October 5, 2020

Here's the latest on Trump's Covid-19 condition and treatment plan

Daily Briefing

    Doctors treating President Trump at Walter Reed National Military Medical Center provided details over the weekend on the president's medical condition and the experimental treatments he's received for Covid-19, and they said Trump could be discharged to the White House as early as Monday.

    What Trump's doctors have said about his condition, treatments

    Over the weekend, the White House, Trump's doctors, and others familiar with the matter provided some details regarding when Trump tested positive for the novel coronavirus, when he first began experiencing symptoms of Covid-19, the severity of Trump's symptoms, and the treatments he has undergone so far.

    For instance, sources familiar with the matter who asked to remain anonymous told the Wall Street Journal that Trump first tested positive for the coronavirus early on Thursday via a rapid test for the pathogen. According to the Journal, Trump's positive result from the rapid test came before his appearance on Fox News Thursday night, during which the president said he was awaiting coronavirus test results.

    After that appearance, sources say, Trump received a positive coronavirus test result from a polymerase chain reaction test, which is the most commonly used type of test for the novel coronavirus in America. Trump then announced his positive result via Twitter early Friday morning.

    According to Politico, it's not yet publicly known when Trump last tested negative for the coronavirus. Sean Conley, the official physician to the president, had declined to say when Trump's last negative test for the virus occurred, the New York Times reports.

    The White House has announced that Trump first began experiencing symptoms of Covid-19 on Thursday, which was one "full day" before the White House initially announced that Trump was having "mild symptoms" of the disease, according to the Associated Press. Conley said Trump on Thursday had been experiencing fatigue, a mild cough, and a stuffy nose.

    During a briefing on Sunday, Conley indicated that Trump's condition had worsened by Friday, which prompted the president's admittance to Walter Reed Friday night. Conley said Trump on Friday had a "high fever," and his oxygen saturation level fell below 94%. At that time, Trump was treated with supplemental oxygen for about an hour, and his oxygen saturation level quickly rose to 95%, Conley said.

    Conley and the other physicians on Trump's medical team said the president's oxygen saturation level fell again on Saturday, dropping to 93%. When asked whether Trump had been treated with supplemental oxygen during the second drop, Conley did not provide a clear response, the Journal reports. "I'd have to check with the nursing staff. I don't think—if he did, it was very limited," Conley said.

    Trump's medical team also said the president's kidneys have not been affected by Covid-19, Politico reports. Trump's doctors haven't yet provided details on whether any of the lung imaging performed on the president's showed signs of damage commonly reported among patients with Covid-19. According to Politico, Trump's doctors have said the images showed "expected findings," but they haven't yet elaborated on those results.

    Trump's medical team on Sunday said the president's condition had improved since he first arrived at the hospital, and they said Trump had received three experimental treatments for Covid-19: a monoclonal antibody cocktail manufactured by Regeneron, Gilead Science's antiviral drug remdesivir, and the steroid dexamethasone.

    As of Monday, FDA hadn't yet approved any treatments for Covid-19. FDA has granted an emergency use authorization for Gilead's remdesivir as an experimental Covid-19 treatment, and early research has suggested that the drug can speed recovery in hospitalized Covid-19 patients. It's not clear if the drug reduces the risk of death from Covid-19, however. Remdesivir typically is administered as a five-day treatment course via infusions that take place in a hospital. Gilead is seeking FDA's formal approval of remdesivir as a treatment for Covid-19.

    FDA also has not yet issued any type of emergency or formal authorizations for Regeneron's antibody drug cocktail to treat Covid-19, but Regeneron has made the drug available to Covid-19 patients via a compassionate use program. According to Politico, the drug cocktail "mimics the body's natural antibodies, [and] is thought to work best when administered early on in" Covid-19's progression. Early research on the drug as a Covid-19 treatment has been "promising," Politico reports.

    Dexamethasone is a steroid drug that "has been around for decades" and is recommended by NIH and the World Health Organization (WHO) for use in Covid-19 patients who are receiving supplemental oxygen or have been placed on a ventilator, Politico reports. Data from a large clinical trial indicates the drug was associated with a reduced risk of death in such patients, but guidelines from both NIH and WHO caution that the drug could have harmful affects in Covid-19 patients who don't require supplemental oxygen or mechanical ventilation, Politico reports.

    Trump's medical team on Sunday said the president could be released from Walter Reed and discharged to the White House as early as Monday. "If he continues to look and feel as well as he does today, our hope is that we can plan for a discharge as early as [Monday] to the White House where he can continue his treatment course," said Brian Garibaldi, a doctor from Johns Hopkins University who is part of Trump's medical team.

    When asked what Trump's treatment might look like if he returns to the White House on Monday, Alyssa Farah, the White House's communications director, said the White House has a "fully operating medical team" and "[t]here's a lot we can do from the White House, the residence."

    Ceremony for SCOTUS nominee emerges as possible source of coronavirus outbreak

    It's not clear how Trump contracted the coronavirus and, as the AP reports, there's "no way to know for sure" where or how Trump may have been exposed to and infected with the virus. As the AP notes, Trump "had a full week of official and campaign events before his hospitalization Friday."

    However, a White House event held Sept. 26 to introduce Trump's latest Supreme Court nominee, Judge Amy Coney Barrett, is emerging as a possible source of a coronavirus outbreak, the AP reports. More than 150 people gathered in the White House's Rose Garden and inside the White House for the event, and many of the attendees had close contact with each other and did not wear face masks or coverings. As of Sunday, at least four people who attended the event had tested positive for the coronavirus: former New Jersey Gov. Chris Christie (R); White House counselor Kellyanne Conway; John Jenkins, president of the University of Notre Dame; and Sens. Mike Lee (R-Utah) and Thom Tillis (R-N.C.).

    But other associates of Trump and White House staff also have tested positive for the virus over the past week, including some who did not attend the event. For instance, Sen. Ron Johnsons (R-Wis.) on Saturday announced that he had tested positive for the coronavirus, but he did not attend the event for Barrett.

    Other White House staff and associates of Trump that have tested positive for the coronavirus over the past week include: First Lady Melania Trump; Hope Hicks, an adviser to Trump; Nicholas Luna, an assistant to Trump; Kayleigh McEnany, the White House press secretary; Bill Stepien, Trump's campaign manager; and Ronna McDaniel, chair of the Republican National Committee.

    According to the AP, the White House has said its medical team is conducting a contact tracing effort (Restuccia/Lucey, Wall Street Journal, 10/4; Associated Press, 10/4; Morello et al., Politico, 10/4; Lim et al., Politico, 10/4; Baker/Haberman, New York Times, 10/4; Buchanan et al., New York Times, 10/4; Savitsky, Axios, 10/5).

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