Three topics for a Sunday evening.
The President is in day three of the public portion of his COVID-19 diagnosis. He seems well, both from his physician’s reports and especially in a video of him speaking at Walter Reed that showed him without shortness of breath or any apparent weakness or trouble standing.
In contrast, there have been reports about the President having episodic drops in his blood oxygen. Fortunately, these drops appear to have been transient and do not appear to be related to a deterioration in his lung function. Transient reductions in blood oxygen saturation do not, in and of themselves, portray worsening COVID-19 lung disease.
The biggest disconnect with the present condition is the fact that he was given dexamethasone. This is a steroid drug that is given predominantly to people with impending respiratory failure or pneumonia. It would not be given to an individual with stable Covid-19 who did not have severe respiratory symptoms.
It is not clear whether the steroid was given to the President out of the utmost caution or because he truly has more severe disease. To listen to his physicians, however, he is stable and doesn’t have worsening lung function. The reports to the contrary seem to come from administration officials, such as the Chief of Staff, and appeared to be more sensationalized then accurate. I would trust the physicians over this person.
Finally, while the limo ride the President took today was not necessary, I am sure that if his physicians thought he was in impending respiratory failure they would’ve literally tied him into his bed to prevent this excursion!
Regeneron’s antibody “cocktail”
There has been much interest in Regeneron’s “cocktail.” This is a confusing term since it is actually two single monoclonal antibodies combined, each one directed against a different part of the spike protein in the SARS-CoV-2 virus. The combination binds to the virus and prevents the virus from infecting cells in the individual who gets the antibody. In addition, these antibodies binding to the virus stimulate the immune response against the virus and help clear the virus from the individual’s blood.
This therapy would theoretically be more active than the convalescent serum from patients who have been infected because the entire antibody in the treatment is directed against the virus. Despite this, the therapy remains experimental and though it showed some efficacy in the small-scale clinical trial, it is not generally available to COVID-19 patients.
Finally, Mayor Bill de Blasio has started to shut down certain portions of New York City. This is reportedly to “prevent a resurgence of COVID-19.” The criteria he used are interesting though since they involve 3% of people who are tested for the virus being positive. This is even below the 5% threshold set to reopen schools. So it’s not clear whether the mayor has a quick trigger or there’s some other issue going on that makes him concerned about a resurgence of COVID-19 in New York City.