On Thursday 1 October 2020, POTUS announced via social media that FLOTUS and himself has tested positive for COVID-19. The announcement came a few hours after the Counselor to the President, Hope Hicks tested positive for COVID-19.
This will not be a political post; the aim will be to track the disease progression and therapeutics used to treat the President.
Like any other human, there are ethical considerations when considering patient confidentiality rights. However, details of the President’s condition (whether fully accurate or not), were made publically available by his own medical team. Therefore, we can some insight into disease progression in a high risk individual (older overweight male), and more importantly his treatment regimen which we can assume to be the “best” strategy for managing COVID-19; we wouldn’t expect the President’s management to be second best.
The morning after the announcement, the President took a helicopter ride to the Walter Reed Medical centre, we he would spend the following three days. When considering that the average incubation time before symptoms is approximately 5-6 days, there is a case for exposure to have occurred at the the White House Rose Garden ceremony on 26 September 2020. Both the outdoor and indoor events were held to announce the nomination of the Honorable Amy Coney Barret as an Associate Justice of the Supreme Court, following the death of Ruth Bader Ginsburg. Following the typical protocols, including the “grillings” at the confirmation hearings, Amy Coney Barret was confirmed and sworn into the Supreme Court on 26 October, 2020 (SCOTUS).
The Rose Garden ceremony of 26 September 26, turned out to be a “superspreader event”, with reports of over 30 VIPs directly linked with event testing positive in the coming weeks. One of those was the White House press secretary, Kayleigh McEnany, who has been a key figure in the GOP election campaign. The former Governor of New Jersey, Chris Christie was also infected presumably at the superspreader event. He ended up with a very severe case of COVID-19, requiring a seven day stint in the ICU.
We don’t know much about the course of disease in most of those infected including FLOTUS who is now fully recovered and back on the campaign trail. FLOTUS did release a statement via the White House (14 October 2020), entitled “My personal experience with COVID-19”. It is apparent that she only experienced a mild form of COVID-19 which was handled with “natural route” of medicine, which included vitamins and healthy eating. She recommends, “diet, fresh air, and vitamins”, which is reasonable for most younger people in the low risk group with a mild form of disease.
The President’s management of COVID-19 is more interesting and we gained an understanding from the media appearances, and statements by Dr Sean Conley, The White House, Physician to the President. By analysing the comments made by Dr Sean Conley, we can assume that the President had a mild form of viral pneumonia (findings from lung imaging – X-rays and CT scans – “as expected”, rather than unremarkable), and significant drops in oxygen levels requiring supplemental oxygen. It was stated that at the White House, the President was given zinc, vitamin D, aspirin, melatonin, and an antacid (famotidine). These are good approaches, however, the “game-changer” may have been the course of the “experimental” Regeneron’s neutralizing antibodies (REGN-COV2 antibody cocktail). At the Walter Reed medical centre, the President who taken care of by essentially the “Dream Team” of pulmonology experts, infectious disease experts, and an anaesthetist. We was given a five-day course of the antiviral, remdesivir (now approved for the treatment of severe COVID-19), and a course of the broad-sprectum anti-inflammatory steroid, dexamethasone. The President made a very rapid recovery and was fully back on the campaign trail within days.
We will take a closer look at the mechanisms of action of the medicines received by the President in later issues, and we’ll revisit superspreader events again… For now, POTUS, FLOTUS, and new SCOTUS are all doing fine and fighting for re-election in a couple of days.
Until next time … Tranquilo Polymaths.