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COVID 19

One big thing: the President tests positive

The President has been struck down by COVID-19 and refuses to listen to doctors or staff as well as refuses to commit to accepting election results; disinformation campaigns are multiplying like rabbits; there’s vacancy on the Supreme Court and multiple Senators heading into quarantine and/or isolation. This is your October surprise: unprecedented uncertainty and tension with “ballot return deadline day” only four weeks away.

The President has been struck down by COVID-19 and refuses to listen to doctors or staff as well as refuses to commit to accepting election results; disinformation campaigns are multiplying like rabbits; there’s a vacancy on the Supreme Court and multiple Senators heading into quarantine and/or isolation. This is your October surprise: unprecedented uncertainty and tension with “ballot return deadline day” only four weeks away.

Just after midnight Thursday night (east coast time, Friday morning), President Trump tweeted that he and Melania had tested positive for COVID-19. This was about eight hours after we had learned that a key Trump advisor, Hope Hicks, had tested positive.

Hicks had helped prepare Trump for Tuesday’s debate with Joe Biden in Cleveland and had traveled on Air Force One to-and-from. She also traveled with him to Minnesota for a rally on Wednesday; that’s when she started showing symptoms.

What we know about Thursday

An hour and a half before a fundraiser, Trump learned that Hicks had tested positive. He went ahead with the fundraiser at his Bedminster, NJ, golf club. That was in direct opposition to CDC guidance; when you know you’ve been exposed, you are to cease interactions with others and quarantine.

People in quarantine should stay home, separate themselves from others, monitor their health, and follow directions from their state or local health department.

“He socially distanced, it was an outdoor event and it was deemed safe by White House operations,” asserted White House Press Secretary Kayleigh McEnany. In contrast to McEnany’s assertion, this photo shows a very-much indoors event for at least part of the evening. That’s because prior to the main event, Trump met with a smaller group inside for a roundtable discussion. There was also an indoor VIP reception, and photos were taken with donors, also indoors.

Trump then returned to the White House, talked to Sean Hannity on Fox, and later tweeted his diagnosis. According to the Wall Street Journal, Trump tested positive with a quick test before getting a confirmation from a more sensitive PCR test.

We do not know when on Thursday that Trump took the quick test or which quick test was usedHowever, “the White House has relied on Abbott’s ID Now Covid-19 tests, which return results within five to 15 minutes of sample collection.”

Those tests have been criticized for their high detection limit — in other words, they only return positive results if individuals tested submit samples with large amounts of viral material. As a result, it’s possible that early in the course of an infection, or as an infection is waning, the test could return a “false negative” result even if its subject is still contagious.

It’s a controversial piece of equipment.

  • We do not know when Trump had last been tested.
  • We do not know if he was tested on Tuesday, the day of his debate with former Vice President Joe Biden. He provided a negative test taken within 72 hours of the debate.

Then there’s Walter Reed

Late Friday morning, Trump’s oxygen levels dipped and he had a “high fever.” Dr. Sean Conley prescribed supplemental oxygen. About 4 pm Conley prescribed an experimental monoclonal antibody drug which has not been approved for any use. The Regeneron CEO, who “has known the president for years”, gave his permission and the FDA cleared it under a “compassionate use” case. We do not know when permission was requested.

After the markets had closed, about 6 pm, Trump flew by helicopter to Walter Reed National Military Medical Center. The last time a sitting president was admitted to Walter Reed was in 1981, when Reagan was shot.

About midnight Friday, Conley released a letter stating that Trump had received his first dose of remdesivir, which appears to have a “modest clinical benefit … although, as the authors acknowledge, the clinical importance of this finding is uncertain.”

Nonetheless, in aggregate, important questions remain regarding the efficacy of remdesivir. First, the optimal patient population is unclear. Second, the optimal duration of therapy is unclear. Third, the effect on discrete clinical outcomes is unclear. Fourth, the relative effect of the drug if given in the presence of dexamethasone or other corticosteroids is unclear.

As of Saturday, Trump began taking dexamethasone, a corticosteroid; it was prescribed after he had another drop in his oxygen levels.

Dexamethasone has been shown to help patients who are severely ill with Covid-19, but it is typically not used in mild or moderate cases of the disease.

This steroid is used to prevent an overreactive immune system response known as a “cytokine storm.” It is normally used only with patients who require oxygen or are on ventilators. “It feels like a whole lot of Kremlinology and I’d just be happier if they’d tell us the truth,” said Robert Wachter, the chair of the University of California, San Francisco’s department of medicine.

Is Trump directing his care (“VIP syndrome”)? Conley conceded that he had held an upbeat news conference for the patient and team.

Between 2-14 days after exposureCOVID-19 patients may exhibit a variety of symptoms, which can include coughs, chills, diarrhea, difficulty breathing, fatigue, fever, nausea and the loss of the sense of smell or taste. In severe cases, patients may have high fever and chest pain.

One of the common early symptoms among elderly Covid patients is a drop in mental acuity or periods of mild confusion…

On Sunday, Trump exited the hospital and rode around in a “hermetically sealed” SUV to wave at supporters lined up outside the hospital. Without an alert to the press pool. This endangered the lives of the Secret Service staff with him, and some are outraged, especially since Secret Service agents have already caught the coronavirus while protecting the president.

Trump also recorded a video where he said he had visited soldiers in the hospital.

It is unlikely that Walter Reed allowed a COVID-19 positive patient to visit other patients; if they did, whomever approved it should lose their license to practice medicine. Delusion or deliberate lie? With Trump it’s hard to tell, but both of these incidents reflect poor judgment and could easily be coronavirus-related.

“Suddenly, they’re throwing the kitchen sink at him,” Dr. Thomas McGinn said. “It raises the question: Is he sicker than we’re hearing, or are they being overly aggressive because he is the president, in a way that could be potentially harmful?”

The official statement of Trump’s symptoms and treatment does not jibe with another Sunday statement that Trump could be released on Monday. The optics don’t look good now if he is not released; they would look worse if he were re-admitted.

With the president determined not to concede weakness and facing an election in just 30 days, officials acknowledged providing rosy assessments to satisfy their prickly patient…

Even as the White House released new details about the president’s condition on Sunday, it continued to withhold others, including when Mr. Trump had his last negative test for the coronavirus and his first positive one.

Reporters are frustrated with “a days-long torrent of falsehoods, obfuscation, evasion, misdirection and imprecision from those surrounding Trump as he faces the greatest threat to a president’s health in decades.”

Americans should be, too.

By Kathy E. Gill

Digital evangelist, speaker, writer, educator. Transplanted Southerner; teach newbies to ride motorcycles! @kegill

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