The President is infected.

I apologize for the lateness of tonight’s post, but I’ve been on national TV discussing the condition of the President. The live stream is at https://wgnamericaupfront.com, with the final interview at 10:15 EDT tonight.

I want to make several quick points about his medical condition and diagnosis. I should say beforehand that I have no personal knowledge of the president’s health or preexisting conditions, nor do I know exactly the symptoms he is suffering. Despite this, several things are apparent to me.

First, the president was reportedly being tested every day for evidence of the virus. When yesterday it was reported that his associate, Hope Hicks, had tested positive for the virus, he was likely tested again. I think the reason there was a delay in reporting once they confirmed his rapid test with a high complexity PCR test was to make sure that it wasn’t a false positive. This was the reason that the announcement that he was infected came in so late in the evening.

If the president first developed symptoms late yesterday, it is likely that he was infected three to four days ago early in the week. This suggests that it could have happened either on Monday or Tuesday, potentially even before the debate.

The president is reported to have low grade symptoms including a fever, some lethargy, nasal symptoms, and a cough. None of these symptoms is alarming, and none suggest a severe disease at the present time. If he were acutely ill, he would likely have been rushed to the closest hospital, George Washington Medical Center, in the District of Columbia. This was where President Reagan was taken after he was shot.    

On advice of his physicians, the president was taken to Walter Reed complex in Bethesda. This again suggested that he was not acutely ill or in respiratory distress since it was done in an orderly fashion. The fact that the president was transported by helicopter is of no issue because the president always goes to those hospitals by helicopter because of logistical issues. I spent over 10 years at Walter Reed as a military physician and I can assure you this was always the case. 

The president made a video before he got on the helicopter where he told the American people of his illness. He showed no evidence of shortness of breath or other symptoms and was able to walk to the helicopter and into the hospital without any problem. This again suggests that he is not having severe symptoms at the present time.         

The president was given an infusion of monoclonal antibodies against the virus developed by a company called Regeneron in Tarrytown, NY. These antibodies can bind, neutralize, and remove the COVID-19 virus. Unlike serum infusions from infected patients the antibodies are all directed against the virus and are therefore more potent. There is some preliminary data from a clinical trial of this material that it can improve the outcome of patients infected with SARS-CoV-2. He likely will also receive Remdesivir, the antiviral drug, and steroids.

The major concern about the president is that he doesn’t develop respiratory disease or pneumonia. This is the most severe complication of COVID-19 and would be the one that would carry the worst prognosis. At Walter Reed, the President’s physicians can monitor his lungs and the amount of oxygen they are getting into his blood very closely. They can therefore intervene and treat him before he gets extremely ill or develops widespread pneumonia.    

Much has been made about the President’s age (74), weight and other potential predisposing illnesses. The president has not previously been reported to have heart or lung disease, and apparently does not have diabetes. Even though he is in his mid 70s and has these concerns, over 90% of patients who are infected with COVID-19 in this risk group survive the infection. So, there is a good likelihood  that he will come through this illness.   

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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