How to Treat the President
As of October 18, 2020, 39.7 million people have been infected by Covid-19, 8.14 million in the United States alone. There currently exists no vaccine for Covid-19. Some who contract the disease may recover on their own, but others develop more severe symptoms and may need to be hospitalized or even face death. Older males with a higher body mass index (BMI) have the highest risk factor for severe COVID-19. Guess who fits all of these risk factors: President Donald J. Trump.
On Thursday October 1, a news reporter broke the story that Hope Hicks, a top aide of President Trump, tested positive. The following day, President Trump’s diagnosis of Covid-19 became public: the White House announced that he had received a dose of Regeneron Pharmaceuticals experimental dual-monoclonal-antibody cocktail, and following that, he was flown to the Walter Reed Hospital.
On Saturday, President Trump’s doctor stated that he was on a five-day course of Remdesivir. On Sunday, the president’s doctor announced he was receiving a steroid Dexamethasone. Two days later, the president left the hospital. It was later revealed that he had also received supplemental oxygen on Friday. Our president underwent intensive treatment in a short period of time: what are all these medications and what do they tell us?
REGN-COV2, an exploratory antibody cocktail, was the first drug the president took. He received it through the Food and Drug Administration’s (FDA) “compassionate use” program, “intended for patients with serious or life-threatening conditions who do not have any available treatment options.” The president was injected with the highest allowable dose of this drug, 8 grams through IV, although the treatment is still currently in Phase 3 trials. Released data on the drug showed that even if the drug did not substantially help those who have already generated their own antibodies, the drug did benefit those who did not have antibodies. Those who had a lower viral load showed that the drug did not have an impact on the amount of virus, while those who had a higher viral load showed faster clearance of the virus. REGN-COV2 is for those who have mild to moderate symptoms and aims to prevent hospitalization, but also doubles as a passive immunization (for preventing infection).
Remdesivir, made by Gilead, was originally made to treat Ebola and Hepatitis C, but is now given to Covid-19 patients in serious condition because it “modestly” prevents viral gene replication. Remdesivir was also the first treatment for Covid-19 to be FDA approved under emergency use. Since the approval, there have been two major studies. One run by Gilead found that Remdesivir shortens the hospital stay from 15 days to 11 days. The other study conducted by the World Health Organization (WHO) shows that Remdesivir has little effect on mortality rates. Thus, the true therapeutic value of the drug is still unknown.
Dexamethasone, a cheap, widely available steroid does not work on the virus itself, but instead works to protect the lung tissue from the side effects of the viral infection. A study of more than 6,000 people found that Dexamethasone reduced deaths by one-third for patients on ventilators, and by one-fifth for patients on oxygen. Dexamethasone does not help those who are not in serious condition, and could, in fact, be harmful to those who are not on supplemental oxygen or a ventilator. Some side effects of Dexamethasone include paranoia, extreme irritability and aggression, delusions, impaired judgment, mania, psychosis, depression, euphoria, mood swings, insomnia, diabetes, heartburn, muscle weakness, and increased risk of infections. Because of its potency, Dexamethasone has to be taken with a very big “dose” of caution.
Based on the drugs President Trump has taken, it can be assumed that at one point, his health was in a precarious state. He may have been sicker than his doctors let on, but it was concealed from the public. Still, whether or not you agree with the president’s policies, all should hope for a speedy and lasting recovery for him. There might not be a cure for Covid-19, but we should at least be encouraged by the treatments and therapeutics on the horizon.