Because, as I understand it (I’m not a doctor), if you give it to them as a precaution you’re repressing the immune system which is not what you want at that stage. This does look very serious. And the fact the doctors are being more honest about this treatment shows that they are genuinely worried about him.
Yes. The point of dex is to inhibit the immune system. Because the respiratory distress caused by an over active immune system is more of a danger to that patient at that point than the virus itself. It is not something you would give lightly to a patient with a virus because it is not specific with regard to immune suppression.
You are reading too much into the early administration of steroids. They take some time to work. I would give it in a mild case too. Particularly for an important case.
The effects of dexamethasone are nearly immediate. Within minutes.
Interesting question: Given the mixed messages we are getting about his condition, is trump being treated by his doctors or real doctors at Walter Reed?
“The President is perhaps the best protected person on the planet. If this virus can affect him, then it can affect anybody.”
Uh. Masks. He and all those around him could have been required to wear masks. It’s just that simple.
The spin doctors are saying – and, surely, a good number of Trump’s supporters are accepting – effectively this:
“Bob got drunk that evening and hopped on his motorcycle without a helmet. Despite the fact that he was traveling at over 100 miles per hour when he crashed into that large oak tree … it could not have been helped. If it could happen to Bob, then it could happen to any of us.”
We get the politicians we deserve. The evil and cynical perpetually prey on the tribal and ignorant.
Right? I said elsewhere, Trump better hope this doctor is better at doctoring than at answering questions of the press.
Dexamethasone, IMHO - will make all but the most critically ill people functional — for a little while.
I remember this from my late partner’s illness. He was a few weeks away from death due to pancreatic cancer, he’d lost 50% of his body weight and looked like a concentration camp news photo. And he popped that pill and went grocery shopping, cooked a 4 course gourmet dinner, played poker until midnight and drove himself home. If he dressed in bulky clothing we could really pretend nothing was wrong,
I loved that drug and the way it let us maintain the illusion of normalcy until the last minute. It’s a powerful thing.
And better than the one who can’t spell.
I would suggest the “may leave hospital on Monday” is being hopefully upbeat at best.
Conspiracies this complex are almost impossible to carry out without someone spilling the truth to the public, especially in a White House as ‘leaky’ as this one.
Or downbeat.
He’s still early in the symptomatic phase. Usually the crisis point hits 7-10 days after the onset of symptoms. He’s still got a ways to go.
But if he’s on that drug then either I’m misunderstanding how it works, the doctors are applying it too early, he’s rapidly deteriorated faster than the typical patient (indicating some comorbidity we don’t know about?), or he’s actually had the virus for much longer than has been indicated.
Or they wanted to get him looking like he was strong and barely affected by the disease. When I’ve seen this used the patient would crash hard when it wore off, we probably won’t get to see it when that happens.
None of those are mutually exclusive of each other.
Well the first one’s probably true, the rest all might be simultaneously true as well…
On dexamethasone treatment.
Although suppression of the immune system is a concern, it does not appear to be correct that it’s indicated only for extremely serious cases. Perhaps the WHO guidelines linked above are taking a conservative approach. If I read this JAMA article correctly, the evidence from the UK study supports its use for anyone on supplemental oxygen.
While early observational data from China suggested a potential mortality benefit of corticosteroids in COVID-19,10 previous studies of corticosteroids in other viral pneumonias, especially severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), found an association with delayed viral clearance, and reinforced concerns that corticosteroids may impair host response to SARS-CoV-2.…
[BUT…]
With a press release on June 16, 2020, reporting the results of the UK-based RECOVERY trial, the existing approach for treating and studying patients with COVID-19 underwent a major change. In this large open-label randomized trial enrolling 6425 patients (2104 randomized to receive dexamethasone and 4321 randomized to receive usual care), treatment with dexamethasone (6 mg/d for 10 days) reduced mortality by one-third in patients receiving mechanical ventilation (29.3% vs 41.4%, respectively; rate ratio, 0.64 [95% CI, 0.51-0.81]) and by one-fifth in patients receiving supplemental oxygen (23.3% vs 26.2%, respectively; 0.82 [95% CI, 0.72-0.94]) compared with usual care alone.13 However, there was no benefit among patients not receiving respiratory support (1.19 [95% CI, 0.91-1.55]), and the possibility of harm could not be excluded.
I’m baffled why they would create this expectation. Now if he doesn’t leave the hospital on Monday, it means that he’s doing worse than they expected. Why say anything at all about a discharge date?
The Trump photographs were staged. Because they’re too stupid to strip out the EXIF data from the images, we know the two “working” photographs supposedly in two different locations and times of day, were in fact staged 10 minutes apart. This explains why he’s signing a blank piece of paper with a Sharpie. source. Or, if you don’t like that source, you can verify yourself with many of the free online EXIF reader tools.
It’s well and good to be skeptical of anything that sounds like a conspiracy theory, but it’s just naive and credulous to automatically dismiss every suspicion of an administration that’s been repeatedly caught in clumsy lies like this.
The higher the stakes are, the more they double down and lie. Right now we’re pretty much at the high-water mark of Trump’s existence, stakeswise.
People on supplemental oxygen are already defining the patient population into “serious” cases. So, dex is given to one fifth of patients that are already in a segment of serious cases.
Obviously, he is president, so these numbers might be meaningless because he will get stuff that other people wouldn’t. But you don’t give dex to a patient lightly. This isn’t a vitamin pill where you say that it can’t hurt. It does have serious side effects and it can be a bitch to taper off once it is started.