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Impressions of today's Walter Reed presser:
a) Conley's mea culpa: “I was trying to reflect the upbeat attitude of the team. Didn’t want to give any information that would steer the course of his illness.” Trump's fingerprints.
But even so, today was only slightly better. (1/8)
a) Conley's mea culpa: “I was trying to reflect the upbeat attitude of the team. Didn’t want to give any information that would steer the course of his illness.” Trump's fingerprints.
But even so, today was only slightly better. (1/8)
b/ Biggest news is that T had 2 episodes of hypoxia (down to 93-94% O2 saturation), & Conley evaded whether sat was ever <90. "Never in low 80s" is all he offered.
c/ Re: Chest CT: "There were some expected findings but nothing of concern." What the hell does that mean?...(2/8)
c/ Re: Chest CT: "There were some expected findings but nothing of concern." What the hell does that mean?...(2/8)
...To be clear, the "expected findings" on a chest CT is NORMAL. If it was normal, he should say that. Anything else should have been described.
(The only semi-benign interpretation would be if the prez has a known chronic finding – like a benign nodule – that was seen)...(3/8)
(The only semi-benign interpretation would be if the prez has a known chronic finding – like a benign nodule – that was seen)...(3/8)
... But it seems far likelier that they found evidence of pneumonia or other manifestations of Covid lung involvement or inflammation, which is serious and raises the level of concern and risk. (4/8)
d/ They pulled trigger & started dexamethasone. So they were clearly concerned. Given documented low O2, dex definitely was indicated.
e/ Said they're starting to plan for possible discharge, as early as tomorrow. Even w/ WH's medical capacity, that seems like an awful call. 5/8
e/ Said they're starting to plan for possible discharge, as early as tomorrow. Even w/ WH's medical capacity, that seems like an awful call. 5/8
f/ Yes, they could give his last doses of IV remdesivir in WH, but still risky to discharge. In RECOVERY trial (which proved value of dexamethasone), mortality rate in TREATMENT group for pts requiring O2 was 23.3% (vs. 26.2% in usual care). A nearly 1-in-4 risk of death. (6/8)
g/ Finally, most tellingly: when T was hypoxic, they tried to put him on O2. "He was adamant he didn't need oxygen." In my 35 years of practice, I've never seen a pt refuse oxygen. It's crazy, & illustrates who is running the show, which may well be scariest thing I heard. (7/8)
Bottom line: it seems like Trump is stable, but remains at high risk, given transient hypoxemia, some findings on chest imaging. The happy talk and evasions are clearly at Trump's direction, putting the docs in a terrible position. No way he's ready for discharge tomorrow. (8/8)
