Back on October 2, 2020, President Donald Trump was admitted to the Walter Reed Army Medical Center with COVID. One medicine probably saved his life. It wasn’t the one he had imagined.
Just a suggestion, Dr. Offit. Maybe you should continue to offer your newsletter for free so people who want to understand your sharp analysis can do so without regard to ability to pay. But like many other Substacks, maybe you should require payment for those who want to comment. That way, if uneducated trolls want to comment (see below), they at least have to pay for it.
Was Dr Offit part of the treatment team? How does he know it was Trump who refused care and denied his illness? Many patients were told early on to go home if they were sick and only come back if they were unable to breathe or got really sick. That was standard.
Wasn’t the patient lucky that Remdisivir didn’t flood his lungs with fluid? And how amazing that he was treated “improperly” and survived the virus. And isn’t it a shame that the steroids weren’t heralded as a helpful treatment but not a lot of the general public know this. Wonder if other antivirals besides Pfizer’s new paxlovid were studied for early virus stage intervention. I am definitely going to read Offits book. We had a family member who got Covid in 20 and only lost taste and vomited for a day. (Tested positive) will be interested if he addresses those symptoms. Our famil
Thank you for describing the stages of the illness and the process of treatment, Dr Offit. And also for reminding us that we really did not know much about how to treat and probably still don’t. I am surprised that Paxlovid is mentioned as a solution. The treatment plan should be between doctor and patient and there are quite a few people who are not eligible for paxlovid.
Corticosteroids. If only we'd known early on that suppressing inflammation was so critical.
Somewhat tangentially, I recall early on that ER docs like Dr. Pierre Kory (who was effectively blacklisted for his later support of Ivermectin) noticed that patients had manifestations of hypoxia approximating Organizing Pneumonia, which is treated with corticosteroids. He was not the only one who made this observation, but it took him and others months to get the rest of the community to understand that this was not a normal situation.
Specifically required 'symptomatic, unvaccinated, nonhospitalized adults' and 'Key exclusion criteria were previous confirmed SARS-CoV-2 infection or hospitalization for Covid-19'.
If Mr. Trump were to get another bout of infection, I don't see RCT data indicating this would be an effective treatment.
Thank you for this. The reference stirs up so many memories. I wasn't there and admit to no first hand knowledge but watched and read every tidbit. If you recall, the former president had been on the campaign trail and preparing for the debates. Chris Christie his debate partner had been hospitalized with severe COVID complications. One of the former president's closest staff members (Hope Hicks) was dx with COVID and had to isolate on AIR FORCE 1. I believe he returned to travel and perhaps even the debate (my memory is clouded) despite being symptomatic. He tested positive but delayed the announcement until a midnight call to FOX NEWS. He had access to the finest ID physicians in the nation at WRMMC ( as I recall his consultants were from JHU ) and NIH is across the street, not to mention Dr. Fauci a phone call away. I have no doubt the medical staff did due diligence and offered the best known care. My guess is that DJT fought them all the way. His political advisors made sure that Dr. Conley humiliated himself and briefed the press with an unlikely story. The former president's COS whispered to reporters that DJT was in fact much sicker. DJT defied no doubt all medical recommendations and went for a ride around the hospital exposing the secret service agents in the car. I remember everyone wonder if the decadron high enabled his winded walk up the stairs on his return to the White House. Agree, much was not yet known at that time about the new medications but my best guess is that denial and " a show of strength " delayed the best care possible. And, of course, now we read that his personal physician was a covid denier.
Just an internist with no special training but Neither EPIC HR or EPIC sr apply so do you have an RCT that applies for vaccinated, previously infected patient over 50 or older with current strains to recommend paxlovid. Thanks for your time and consideration.
Thanks for your post, Paul. Always informative. I seriously doubt that a stubborn and ignorant person like Trump would take your advice or that from any other health expert if he gets COVID-19 again. In fact, it’d be better if no advice is given so that natural selection ensues. Many of us want a better world.
Your article reads like a pharmaceutical advertisement. I like to think that you suffer from some sort of brainwashing or complete lack of critical thinking skills, because the alternative
is that you are writing these lies knowing full well that the risks of your purported regimen far out weigh the benefits and that the risks include death and permanent disability.
Dexamethasone was indeed the likely best treatment for him at the time. And your characterization, that we were still learning about the timing for MCA and antivirals was exactly correct, although some of us had started sorting that out. Unfortunately, we were still confused by the timing for dexamethasone… but once we realized its benefit was in reducing the effects of cytokine storm, that issue was on its way to resolution. Perhaps the biggest problem was the lead physician managing that particular patient had a patient who thought he was able to dictate, successfully, his own medical care. There’s little doubt in my mind that Trump checked out AMA and should have convalesced at WRNMC for upwards of a week rather than rushing a return to the White House. But that was how that particular patient played out.
Thank you for making this available. Retired and on a fixed income, I can’t afford to pay separately to read or listen to all I would like. Question: Do you think the behaviors witnessed over the past year or so are signs of damage to the patient’s brain?
What is increasingly clear is that Offit (whose entire carreer was sponsored by the industry which profits from injecting children) is a political hack. Always was, always will be. That explains a lot of the scientific fraud. Watch out children.
Decadron was/is highly effective and is cheap. Every time I hear this ivermectin conspiracy nonsense from Weinstein/Rogan/etc, about how the research was suppressed so that the vaccine could be approved, I always wish someone would ask him, “what about decadron?” Decadron is cheap, effective and safe, yet somehow it wasn’t surpressed in the same manner that you feel ivermectin was. Unless, of course, ivermectin (like hydroxychloroquine) does not work.
Just a suggestion, Dr. Offit. Maybe you should continue to offer your newsletter for free so people who want to understand your sharp analysis can do so without regard to ability to pay. But like many other Substacks, maybe you should require payment for those who want to comment. That way, if uneducated trolls want to comment (see below), they at least have to pay for it.
Was Dr Offit part of the treatment team? How does he know it was Trump who refused care and denied his illness? Many patients were told early on to go home if they were sick and only come back if they were unable to breathe or got really sick. That was standard.
Wasn’t the patient lucky that Remdisivir didn’t flood his lungs with fluid? And how amazing that he was treated “improperly” and survived the virus. And isn’t it a shame that the steroids weren’t heralded as a helpful treatment but not a lot of the general public know this. Wonder if other antivirals besides Pfizer’s new paxlovid were studied for early virus stage intervention. I am definitely going to read Offits book. We had a family member who got Covid in 20 and only lost taste and vomited for a day. (Tested positive) will be interested if he addresses those symptoms. Our famil
Thank you for describing the stages of the illness and the process of treatment, Dr Offit. And also for reminding us that we really did not know much about how to treat and probably still don’t. I am surprised that Paxlovid is mentioned as a solution. The treatment plan should be between doctor and patient and there are quite a few people who are not eligible for paxlovid.
Nope. There is no good evidence for Paxlovid in somebody with prior immunity.
And none for Remdesavir either.
Corticosteroids. If only we'd known early on that suppressing inflammation was so critical.
Somewhat tangentially, I recall early on that ER docs like Dr. Pierre Kory (who was effectively blacklisted for his later support of Ivermectin) noticed that patients had manifestations of hypoxia approximating Organizing Pneumonia, which is treated with corticosteroids. He was not the only one who made this observation, but it took him and others months to get the rest of the community to understand that this was not a normal situation.
I am concerned the Paxlovid recommendation is misinformation.
Can someone direct me to the evidence that shows paxlovid provides benefit to previously infected and vaccinated individuals who contact COVID?
The approval trial EPIC-HR : https://www.nejm.org/doi/full/10.1056/nejmoa2118542
Specifically required 'symptomatic, unvaccinated, nonhospitalized adults' and 'Key exclusion criteria were previous confirmed SARS-CoV-2 infection or hospitalization for Covid-19'.
If Mr. Trump were to get another bout of infection, I don't see RCT data indicating this would be an effective treatment.
Thank you for this. The reference stirs up so many memories. I wasn't there and admit to no first hand knowledge but watched and read every tidbit. If you recall, the former president had been on the campaign trail and preparing for the debates. Chris Christie his debate partner had been hospitalized with severe COVID complications. One of the former president's closest staff members (Hope Hicks) was dx with COVID and had to isolate on AIR FORCE 1. I believe he returned to travel and perhaps even the debate (my memory is clouded) despite being symptomatic. He tested positive but delayed the announcement until a midnight call to FOX NEWS. He had access to the finest ID physicians in the nation at WRMMC ( as I recall his consultants were from JHU ) and NIH is across the street, not to mention Dr. Fauci a phone call away. I have no doubt the medical staff did due diligence and offered the best known care. My guess is that DJT fought them all the way. His political advisors made sure that Dr. Conley humiliated himself and briefed the press with an unlikely story. The former president's COS whispered to reporters that DJT was in fact much sicker. DJT defied no doubt all medical recommendations and went for a ride around the hospital exposing the secret service agents in the car. I remember everyone wonder if the decadron high enabled his winded walk up the stairs on his return to the White House. Agree, much was not yet known at that time about the new medications but my best guess is that denial and " a show of strength " delayed the best care possible. And, of course, now we read that his personal physician was a covid denier.
Just an internist with no special training but Neither EPIC HR or EPIC sr apply so do you have an RCT that applies for vaccinated, previously infected patient over 50 or older with current strains to recommend paxlovid. Thanks for your time and consideration.
Thanks for your post, Paul. Always informative. I seriously doubt that a stubborn and ignorant person like Trump would take your advice or that from any other health expert if he gets COVID-19 again. In fact, it’d be better if no advice is given so that natural selection ensues. Many of us want a better world.
Your article reads like a pharmaceutical advertisement. I like to think that you suffer from some sort of brainwashing or complete lack of critical thinking skills, because the alternative
is that you are writing these lies knowing full well that the risks of your purported regimen far out weigh the benefits and that the risks include death and permanent disability.
Dexamethasone was indeed the likely best treatment for him at the time. And your characterization, that we were still learning about the timing for MCA and antivirals was exactly correct, although some of us had started sorting that out. Unfortunately, we were still confused by the timing for dexamethasone… but once we realized its benefit was in reducing the effects of cytokine storm, that issue was on its way to resolution. Perhaps the biggest problem was the lead physician managing that particular patient had a patient who thought he was able to dictate, successfully, his own medical care. There’s little doubt in my mind that Trump checked out AMA and should have convalesced at WRNMC for upwards of a week rather than rushing a return to the White House. But that was how that particular patient played out.
Thank you for making this available. Retired and on a fixed income, I can’t afford to pay separately to read or listen to all I would like. Question: Do you think the behaviors witnessed over the past year or so are signs of damage to the patient’s brain?
You either violated health privacy or you aren't telling the truth. Which one?
I want to know why when I block Albus, I still see his comments. I guess I will have to file a bug report with Substack.
What is increasingly clear is that Offit (whose entire carreer was sponsored by the industry which profits from injecting children) is a political hack. Always was, always will be. That explains a lot of the scientific fraud. Watch out children.
Decadron was/is highly effective and is cheap. Every time I hear this ivermectin conspiracy nonsense from Weinstein/Rogan/etc, about how the research was suppressed so that the vaccine could be approved, I always wish someone would ask him, “what about decadron?” Decadron is cheap, effective and safe, yet somehow it wasn’t surpressed in the same manner that you feel ivermectin was. Unless, of course, ivermectin (like hydroxychloroquine) does not work.
Small correction. The monoclonal antibody treatment was called REGEN-COV. The company that made it is Regeneron.