After being diagnosed with COVID-19 last week before heading to the hospital, President Donald Trump received cutting-edge coronavirus treatments and the best health care that the United States has to offer. Today, Trump reportedly left the hospital in good spirits, telling the public "don't be afraid of COVID," in spite of the 210,000 American deaths from COVID-19 registered so far.
Yet the treatments and the medical care lavished on Trump and which led him to a quick recovery were unique, experts say. Indeed, the president had access to special medical resources, drugs and attention that the average COVID-19 hospital patient is unlikely to get, and which likely sped his recovery and greatly raised his chance of recovery.
The president's regimen at Walter Reed National Military Medical Center in Washington, D.C. included the steroid dexamethasone to address his lowered oxygen levels, according to The New York Times. Medical experts agree that the use of dexamethasone suggests the president's lungs were compromised, as that drug is intended to stop one's immune system from killing the patient with an immune overreaction. Notably, the drug is only recommended for patients with severe illnesses, because it is quite risky. If given to a patient who does not need it, dexamethasone actually increases their chances of dying.
"Dexamethasone is only approved for patients with very severe disease mechanically ventilated in the hospital, so the President does not fit the criteria for dexamethasone by the statements coming from his doctors, and this drug can cause harm in more mild disease," Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California–San Francisco, told Salon by email.
Trump is also receiving a five-day course of the antiviral drug remdesivir, according to CNN. This drug is meant to improve recovery time for patients. In August the medical journal JAMA revealed that remdesivir was successfully used during a Phase 3 clinical trial (the last phase before a tested substance can officially become a drug) in hastening recovery for patients who were moderately ill with COVID-19.
"Remdesivir may shorten hospital stays but are usually given to patients with more severe disease, although the severity of disease was difficult to tell with the conflicting information coming out about the President regarding oxygen saturation and other signs/symptoms," Gandhi told Salon.
In addition to dexamethasone and remdesivir, Trump is also receiving an 8 gram dose of an experimental drug called REGN-COV2 from the biotechnology company Regeneron, according to CNBC. Although the Food and Drug Administration (FDA) has not approved REGN-COV2 for public use, the president is being allowed to take it due to a "compassionate use" request by his staff. REGN-COV2 is a monoclonal antibody treatment that, according to Regeneron's website, shows "greatest improvements in patients who had not mounted their own effective immune response prior to treatment."
In an interview with CNBC, Regeneron CEO Dr. Leonard Schleifer explained the decision to allow Trump to use their experimental medication as "a very tough situation" for the company, arguing that they were taking "a principled approach" and concluding that "giving it to [Trump] or to others who might not be able or don't qualify for clinical trials is the right use of compassionate use. That's for small numbers of people, for these exceptions. We want everybody to be potentially able to benefit. We understand we don't make that decision. This is a decision the FDA has to make."
If Trump leaves the hospital today as he has stated he will, it is very possible that his specialized medical care is what helped him recover so quickly. The president's age, weight and sex put him into a high risk category, and there is a chance that despite the medical community's best efforts, he may join the ranks of presidents like William Henry Harrison who died in office because they ignored medical advice (in Trump's case, to wear a mask and social distance).
Yet assuming Trump's medication regimen did indeed speed his recovery, does that mean other Americans will also benefit from similar treatments?
"The therapies that President Trump is getting are available to many patients with COVID-19, [but] there are two issues," Dr. Georges Benjamin, executive director of the American Public Health Association, told Salon by email. "The first is VIP medicine where there is the risk of over-treatment or under-treatment because of who he is and not his clinical condition. We don't know the extent of this either way because they have not been as transparent with his clinical status." Benjamin specifically expressed concern about Trump being prescribed dexamethasone because it can be dangerous.
"The second issue is the fact that he has universal access to all the care he needs from the military health care system, which in fact has all the attributes of a single payer health system: a form of health care funding and delivery he has politically opposed," Benjamin added. "Most Americans do not have access to that kind of care at one of the best hospitals in the world. Access to any test he needs, and any medication, without a concern for costs."
Dr. Richard D. Wolff, professor emeritus of economics at the University of Massachusetts Amherst, echoed Benjamin's observations.
"Privilege is the key adjective to describe not only the medical care Trump is now receiving but the entire package of first-rate health care provided freely to top officials, the Congress, etc," Wolff wrote to Salon. "It is a long-standing reproach to the deep inequalities of US capitalism that the same governmental officials whose votes deny a first-rate universal health care system to the mass of Americans can and do luxuriate in just such a system for themselves. It only adds insult to that injury that the President gets medicines and treatments not available to the public."
He added, "Were democracy to be taken seriously, especially in a country as rich and medically equipped as the US, the quality of healthcare given to officialdom would match that given to us all."
Gandhi expressed the same view, telling Salon that "the drugs the President got are not given to ordinary Americans, especially the antibody cocktail which has not been approved and is still under study. Similarly, a patient of his description would not be given medications for severe disease (Remdesivir, dexamethasone) since the steroids can be harmful and the anti-viral is of uncertain efficacy in that situation."