Trump’s determination to attend next week’s debate, seen as part of a reckless pattern

However, Trump’s determination to attend the debate on October 15 by some outside health professionals is part of the reckless pattern that defined his response to the pandemic, the president and his aides. Said he was not wearing or observing the mask Avoid crowds.. At least 19 people His staff, campaigns, or anyone who attended a recent White House event have tested positive for the virus in the past week.

On Tuesday, White House doctor Sean P. Conley continued to report brightly about Trump’s recovery and issued a three-sentence note that the president had a stable vital sign of “not reporting symptoms.” .. “Overall, he’s doing very well,” the memo said.

How Conley and other White House officials know when Trump may be safe to go out in public for his own health or for others near him. It doesn’t say whether to decide.

Some outside medical experts said the president’s actions were due to his own experience of being infected with the virus, which killed more than 210,000 Americans, or the spread of the infection between his own staff and supporters. He suggested that he was showing dissatisfaction.

Playing cards Removal of his mask Michael Mina, a doctor and assistant professor of epidemiology at Harvard University TH, said shortly after returning to the White House on Monday night, and his subsequent allegations that he would participate in the debate were “irresponsible, reckless and frank. It borders on malicious things. ” Chan School of Public Health.

“We should throw him a kitchen sink, not only for treatment, but also to ensure that he can safely enter society and not risk the citizens of this country,” Mina said. I did.

Mina said the president’s medical team has many ways to determine the status of his infection. Besides performing the “PCR” test, which is considered the most definitive way to assess whether someone has the virus, doctors cough on Petri dishes to see if the virus propagates. Or wipe the nose to culture the specimen, or do an antigen test to see if there is viral protein in the nose.

“The average American doesn’t have the tools to go through this,” Mina said. “But the president is a very special person. There are tools to do this.”

Guidelines say that Covid-19 patients with serious illness may need to remain isolated from the first symptoms for as long as 20 days.

The CDC has not defined a serious case, and Trump’s doctors withhold specific information that gives a clearer indication of his condition. For example, whether blood oxygen levels have dropped twice, and whether CT scans show signs of pneumonia or lungs. damage.

If Trump develops symptoms late last week, the 10-day window ends before the discussion.

External doctors discussed whether 10 days of mild to moderate cases should be applied to the president and whether it would be premature to go public next week.

Thomas M. File Jr., an infectious disease specialist in Akron, Ohio and chairman of the Infectious Diseases Society of America, said that the company he works for, Summa Health, generally follows CDC guidelines. Except in the most serious cases, he said, “I will allow someone to enter the general public within 10 days of the onset of symptoms.”

Georges C. Benjamin, secretary general of the American Public Health Association, said most patients became infectious after 10 to 14 days. But given the known timing when Trump began to feel sick, “He’ll be really close. All you have to do is be wrong within a day or two, and He can still be easily infected .. .. will be tight. “

Rajesh Gandhi, an infectious disease physician at Massachusetts General Hospital and Harvard Medical School, said the CDC guidelines made sense, but emphasized that the cases of covid-19 were very different. About 80% of people have no symptoms or have mild to moderate illness. Another 15% have been hospitalized for serious cases like the president, and the remaining 5% are seriously ill, according to Gandhi.

“On average, I repeat the most cautious things about a week after my symptoms appear,” Gandhi said.

According to Mina, the CDC guidelines are the average for the entire population and balance the risk of transmitting the virus with the desire of people to return to work and other aspects of normal interaction.

“The president is in a position to act as an absolute gold standard,” he said, adding that Trump needs to get as much testing as possible. “Given that he is president, there are so many opportunities for communication with people given that he is doing so many things.”

Despite what seemed to be the president’s dyspnea, experts had little to worry about Trump’s brief appearance in the White House.

“What I saw was that he stood there and took a deep breath. He had just climbed two flights with a mask on his face,” said Johns Hopkins lung and critical care specialist. Said David Hager. “I think he looks good.”

Other doctors thought it might be premature for Trump to make a plan for his health. It’s just because of the unpredictable course of the disease.
John Zello, head of the Philadelphia-based Jefferson Health Infectious Diseases Division, said the president’s plans could change as the disease progresses, deceiving doctors and patients alike. It was.

People who look and feel good can suddenly crash and need to be ventilated, Zerlo said. “if [the president’s doctors] Not waiting to be ready to do it, they would be stupid. This infection is quite capricious. “

Kevin Chess, a critical care neurologist at Yale University, said the president should be monitored and tested for cognitive problems.
“You want to survive the respiratory tract, but you know there are neurological complications,” he said. These may include problems such as stroke, inflammation, and long-term changes in cognitive function.

“For those in a leadership position, that’s what I’m worried about,” Chess said. “Obviously, the virus in some patients affects the brain.”

Many public health officials and some doctors believe he has given the tweet and symbolism of action since the president’s diagnosis, and the safety message he is trying to convey to curb the worst public health crisis in the United States. For over a century, he said he was angry with the damage.

A few hours before leaving the hospital on Monday, Trump tweeted. “Don’t be afraid of Covid. It shouldn’t dominate your life.”

His tweet said, “I feel better than 20 years ago!” External doctors have pointed out that the treatment Trump is receiving includes dexamethasone, a steroid used to treat inflammation. This has been shown to increase survival in the most ill covid-19 patients. Side effects of the drug include insomnia, irritability, and euphoria.

Keith Hamilton, an infectious disease specialist and associate professor of clinical medicine at the University of Pennsylvania Perelman School of Medicine, said: “Steroids make everyone feel good.”

Some doctors said they saw patients taking steroids getting angry, confused, and mania, but such cases are rare and people usually get high doses. It occurred when I received it.

Former Dean of the School of Public Health Johns Hopkins Bloomberg, who used public health tools to fight diseases such as smallpox worldwide, said the president thought short-term about his own recovery and reelection. Said that. The pandemic is far from running that course. “

“We are exorbitantly and irresponsibly ignoring our best and most informed medical knowledge and public health practice advice,” Trump claimed.

Peter Bayrenson, director of health services at Sacramento County, where cases of coronavirus were seen, made his own efforts to counter people’s desire to abolish public health measures as the danger appears diminished. He called the president’s actions “totally irresponsible.”

“This is the best-treated man in the world funded by taxpayers, behaving as if it weren’t a big deal, and we need to deal with it,” Bayrenson said. Over 210,000 According to him, death is a myriad of patients known as long-distance transporters, “people with widespread problems with respiratory, heart, nerves, months, and perhaps forever. I don’t know.”

Josh Schaffstein, vice dean of public health practice and community involvement at the Johns Hopkins Bloomberg Public Health School, said that even if the president won the fight against the virus, it would undermine the well-being of Americans. “The confusion he causes benefits the virus,” Sharfstein said.