There was another update on President Trump’s COVID from Walter Reed and the medical team.
Trump is now getting the steroid Dexamethasone. This was due to oxygen levels getting to around 94. The steroid Dexamethasone was given to patients in the UK. COVID patients requiring only oxygen, mortality was cut by about one fifth.
Trump is on the second day of five days of Remdesivir. Trump received the Regeneron antibody cocktail a few days ago.
The team mentioned they are considering discharging Trump to the White House tomorrow. Tomorrow would be day 5 of symptoms. Days 7-10 are the time when COVID can turn acute with little warning. However, those days of disease progression are without the entire treatment range. The White House normally has about twenty-five medical staff. This situation would see far more medical staff and equipment at the White House.
COVID-19 patients may be discharged from the hospital and moved to home care (or other types of non-hospital care and isolation) based on:
* clinical criteria (e.g. no fever for over 3 days, improved respiratory symptoms, pulmonary imaging showing obvious absorption of inflammation, no hospital care needed for other pathology, clinician assessment)
* laboratory evidence of SARS-CoV-2 clearance in respiratory samples; 2 to 4 negative RT-PCR tests for respiratory tract samples (nasopharynx and throat swabs with sampling interval ≥ 24 hours). Testing at a minimum of 7 days after the first positive RT-PCR test is recommended for patients that clinically improve earlier.
* Serology: appearance of specific IgG when an appropriate serological test is available.
I would think that the Walter Reed team would be sure all of these tests show clearance of the virus before they discharged.
SOURCES- CSpan, ECDC, Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19
A Randomized Clinical Trial, JAMA. 2020;324(11):1048-1057. doi:10.1001/jama.2020.16349
Written By Brian Wang, Nextbigfuture.com