday afternoon, Fox News host Neil Cavuto warned hydroxychloroquine ‘will kill you’ immediately after Trump said he used it.
The president spent his evening rage tweeting about his favorite network, claiming he is looking for a new outlet with less ‘anti-Trump people.
Additionally, MSNBC morning show host Joe Scarborough, who often publicly feuds with Trump, claimed Tuesday morning the president is lying about taking hydroxychloroquine.
‘Wen the president of the United States actually says he’s doing something which, let me assure you, he is not doing — let me assure you, the president of the United States is not taking hydroxychloroquine,’ he said during MSNBC’s Morning Joe.
‘In all the time that I knew him, I only sat for one meal with him,’ Scarborough said. ‘Before that meal, he had wipes like this high and would go through the wipes, compulsively, and wipe his hands, sanitize his hands before eating anything.’
‘So he is not taking something that his own administration has said will kill you,’ he continued. ‘That his own FDA said will kill you. That the [Department of Veterans Affairs] said will kill you. … That’s what doctors will say, too. The FDA said, take it if you’re in the hospital or take it if you’re in a closely watched clinical trial. But, don’t take it unless you’re under those two circumstances.’
‘So the president is not taking it, and yet, and yet, he’s telling Americans that they should take it,’ Scarborough asserted in claiming the president is lying.
Senate Majority Leader Chuck Schumer said told Morning Joe on Tuesday that he thinks Trump has some other interest in promoting hydroxychloroquine, like knowing someone with vested interest in the company that makes it. He also said the president could be lying about taking it
During an interview with the Morning Joe panel on Tuesday, Senate Minority Leader Chuck Schumer said it’s likely Trump has some other interest in hydroxychloroquine other than its supposed healing properties.
‘So I don’t know why he did it,’ the New York Democrat said. ‘Maybe he has family or friends who own part of the company. It’s not unlike the president. Someone at Mar-A-Lago, calls him on the phone, tells him, ‘Oh, this is a good company,’ and he just talks about it. Maybe he did it to divert attention from all the bad things happening, and maybe he’s just lying.
‘This president doesn’t tell the truth. He may be taking this, may not,’ Schumer continued.
But McEnany told reporters at the White House that the president should be taken ‘at his word.’
‘The reason [you should believe he is taking it] is the President of the United States said it. And if it were any other President of the United States, the media would take him at his word,’ she said.
She claimed that the White House doctor who confirmed President Trump was taking hydroxychloroquine helped give a ‘medical rationale’ for Trump’s decision to take the drug as a preventative measure in his letter that was released to the public.
Trump, 73, said Monday that he started taking the medication ‘a couple of weeks ago’ because ‘good things are being said about it’ helping coronavirus patients.
He has previously touted hydroxychloroquine as a coronavirus ‘cure’, but the FDA has warned the drug – which is typically used to treat malaria – has a range of possibly lethal side-effects and has not been proven as an effective COVID-19 treatment.
Several studies are underway into the drug’s effectiveness in treating coronavirus and whether it can also protect against the disease, but so far there is no clear evidence it is beneficial.
Following Trump’s admission, Speaker Pelosi was among a host of doctors and politicians who branded the move irresponsible.
Pelosi told CNN: ‘He’s our president and I would rather he not be taking something that has not been approved by the scientists. Especially in his age group and in his, shall we say, weight group, what is morbidly obese, they say. So, I think that it’s not a good idea.’
Nancy Pelosi told CNN’s Anderson Cooper on Monday that ‘morbidly obese’ Donald Trump should not take hydroxychloroquine to prevent COVID-19
The White House physician, released a memo Monday night, saying he and Trump discussed the matter and believed the gain from using hydroxychloroquine outweighed its risk factors – he did not say, however, if he had prescribed the drug to the president
White House physician Dr. Sean Conley said in a memo that the benefits of Trump taking the drug outweighed the negatives, while the president touted physicians writing to him about the unproven treatment
However, a memo released by the White House shows that physician Dr Sean Conley discussed the drug with Trump and concluded that the potential benefits of taking it outweighed the risks.
Trump’s spokeswoman later told the New York Times that the president had been prescribed the drug and has been taking it, after Dr Conley’s note left some doubt.
The president said he does not have the virus, which has infected 1.53 million Americans and killed more than 90,000.
But speaking at the White House during an event with restaurant workers he said: ‘I’m taking it – hydroxychloroquine. Right now yeah. A couple of weeks ago, started taking it.’
Trump did not say what prompted him to start taking the drug, though it comes after several White House staffers were diagnosed with coronavirus.
The Food and Drug Administration warned in April that hydroxychloroquine can significantly increase the risk of death in people, especially those with heart problems, and cautioned against its use.
A study of 150 patients published in peer-reviewed medical journal The BMJ this month found the drug did not significantly improve outcomes for coronavirus patients, but did induce potentially-serious side effects in a third of those taking it.
Hope was sparked early on in the crisis when an early French study suggested the drug could have both antiviral and anti-inflammatory effects.
It triggered a flurry of research across the world, an endorsement from Trump and emergency authorization from US regulators.
But other research has dealt a blow to the drug, with one Chinese trial last month finding it did not speed up the recovery of COVID-19 patients.
And New York researchers last week said patients got no benefits whether they took just the drug or paired it with the antibiotic azithromycin.
Leading doctors have warned the drug can cause severe side effects, and can even throw off the process that makes the heart beat in time – and one trial in Brazil was stopped short because so many of the enrolled coronavirus patients given the drug developed these arrhythmias.
The president has repeatedly touted hydroxychloroquine – used to treat malaria, lupus and other diseases – and the antibiotic azithromycin, often referred to as ‘Z-pack,’ to be used to treat the coronavirus.
Medics around the nation have expressed concern at the news, warning Americans to not take the drug without at least consulting their doctor
While studies are being carried out into hydroxychloroquine’s effectiveness in treating coronavirus, early results have suggested it provides only marginal benefits with serious risks – something medics pointed out online
Trump has repeatedly touted hydroxychloroquine as a treatment for coronavirus, despite warnings from medics that it carries serious risks including inducing potentially-fatal heart arrhythmias
Hydroxychloroquine and coronavirus: What does the evidence say?
Hydroxychloroquine – branded as Plaquenil – is a cheap drug that has been used as a prophylaxis against malaria for decades.
But no evidence currently exists to show the drug can prevent patients being struck down with COVID-19, the disease caused by the coronavirus.
Scientists also warn there is no proof hydroxychloroquine, which was touted as a wonder drug by Donald Trump and can be given to arthritis and lupus patients, can even treat COVID-19.
Hope was sparked early on in the crisis when an early French study suggested the drug could have both antiviral and anti-inflammatory effects.
It caused a flurry of research across the world, including in Britain, an endorsement from Trump and emergency authorization from US regulators.
But other research has dealt a blow to the drug – one Chinese trial last month found it did not speed up the recovery of COVID-19 patients.
And New York researchers last week said patients got no benefits whether they took just the drug or paired it with the antibiotic azithromycin.
Leading doctors have warned the drug can cause severe side effects, and may even throw off the process that makes the heart beat in time.
One trial in Brazil was stopped early because so many of the enrolled coronavirus patients given the drug developed these arrhythmias.
SO, WHAT HAVE THE STUDIES SHOWN?
INFECTED PATIENTS ‘GET NO BENEFIT FROM TAKING HYDROXYCHLOROQUINE’
Researchers funded by the National Institutes of Health looked at data from 1,438 COVID-19 patients across 25 hospitals in New York.
The study, published in JAMA last month, was observational and looked at the outcomes of patients given different drug combinations.
About 25 per cent of patients who received hydroxychloroquine and azithromycin – another promising coronavirus drug – died.
In comparison, the rate was 20 per cent for those only given hydroxychloroquine alone and was 10 per cent for those on azithromycin.
90% OF CRITICAL PATIENTS GIVEN THE DRUG DEVELOP ARRHYTHMIAS
Scientists in the US and France last month found 90 per cent of critically-ill COVID-19 patients given hydroxychloroquine developed heart arrhythmias.
Massachusetts General Hospital researchers monitored 90 patients in intensive care units, while University of Lyon academics analysed 40 patients.
Both uncovered similar results in JAMA Cardiology, after looking at the QT intervals – the time between the heart’s ventricular muscles contracting and then relaxing.
When this interval becomes too long, the patient has developed a dangerous form of heart arrhythmia, called atrial fibrillation.
HYDROXYCHLOROQUINE MAY IMPAIR ABILITY OF IMMUNE SYSTEMS
Hydroxychlorouquine may impair the ability of patients’ immune systems to fight off the infection, a review suggested at the start of April.
Harvard scientists analyzed 10 studies as well as anecdotal reports from doctors that suggested the drug could help coronavirus patient.
The review found many of the clinical trials were poorly conducted and anecdotal reports carried little weight.
HYDROXYCHLOROQUINE DOES NOT SPEED UP RECOVERY
The antimalarial drug hydroxychloroquine did not speed up coronavirus patients’ recovery in a trial in China, scientists revealed in April.
In a disappointing blow for the promising drug, doctors said it did not work as a cure.
Patients who were taking it suffered fewer symptoms than others who were treated alongside them without the medication but their recovery time was the same.
They had tested hydroxychloroquine on 75 COVID-19 patients in hospitals and compared their illnesses to 75 patients who didn’t receive the drug.
BRAZIL TRIAL STOPPED EARLY BECAUSE OF HEART PROBLEMS
A clinical trial in Brazil had to be stopped early, it was revealed last month, because patients developed heart problems.
The Brazilian study, taking place in the Amazonian city of Manaus, had planned to enroll 440 severely ill COVID-19 patients to test two doses of chloroquine.
But researchers reported their results and called a halt to the experiment after only 81 people had received the high-dose treatment which gave them 1,200mg per day.
One in four of the patients had developed heart rhythm problems and early data suggested death rates were higher among those patients.
MALARIA DRUG DOES IMPROVE SURVIVAL ODDS, PHYSICIANS CLAIM
Hydroxychloroquine has improved the survival and recovery odds for about 90 per cent of patients treated, a physicians group claimed.
The Association of American Physicians and Surgeons (AAPS) presented data on 2,333 patients treated with hydroxychloroquine.
Results showed 91.6 per cent of those who got the controversial drug fared better after treatment, it was reported at the end of April.
COMBINING DRUG WITH DIET SUPPLEMENT COULD WORK BETTER
Combining hydroxychloroquine with the dietary supplement zinc could create a more effective treatment for coronavirus patients, a study suggested last week.
Researchers found taking the drugs together, along with the antibiotic azithromycin, increased patient’s chances of being discharged and decreased their risk of dying.
It did not, however, change the average time patients spent in hospital, how long they spent on a ventilator or the total amount of oxygen required.
The team, from New York University Grossman School of Medicine, says the findings are encouraging but that more studies are needed.
HYDROXYCHLOROQUINE COULD HELP TREAT PATIENTS, STUDY SAYS
French researchers last month found hydroxychloroquine could treat coronavirus patients, sparking hope of a cure.
Thirty patients were treated with hydroxychloroquine for 10 days, combined with azithromycin, an antibiotic.
Although very small, the study ‘showed a significant reduction of the viral carriage’ after the six days.
And results showed patients had a ‘much lower average carrying duration’ compared to patients who received other treatments.
Several weeks later, the study’s publisher said the paper ‘did not meet its standards’ because it excluded data on patients who did not respond well to the treatment.
Trump said he took one dose of the z-pack antibiotic and is now taking a zinc supplement along with a daily hydroxychloroquine pill. He noted he’s had no side effects.
‘I’m taking the two – the zinc and the hydroxy,’ he said. ‘So far I seem to be okay.’
‘I have been taking it for about a weekend for about a week and a half,’ he noted. ‘Every day. I take a pill every day.’
‘At some point I’ll stop,’ he added.
Pelosi was not the only figure who reacted strongly to Trump’s public announcement.
Fox News anchor Neil Cavuto warned his viewers that the drug ‘will kill you’ if you are in an at-risk group.
‘If you are in a risky population here, and you are taking this as a preventative treatment to ward off the virus, or in a worse-case scenario you are dealing with the virus and you are in this vulnerable population, it will kill you.’ he said.
‘I cannot stress enough. This will kill you,’ Cavuto, who suffers from MS and is immunocompromised, said.
That prompted Trump to furiously tweet that he was ‘looking for a new outlet’ because of the number of ‘anti-Trump people’ on the network.
White House physician, Dr Conley noted: ‘After numerous discussions, he and I regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from the treatment outweighed the relative risk.’
‘In consultation with our inter-agency partners and subject matter experts around the country, I continue to monitor the myriad studies investigating COVID-19 therapies and I anticipate employing the same shared medical decision making based on the evidence at hand in the future,’ he said.
Conley, a commander in the U.S. Navy, noted President Trump is ‘in very good health and has remained symptom-free. He receives regular COVID-19 testing, all negative to date.’
Trump said he started taking the drug after talking with Conley. ‘He said well if you’d like it. I said yeah I’d like it, I’d like to take it,’ Trump said.
The president shrugged off warnings about the side effects of hydroxy issued by the FDA and the National Institutes of Health.
Both medical organizations note the drug is only approved for the use of patients in hospitals who have been diagnosed with the coronavirus.
‘You’re not going to get sick or die,’ he said about taking the medication. ‘I’ve taken it about for a week and a half now. And I’m still here.’
He said he’s heard ‘a lot of good stories’ about the drug.
‘I’ve heard a lot of good stories. And if it is not good, I will tell you right. I’m not going to get hurt by it. It has been around for 40 years for malaria, for lupus, for other things. I take it,’ Trump said.
‘I was just waiting to see your eyes light up when I said this,’ he told the assembled media.
This is not the first time that Trump has touted potentially-lethal treatments for coronavirus.
Last month he was heavily criticised after questioning whether injecting patients with disinfectant could potentially cure the virus.
He also asked whether exposing the body to high-intensity ultraviolet light, which is commonly used to disinfect hospital wards after exposure to coronavirus, could also help people.
‘You’re going to have to use medical doctors. But it sounds interesting to me,’ he said.
Medical doctors have since warned that both methods would quickly kill patients.
At least two White House staffers tested positive for the coronavirus this month, both of whom had access to the president: his Navy valet who serves him meals and Vice President Mike Pence’s press secretary Katie Miller, who speaks for the Coronavirus Task Force and is married to Trump senior adviser Stephen Miller.
After the outbreak, new safety protocols were put into effect at the White House, including daily testing of senior staff who get close to the president. Additionally, staff and Secret Service agents have started wearing face masks around the complex, where close working conditions make social distancing impossible.
Trump last underwent a partial checkup in a November visit to Walter Reed National Military Medical Center that was not on his public schedule. He has said in March he would complete his physical in the next 90 days.
At his last physical Trump weighed 243 pounds, which is considered obese for a man of his reported height of 6 feet 3 inches. Past reports said he’s taking rosuvastatin, a lipid-lowering drug, to control his cholesterol.
The president has touted his love of steak and fast food. His only exercise is golf, which has been on hold since early March as the coronavirus pandemic causes courses to be closed.
Hydroxy has potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death, and the FDA has warned against its use for coronavirus infections except in formal studies.
‘Although there is anecdotal evidence that hydroxychloroquine and azithromycin may benefit people with COVID-19, we need solid data from a large randomized, controlled clinical trial to determine whether this experimental treatment is safe and can improve clinical outcomes,’ Dr. Anthony Fauci, the nation’s top infectious disease expert and head of the NIH, said last week.
Trump dismissed studies that claim hydroxychloroquine is not effective, and rather dangerous, complaining that they were done by the Veterans Administration, where he does not have a lot of supporters.
‘Here’s my evidence. I get a lot of positive calls about it. The only negative I heard — was at the VA? People that aren’t big Trump fans,’ he said.
‘If you look at that phony report that was put – in that report or the hydroxy was given to people that were an extraordinarily bad condition, extraordinary bad people that were dying. No, I think for whatever it’s worth I take I was,’ he said.
Trump also said he has ‘zero symptoms’ of the coronavirus, is tested daily and has tested negative.
‘Totally negative, no symptoms, no nothing,’ the president said.
He did not mention a name but the description fits that of Vladimir Zelenko, a New York doctor who has promoted hydroxy as a coronavirus treatment and has been touted by Fox News host Sean Hannity.
Trump’s enthusiasm for hydroxy was based on a French study of 20 patients in March that showed the drugs might work against the virus. But many scientists have questioned the methods that study and one from China used, saying more research on the drug was needed.
Trump has repeatedly touted stories he’s heard of hydroxy’s effect on those with the coronavirus.
In early April, he talked about Michigan State Rep. Karen Whitsett, who he saw on Ingraham’s show the previous evening talking about her experience with the drug.
HOW TO CALCULATE YOUR BODY MASS INDEX – AND WHAT IT MEANS
Body mass index (BMI) is a measure of body fat based on your weight in relation to your height.
- BMI = (weight in pounds / (height in inches x height in inches)) x 703
- BMI = (weight in kilograms / (height in meters x height in meters))
- Under 18.5: Underweight
- 18.5 – 24.9: Healthy
- 25 – 29.9: Overweight
- 30 or greater: Obese
‘A woman last night, I watched her on one of the shows, good show, Laura, and she thought she was dead. She was a representative from Michigan. She was just in horrible shape for 12 days, 14 days. She thought she was dead. I think she said that her doctor said it’s going to be very tough. She saw me talking about this and she asked her husband to go to the drugstore. This is a Democrat representative, a person that you know perhaps wouldn’t be voting for me. I think she will be voting for me now even if she’s a Democrat,’ he said.
‘She asked her husband, she said please go out. I’m not going to make it. You have to hear her story. Please go out and get it. He went at 10:00 in the evening to the drugstore and he got it. He gave it to her. I don’t say it works like this but four hours later she woke and she said I feel better. And then shortly thereafter she felt great,’ the president said.
Ingraham met with Trump in the Oval Office to tout the drug. Rudy Giuliani, Trump’s personal attorney, has been an advocate of hydroxy.
Trump repeatedly has advocated for hydroxychloroquine to be used as a treatment option for the coronavirus even as many medical officials – including Dr. Tony Fauci, who sits on the White House Coronavirus Task Force – have urged a more cautious approach, noting the lack of reputable scientific studies on hydroxychloroquine.
And, in early April, during an impromptu White House press briefing Trump stopped Fauci from answering a question from a reporter about the effectiveness of hydroxychloroquine.
When reporters tried to get Fauci’s opinion on the drug – after he previously warned against seeing the malaria medication as a wonder drug – Trump stepped in and stopped the question.
‘We’re starting to see light at the end of the tunnel. And hopefully in the not-too-distant future we’ll be very proud of the job we all did,’ Trump said, instead of letting Fauci answer.
Fox News host Laura Ingraham and Rudy Giuliani, Trump’s personal attorney, has both been advocates of hydroxychloroquine