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POTUS is now reported to have COVID symptoms, which, combined with his other baseline risk factors, is concerning. https://www.cnn.com/2020/10/02/politics/president-donald-trump-coronavirus-positive-test/index.html Most likely, he will recover, but the medical path is not assured and the political implications are substantial. https://twitter.com/NAChristakis/status/1312053363916378114
POTUS is confirmed to have fever and cough, consistent with *lower* respiratory infection. If hospitalized, this will indicate even greater severity. The coming week will be very indicative of likely path he will take through this serious viral illness. https://twitter.com/maggieNYT/status/1312121651492872192?s=20
If he is hospitalized in the coming days (and not simply and truly out of an abundance of caution), POTUS will be facing a roughly 1 in 6 chance of death from COVID19.
If he is intubated, the risk will be higher still.
People to whom he spread the disease may also get sick. 3/
If he is intubated, the risk will be higher still.
People to whom he spread the disease may also get sick. 3/
Even in the last few minutes, POTUS is now heading to Walter Reed hospital. If he is admitted, this will be a concern. Remember that coronavirus infection can cause patients to “crump” extremely fast. They can become very sick very fast. 4/
The timing of all this will be worked out soon, but there is a chance that POTUS himself could wind up being the source of a super-spreader outbreak in his staff and among others, given his centrality in his network. 5/ https://twitter.com/ASlavitt/status/1312134788573089792
POTUS just walked across White House lawn to Marine One and climbed a few stairs with ease. That is a positive sign, and less consistent with hospitalization for cause. Hopefully, we will be told reliable and precise information as this case unfolds, to minimize speculation. 6/
Many credible docs on twitter , such as @jflier, are judging that the administration of an unproven drug to POTUS is a bad sign. Again, absent reliable information, it’s so hard to be sure. 7/ https://twitter.com/jflier/status/1312130948289372160
Given the number of cases, it is at this point a rebuttable presumption that there was a super-spreading event of COVID19 at the White House. There will quite likely be more cases emerging, and secondary transmissions too. 8/
Here is a dashboard to track the POTUS COVID-19 outbreak via @bhrenton et al: https://public.tableau.com/profile/peter.james.walker#!/vizhome/COVID-19attheWhiteHouse-ContactTracking/OverviewDash 9/
Photos via @gtconway3d
In a time of a pandemic, this sets a bad example and is not good public health practice. It’s not fair to the friends and family of all these people either. 10/
In a time of a pandemic, this sets a bad example and is not good public health practice. It’s not fair to the friends and family of all these people either. 10/
It will be interesting to see how this pattern develops. There is a correlation, of course, between where people are seated here and the likely intimacy of their social interactions before and after this event. https://www.cnn.com/2020/10/02/politics/mike-lee-tests-positive-covid/index.html 11/
This photo, via @DemFromCT, shows behavior that is very irresponsible. These people have a duty to keep the White House functioning, an obligation to their friends and relatives to whom they could transmit it, and an obligation to set an example of safe practice for the USA. 12/
POTUS may have shortness of breath, if new reports are accurate. This is not a good sign from the point of view of his health. https://www.rawstory.com/2020/10/trump-is-having-trouble-breathing-jim-acosta-reports-white-house-advisor-is-admitting-this-is-serious/ 13/
From the news conference just completed, these observations:
POTUS likely was on oxygen at some point. That is important (unless again for an “abundance of caution”).
Dates of prior negative tests have not been revealed.
He could be moved to an ICU within 24 hours.
14/
POTUS likely was on oxygen at some point. That is important (unless again for an “abundance of caution”).
Dates of prior negative tests have not been revealed.
He could be moved to an ICU within 24 hours.
14/
I think POTUS is probably sicker (and for longer) than they are telling us. And if, as a 74 yo obese man, he has gotten that sick this fast, there is a high chance that he will continue to worsen. He could be in ICU within 48 hrs. It is hard to say given lack of transparency. 15/
This story is so fast-moving. That’s what serious COVID-19 infection is like in the elderly or those seriously ill. Patients “crump” rapidly. This just in! He *is* sicker than described. 16/ https://twitter.com/stevenportnoy/status/1312423908096827392
Late afternoon, October 3: POTUS releases 4 minute video addressing camera. To me, he seems slightly short of breath, but otherwise in decent shape. Yet COVID19 is tricky. He says he is getting "several treatments" and will be in hospital for few days. https://www.cnn.com/politics/live-news/trump-covid-19-updates-saturday/h_6a451f7b6dc44d36059a5dc18c3ddbcd 17/
Commentary by @emptywheel on the video and photographs released yesterday by POTUS document many staged elements, with implications for conclusions about his respiratory and health status.
Still waiting to see if he winds up requiring oxygen or intubation or dexamethasone. 18/ https://twitter.com/emptywheel/status/1312662122627764225
Still waiting to see if he winds up requiring oxygen or intubation or dexamethasone. 18/ https://twitter.com/emptywheel/status/1312662122627764225
On the use of the only decent drug we have so far for the treatment of serious COVID19, dexamethasobe, see this prior thread: 19/ https://twitter.com/nachristakis/status/1275910030567583746
Updated photo of Rose Garden super-spreader event, with Chris Christie. As noted earlier, we are likely to hear of more cases. Via @davidrosenthal 20/
October 4 briefing. We now learn that on Oct 2, POTUS had high fever and oxygenation dips. Not good. Docs worried about rapid progression at that time. They have now started dexamethasone. IMO, is he is still early in course, risks may outweigh benefits (see thread above). 21/
In short, docs & White House were misleading yesterday, they admit. This degrades trust. Can we believe them now?
They did not share X-ray or lab findings.
POTUS is apparently improving and is not on oxygen now. But COVID19 patients can suddenly worsen, still. We shall see. 22/
They did not share X-ray or lab findings.
POTUS is apparently improving and is not on oxygen now. But COVID19 patients can suddenly worsen, still. We shall see. 22/
I want to be clear:
If POTUS is NOT that sick, then starting dexamethasone might actually HARM him, as noted here: https://twitter.com/NAChristakis/status/1275910048787685378?s=20
If he IS that sick, then the use of dexamethasone means they are minimizing how ill he is.
NB @iwashyna 23/
If POTUS is NOT that sick, then starting dexamethasone might actually HARM him, as noted here: https://twitter.com/NAChristakis/status/1275910048787685378?s=20
If he IS that sick, then the use of dexamethasone means they are minimizing how ill he is.
NB @iwashyna 23/
Using data in RCT that showed efficacy of dexamethasone, and making rough adjustment for age, sex, & condition, and as noted above, POTUS risk of death may now be as high as 1/3.
So the upbeat presentation by his doctors is confusing. I don't know if they are being truthful. 24/
So the upbeat presentation by his doctors is confusing. I don't know if they are being truthful. 24/
In addition to the risk of death, which I think is as high as 25-33% (if we can believe facts we've been given), POTUS faces other neurological risks, including from COVID-19 itself and, now, its treatment. https://twitter.com/jflier/status/1312794587971358721?s=20 via @jflier 25/
Fine analysis by my colleague @hmkyale regarding the antibody treatment given to POTUS. Note that, given how POTUS differs from trial participants, I suspect this treatment will be of minimal value in him. Impossible to say for sure, however. 26/ https://twitter.com/hmkyale/status/1312815735018840064
