Covid: Trump, the Nation, and Anything

[The Nehor]

38 minutes ago, pogi said:

I think he has some valid points, but I don't think he is considering other possibilities. 

Very true, but I don't think he is considering the possibility that Remdesivir really works.  If Trump was only given access to treatments that the rest of America receive (American's don't have access to Remdesivir or dexamethasone in the early stages - it is in fact, contraindicated for all other Americans at that stage), I think there is a very good chance he would have died from this given his age, comorbidities, and rapid onset hypoxemia.  The fact that his O2 sats dropped so quickly so early is a very, very, bad, bad sign.   It is possible that he could get worse, but typically, once someone gets off oxygen, they don't get back on. I am really surprised at how quickly he was maintaining oxygen sats on room air after dropping so fast.  It's hard to know what to predict what will happen with his untested treatments however.  It very well could still get worse.  His untested treatments could even potentially cause more harm then good.  Or, it could be the miracle that we have all been hoping for.   I wouldn't have given him much of a chance of a positive outcome without the treatment however.  Maybe that is why they were willing to take such drastic measures with untested treatments and untested combinations of therapies.

It absolutely could cause more complications, but it could also save his life.  The fact that he is off oxygen with very high O2 sats on room air, that is a very good sign things are improving.  Once they are off, they don't usually need it later.  There is about a 50/50 chance he has drug induced hyperglycemia from dex.  It happens to about half of patients. It is not necessarily a given.

Again, if Trump was any other American, this would be true.  I don't think he is really considering the possibility that the drugs might actually be therapeutic and that Trump won't be getting worse before getting better.  It is impossible to predict what will happen.  He is right that it is too early to be too optimistic though.  I think "cautiously optimistic" is a fair judgment by his doctor given his improvement in vital signs, however.

I am not 100% convinced he was ever on oxygen beyond the reported getting some to make the walk to the helicopter and some use to help him stay lucid. I am not sure he was ever on a ventilator.

Edited October 4, 2020 by The Nehor

[Calm]

1 hour ago, Robert J Anderson said:

At first it was merely about flattening the curve to not overwhelm hospitals, and now that the curve is flattened, the Michigan governor wants to continue the lockdowns.  In contrast, the Florida governor recently opened up the state.  It's hard not to see the politics involved.

Given Wisconsin is next door to Michigan and what is happening there, I think it reasonable the governor is cautious.  Also weather is cooler up than in Florida and going indoors more for gettogethers, etc. is going to contribute.

The curve can easily start spiking again and they aren't sure yet why it did in Wisconsin, I believe.

[Calm]

1 minute ago, The Nehor said:

I am not 100% convinced he was ever on oxygen beyond the reported getting some to make the walk to the helicopter.

Why?

[Calm]

59 minutes ago, strappinglad said:

Seems that the docs are fighting to maintain some semblance of compliance with HIPAA rules. Maybe Trump has given carte blanche to any info on his health and treatment, but if not, the docs are treading on thin ice here. 

More likely he has given some difficult instructions to follow, possibly contradictory (because the way he talks can be confusing).

[pogi]

10 minutes ago, The Nehor said:

I am not 100% convinced he was ever on oxygen beyond the reported getting some to make the walk to the helicopter and some use to help him stay lucid. I am not sure he was ever on a ventilator.

If not, then his doctors are a national security threat with how aggressive and experimental they are being with a president who only had mild symptoms.

Edited October 4, 2020 by pogi

[Calm]

Just now, pogi said:

If not, then his doctors are a national security threat with how aggressive and experimental they are being with a presidents who only had mild symptoms.

Well, they have a president who is likely telling them he wants to fight this with everything they got because he won't be locked up.  It may be hard to be appropriately restrained depending on how much he is willing to take advice he doesn't like.

[The Nehor]

1 hour ago, Robert J Anderson said:

How about responding to the issue of lockdowns?  Do you think they were effective?  How do you account for the different responses depending on whether or not the given state is controlled by a republican governor or a democratic governor?  Was killing the economy worth it?  What if the thrust of the article were true and that the lockdowns didn't really prevent the spread?  At first it was merely about flattening the curve to not overwhelm hospitals, and now that the curve is flattened, the Michigan governor wants to continue the lockdowns.  In contrast, the Florida governor recently opened up the state.  It's hard not to see the politics involved.

I do think they were effective. I account for the different responses based on party leadership as being due to one party telling everyone it was overblown and/or a hoax and one treating it like a legitimate health crisis.

I would rather kill the economy than kill people.  “For behold, ye do love money, and your substance, and your fine apparel, and the adorning of your churches, more than ye love the poor and the needy, the sick and the afflicted.”

I do not believe the thrust of the article is true and the National Review has posted bald-faced lies in enough articles I have read that I see no reason to give them any benefit of the doubt. When a source is regularly unreliable you should stop using it. The “flattening the curve” response was something some states gave as a reason for the lockdowns. There is merit to the idea but do we really want to base public health policy entirely on whether the hospitals are overwhelmed? Maybe we should try to prevent people from having to be put on a ventilator even if there is a ventilator available?

The day I can accurately use Florida’s government as a positive example of anything is the day I know the Millenium started.

[The Nehor]

4 minutes ago, pogi said:

If not, then his doctors are a national security threat with how aggressive and experimental they are being with a presidents who only had mild symptoms.

 

1 minute ago, Calm said:

Well, they have a president who is likely telling them he wants to fight this with everything they got because he won't be locked up.  It may be hard to be appropriately restrained depending on how much he is willing to take advice he doesn't like.

I think both of these statements are true. When you choose your physician based on them telling you what you (and the rest of the nation) want to think you deserve what you get.

[The Nehor]

11 minutes ago, Calm said:

Why?

There are reports he took in some oxygen so he would look better walking to the helicopter. I suspect they did the same thing before the video they shot and those ridiculous pictures of the President working so he was “on oxygen” but not on a ventilator. That is my theory.

[pogi]

16 minutes ago, Calm said:

Well, they have a president who is likely telling them he wants to fight this with everything they got because he won't be locked up.  It may be hard to be appropriately restrained depending on how much he is willing to take advice he doesn't like.

I understand the pressure that they might feel, but he is still their patient, and they have an ethical obligation to him and a moral obligation to our country to not threaten our national security by placing the commander in chief in unnecessary risk by making him a medical guinea pig when his symptoms are just mild.   This is an extreme measure they have taken that no doctor in good conscience would have given to a lay person who only had mild symptoms.  It would be completely unethical.  It is in fact contraindicated to give dex with mild symptoms. To give a completely untested medicine while simultaneously administering a contraindicated use of a medicine is almost unthinkable unless his life was at grave risk and they are throwing a Hail Mary.

Edited October 4, 2020 by pogi

[Rain]

@pogi

I don't know if you saw my question or not.  I'm talking about the second question here:

Quote

Is Trump a diabetic?  If not do they normally give non diabetics insulin in cases like this?

 

[readstoomuch]

Just now, Rain said:

@pogi

I don't know if you saw my question or not.  I'm talking about the second question here:

 

Corticosteroids (cortisones) can raise anyone’s blood sugars.  In diabetics or prediabetics, those individuals may have to receive insulin subcutaneously if their blood sugar gets above 180-200.  Trump is not diabetics, but he is 244 lbs and six foot three.  That probably puts him in a prediabetic category.  So, he may have to receive some insulin depending on how much dexamethasone (corticosteroid) that he received.  

[Rain]

1 minute ago, readstoomuch said:

Corticosteroids (cortisones) can raise anyone’s blood sugars.  In diabetics or prediabetics, those individuals may have to receive insulin subcutaneously if their blood sugar gets above 180-200.  Trump is not diabetics, but he is 244 lbs and six foot three.  That probably puts him in a prediabetic category.  So, he may have to receive some insulin depending on how much dexamethasone (corticosteroid) that he received.  

Thanks!

[pogi]

2 minutes ago, Rain said:

@pogi

I don't know if you saw my question or not.  I'm talking about the second question here:

 

Sorry, I did miss your question. He is not a diabetic that I know of.  If they are giving him insulin, it would be due to drug induced hyperglycemia from the dexamethasone (a common side effect).

[pogi]

17 minutes ago, readstoomuch said:

Corticosteroids (cortisones) can raise anyone’s blood sugars.  In diabetics or prediabetics, those individuals may have to receive insulin subcutaneously if their blood sugar gets above 180-200.  Trump is not diabetics, but he is 244 lbs and six foot three.  That probably puts him in a prediabetic category.  So, he may have to receive some insulin depending on how much dexamethasone (corticosteroid) that he received.  

It happens in about 50% of non-diabetics/prediabetics as well. 

Edited October 4, 2020 by pogi

[The Nehor]

27 minutes ago, pogi said:

I understand the pressure that they might feel, but he is still their patient, and they have an ethical obligation to him and a moral obligation to our country to not threaten our national security by placing the commander in chief in unnecessary risk by making him a medical guinea pig when his symptoms are just mild.   This is an extreme measure they have taken that no doctor in good conscience would have given to a lay person who only had mild symptoms.  It would be completely unethical.  It is in fact contraindicated to give dex with mild symptoms. To give a completely untested medicine while simultaneously administering a contraindicated use of a medicine is almost unthinkable unless his life was at grave risk and they are throwing a Hail Mary.

This is the same doctor who gave him malaria medicine as a prophylactic. One question I wanted asked was how they are monitoring the President for emotional stability as dexmethasone can cause emotional instability. Can we hide the nuclear football for a few days?

Edited October 4, 2020 by The Nehor

[readstoomuch]

I think it is an interesting conversation about too much vs too little medical treatment to receive with any condition including Covid.  It is easy to be an armchair quarterback.  For me personally if a treatment is fairly innocuous, I would prefer to be a tad on the aggressive side.   I understand that it looks like they might be trying to hide details or not fully disclose medical conditions.  He should be able to have some privacy.  Given my reading about John F Kennedy`s severe back condition and the medications that he was getting during the Cuban Missile Crisis, the level of knowledge that we have about Trump seems reasonable.  I don’t think anyone in the public had any idea about Kennedy`s situation.  

[The Nehor]

Just now, readstoomuch said:

I think it is an interesting conversation about too much vs too little medical treatment to receive with any condition including Covid.  It is easy to be an armchair quarterback.  For me personally if a treatment is fairly innocuous, I would prefer to be a tad on the aggressive side.   I understand that it looks like they might be trying to hide details or not fully disclose medical conditions.  He should be able to have some privacy.  Given my reading about John F Kennedy`s severe back condition and the medications that he was getting during the Cuban Missile Crisis, the level of knowledge that we have about Trump seems reasonable.  I don’t think anyone in the public had any idea about Kennedy`s situation.  

There is a long history of President’s hiding ailments. President Wilson was probably the most extensive with the President largely incapicitated for over a year in office but his VP and cabinet were unwilling to remove him and it was some time before the public found out he was that ill.

I don’t think there is an expectation of privacy any more. You choose to run for President at which point your life is not entirely your own. If they stated that they did not want to reveal anything I would respect that more than obfuscation and lying. There is also Trump’s longstanding policy of mocking his opponents for physical weakness that makes it hypocritical to hide now. He has accused Biden of using “uppers” in the debate and claimed Clinton getting a cold proved her too weak to hold office. Or, as the ghost of John McCain is reputed to now be saying “I prefer Presidents that don’t catch the coronavirus.” I do not see any need to grant him privacy at this time. I consider him to have forfeited that right.

[pogi]

14 minutes ago, readstoomuch said:

I think it is an interesting conversation about too much vs too little medical treatment to receive with any condition including Covid.  It is easy to be an armchair quarterback.  For me personally if a treatment is fairly innocuous, I would prefer to be a tad on the aggressive side.   I understand that it looks like they might be trying to hide details or not fully disclose medical conditions.  He should be able to have some privacy.  Given my reading about John F Kennedy`s severe back condition and the medications that he was getting during the Cuban Missile Crisis, the level of knowledge that we have about Trump seems reasonable.  I don’t think anyone in the public had any idea about Kennedy`s situation.  

If a drug is fairly “innocuous” then there is nothing “aggressive” about it.   You don’t mess with immunocompromising steroids unless you really need them.  There is a reason they are contraindicated with mild symptoms.   We don’t know if Remdesivir is innocuous or not.  That is why it is not available to the American public.

Regarding his health privacy, he has consented to the information given.  But they can’t give a straight story.  Why?

Edited October 4, 2020 by pogi

[readstoomuch]

I would really like the situation with Trump to make sense and have the information.  That usually takes awhile.  We are a good 9 or 10 months into the pandemic and we are still figuring things out.  For instance, if you can be more than six feet from someone at work (social distancing) then do you have to wear a mask?  Is a ceiling fan in a health club good ventilation or does it just toss the air filled with Covid around?  Guidelines are based on statistical models supplemented with contract tracing and followup interviews.  

Yes, maybe they should have limited the information until they had the story straight. I think public figures are allowed to have some level of privacy, though not as much as most people.  

[The Nehor]

The President is reportedly furious that his Chief of Staff Mark Meadows said that he had a rough period and the next few days would be critical and contradicting his doctors. Makes me believe that quote a little more.

This is how I picture his “doctor” at this point:

 

[bsjkki]

 

[The Nehor]

The Secret Service are not happy with this situation:

https://www.washingtonpost.com/politics/trump-seemed-to-defy-the-laws-of-science-and-disease-then-the-coronavirus-caught-up-with-him/2020/10/02/5b4c5232-04bf-11eb-897d-3a6201d6643f_story.html
 

Quote

 

Secret Service agents expressed their anger and frustration to colleagues and friends Friday, saying that the president’s actions have repeatedly put them at risk. “He’s never cared about us,” one agent told a confidant, who spoke on the condition of anonymity to describe the internal reaction.

Former Secret Service agents said it was unheard of for agents to openly complain about their president but that some currently in the ranks had become convinced during the pandemic that Trump was willing to put his protectors in harm’s way.

Agents who work in field offices around the country complained that since late August, they are no longer being tested when they return home from working at a rally for the president.

“This administration doesn’t care about the Secret Service,” one current agent relayed in an internal discussion group. “It’s so obvious.”

Judd Deere, spokesman for the White House, said in a statement: “The President takes the health and safety of himself and everyone who works in support of him and the American people very seriously.” Various staffs work together, he said, to “ensure all plans and procedures incorporate current CDC guidance and best practices for limiting COVID-19 exposure.”

 

Someone should tell the President the history of the Praetorian Guard.

Outside a hospital with a strict quarantine, possibly with people dying getting their last zoom call with their families, and he decides to hold a parade while contagious.

From a doctor at the hospital:

In other news AG Bill Barr is now reportedly self-quarantining. This is a prevalent story but have not found a solid source for it yet. No word yet on whether, if this is true, if it is out of caution or due to a positive test.

Update: The DOJ has said that Barr’s latest test was negative. I am not sure I believe that statement.

Edited October 4, 2020 by The Nehor

[Calm]

4 minutes ago, The Nehor said:

Outside a hospital with a strict quarantine, possibly with people dying getting their last zoom call with their families, and he decides to hold a parade while contagious.

Great, screaming and yelling (more aerosols), packed in and lots of masks missing (let’s all spit at each other and save time and effort).

That some might like to be reassured by seeing him...I can see that, but turning the area into a rally given as you say people are dying there plus just the usual patients’ experiences...seems rather lack of empathy. 

[bsjkki]

26 minutes ago, Calm said:

Great, screaming and yelling (more aerosols), packed in and lots of masks missing (let’s all spit at each other and save time and effort).

That some might like to be reassured by seeing him...I can see that, but turning the area into a rally given as you say people are dying there plus just the usual patients’ experiences...seems rather lack of empathy. 

People have been there since he was admitted. They’re his supporters. He didn’t ask them to come. They just did. He is thanking them.