The letter from the treating physician for the US president is emblematic of “VIP medicine”. Almost none of it is a good idea even on its own, and no one has a clue what happens when you throw all these therapies together in one giant bag of too much.

Monoclonal antibodies (not polyclonal antibodies, as the letter indicates) are a promising therapy and we have two very early hints from premature soft reports. So that’s outstripping the evidence, but it’s not crazy.The vitamin D and famotidine are crazy town,

There’s no good evidence for zinc, and the letter does not even mention remdesivir, which (admitting that critics are skeptical of a massive effect), I think does have reasonable evidence for moderate effectiveness. The trials of aspirin are just getting underway.

Presumably the treatment strategy is changing as the president is admitted to the hospital, but the treatment regimen used according to the initial letter released was very strange. But also entirely typical of how “very important persons” are commonly treated when they get sick.

After watching that cottage industry in a premier teaching hospital, I developed the conviction that I would never want to be treated medically as a very important person. The letter from the presidents physician confirms me in that conviction.