Among the now nearly 7.9 million Americans infected with Covid-19 we can include the President and First Lady of the United States. More on this later.
Unfortunately, the ravages of COVID-19 are increasing in our country. Forty-one states are experiencing rising case numbers with nine states recording all-time high numbers of daily cases. There were 56,191 new cases yesterday. Dr. Anthony Fauci stated yesterday that the daily case counts need to be under 10,000 for him to feel comfortable about limiting spread. The infection rate is over 5% in thirty states, with 11 of those being over 10%, and Idaho and South Dakota being over 20%. We have lost 213,360 of our fellow citizens to this virus.
On the news front, science has won two battles over political White House influence, at least for now. This is evidenced by the CDC finally posting that this virus is indeed spread airborne by aerosol and the FDA has passed rules preventing COVID-19 vaccine release before adequate testing. Several universities, sports organizations, and some airlines have demonstrated that adequate, rapid results, accurate testing facilitates safer operations. We can only imagine where life in America would be if the President had, or would, use his unique authority to fully implement the Defense Production Act to doggedly address testing and PPE shortages. Of course, testing alone will not keep us safe. Yet it is the gateway to contact tracing and isolation of those who are contagious. We must still WEAR, WASH, and WATCH. Secondly, in the news front is a Northwestern University study that reveals 8 of 10 hospitalized COVID-19 infected patients suffer from neurological complications. Approximately 10% of the patients had symptoms so severe that they were unable to care for their own affairs. Thirdly, in a study published on October 8 in the New England Journal of Medicine, the antiviral drug Remdesivir was shown to shorten the time to clinical improvement in hospitalized patients with Covid pneumonia from 15 days down to 10 days. Unfortunately, its use did not change the number of people requiring ventilators nor the risk of death in the study patients. Lastly, the news is that two companies have requested Emergency Use Authorization from the FDA requesting that their monoclonal antibodies be made available in appropriate circumstances. These disease fighting antibodies are still being studied but are showing promise in small numbers of people with COVID-19. Ironically, their development has utilized fetal tissue research which the Trump administration severely limited in 2019.
The shortcomings of testing alone are apparent considering that a “superspreader event” apparently occurred at the White House. This presidential administration is known for touting its testing program allows them to disregard mask wearing and social distancing during its daily work and gatherings. It is now also known for 22 infections amongst staff and personnel. It is reported that the much relied upon Abbott rapid test has produced up to 30% false negative results (meaning the test is negative although the person actually has COVID-19). Secondly, any diagnostic test cannot be blamed IF it is not actually being conducted! The White House has declined to reveal when the President took his last negative test before the positive test was announced on Friday October 2nd. From a public health standpoint this really matters since the science states that a person is most contagious up to 2-3 days before testing positive. Those people who attended events or who were in close contact with the President deserve to be notified and contact tracing implemented to prevent further spread.
Since the doctors who know are not telling the public the severity and duration of Mr. Trump’s infection, we as physicians, cannot scientifically comment on the usage of experimental monoclonal antibodies. They were heretofore only used in a handful of COVID-19 patients outside of clinical trials. We know that Remdesivir and the steroid Dexamethasone, which he reportedly received, are approved to be used in moderate and/or severe COVID-19 disease. We also know that, except for the steroids, those treatment which he received are not available to every citizen, even if necessary. This demonstrates another profound inequity in our healthcare system.
VOTE! The person who is President has a huge influence on your health and very existence.
Clyde E. Henderson, MD
Treasurer
Cincinnati Medical Association