The Health 202: Trump is taking Regeneron’s new coronavirus treatment. It’s used for mild symptoms.

But Trump is also taking a vaccine-like drug made by Regeneron Pharmaceuticals, a promising covid-19 treatment.

Researchers are using Regeneron’s experimental antibody drug in a very different way: They’re giving it to patients with only mild symptoms. 

Many experts view the drug as the best bet to stymie the coronavirus and transform it from a potentially lethal disease into a treatable illness. 

“This drug, called a monoclonal antibody cocktail, aims to keep people out of the hospital altogether,” my colleague Carolyn Y. Johnson wrote recently. “The experimental shot of lab-generated antibodies imitates the body’s own disease-fighting force. The goal is to boost a person’s immune defense, instead of waiting for human biology to muster its own response — and possibly lose to the virus.” 

The antibodies are grown in rodents that are genetically engineered to have humanized immune systems, Carolyn explains. 

Last week, Regeneron announced its drug appeared effective against the virus, reliving symptoms when given to people recently diagnosed with covid-19. And last month Eli Lilly announced interim data that its monoclonal antibody seemed to reduce hospitalizations when given to people, although the data haven’t yet been peer reviewed.

Trump may be returning home today from Walter Reed National Military Medical Center after a three-night stay.

Conflicting and incomplete reports from the White House and Trump’s doctors provoked a flurry of questions about exactly how sick the president was. 

Trump’s doctors said he had a “high fever” on Friday and his blood oxygen levels dropped that day and again on Saturday. Yet he briefly left the hospital to wave to supporters and appeared in two videos insisting he was feeling better. 

“We’re getting great reports from the doctors,” Trump said in the video before promising a “little surprise” to his supporters. “It’s been a very interesting journey. I learned a lot about covid.” 

The attending physician at Walter Reed National Military Medical Center noted the risk to Trump’s Secret Service agents:

The White House also still won’t say whether President Trump is on Day 5 or further along in the course of his coronavirus infection, prompting widespread confusion over when the president first contracted the virus. 

The president was given Regeneron’s drug before heading to the hospital on Friday.

That’s great timing, if Friday was only the second day of Trump’s infection.

“He’s got therapy so early, I think he’s out of the woods,” said Carlos Del Rio, professor of medicine and global health at Emory University. 

But it’s not entirely clear Trump was infected with the virus on Thursday. While the president tested positive for the virus twice that day, administration officials haven’t answered questions about whether he was tested for the virus in the days before, and the results of those tests.

Some medical professionals have pointed out it’s unusual to develop serious symptoms so quickly after contracting the virus. Trump was given supplemental oxygen on Friday, his doctors said.

Leana Wen, former health commissioner of Baltimore:

Bloomberg News’s Steven Dennis:

It’s possible, some have suggested, that Trump was first infected with the virus days earlier and only received a test after his aide Hope Hicks tested positive.

But if that’s the case — and Trump is farther along in his illness — there’s still reason to believe he’s out of the woods. Doctors have found that older patients, particularly those with underlying conditions such as obesity, are most likely to develop respiratory complications from covid-19 in days five to 10 after first becoming infected.

“That second wave is often when patients deteriorate substantially, and that occurs usually around day seven to 10,” said Leana Wen, an emergency room physician and public health professor at George Washington University.

There are additional reasons it’s important to know the date of Trump’s last negative test.

It could help determine how long the president may have been contagious — and how many people he may have put at risk by traveling frequently, eschewing masks and meeting with large crowds against the advice of public health guidelines, The Washington Post’s Toluse Olorunnipa, Josh Dawsey and Amy Goldstein report.

“Hicks tested positive for the coronavirus on Thursday morning — long before Trump traveled on Air Force One that afternoon for a fundraiser in New Jersey,” they write.

“After returning, Trump took a rapid test, which came back positive, followed by another test. While awaiting those results, he appeared on Sean Hannity’s Fox News television show and did not disclose the positive result of his rapid test. Later that night, the results of the more precise test also showed he was positive, and the president disclosed his diagnosis in a tweet.” 

Ahh, oof and ouch

AHH: The White House’s top medical officer told co-workers this spring he was under intense personal stress in his job.

Navy Cmdr. Sean Conley is a 40-year-old doctor responsible for the world’s most high-profile patient: a president who has insisted on holding public events amid a global pandemic and rarely donned a mask, overriding the advice of his own health officials, Carol D. Leonnig and Robert O’Harrow Jr. report.

“Conley’s handling of the situation has come under intense criticism after he gave a rosy pronouncement of Trump’s status Saturday without disclosing that the president had been given supplemental oxygen or put on a steroid reserved for severely ill coronavirus patients,” they write.

“Long before the president contracted a virus especially lethal to older people, some of Conley’s former colleagues said they were disappointed in what they view as his lack of independence from White House politics,” Carol and Robert add.

“Every statement he is giving appears to be political, dictated by the White House or the president,” said one person who has worked with him, who, like others interviewed for this report, spoke on the condition of anonymity to avoid angering the White House. “These are not the statements a medical doctor gives.”

OOF: Weaknesses in the White House’s testing strategy could have contributed to a coronavirus cluster.

Despite the use of rapid coronavirus tests to screen attendees at the Sept. 26 event for judge Barrett, at least eight people who attended the ceremony have since tested positive. Experts say that this may be because the administration did not appropriately use Abbott Laboratories’ ID Now rapid test, the Wall Street Journal’s Sarah Toy and Daniela Hernandez write.

The tests, which has a 91 percent accuracy rate according to some studies, is not supposed to be used as a one-time screener and it is certainly not supposed to be a stand-in for social distancing, mask wearing, or other actions to mitigate risk, according to public health experts. Instead, experts say that such antigen tests should be administered multiple times over a period of days, so that if it misses the virus one day it can catch it on another day. Even then, it is unlikely to catch the earliest stages of an infection.

“A metal detector that misses 10% of weapons—you’d never, ever say that’s our only layer of protection for the president,” Ashish Jha, dean of Brown University’s school of public health, told the Journal.

“Infectious-disease experts say it is too early to call the Sept. 26 gathering, which included the Rose Garden ceremony and a smaller gathering with Judge Barrett and her family indoors, a superspreader event, but that it had all the ingredients for one: prolonged, close contact without masks among a large group of people,” Toy and Hernandez write.

University of Washington professor Carl Bergstrom:

OUCH: There is little evidence the White House had coordinated contact tracing for people who interacted with Trump.

In the days before Trump tested positive for the coronavirus, he held a campaign fundraiser in New Jersey for 200 people, greeted supporters at the Minneapolis-St. Paul airport, and mingled with 150 people as part of a celebration for his nomination of Amy Coney Barrett. There was little evidence on Saturday, however, that the White House or the Trump campaign had coordinated contact tracing for people who interacted with Trump while he may have been contagious, The Post’s Josh Dawsey, Yasmeen Abutaleb, Isaac Stanley-Becker and Joel Achenbach report.

Many people who attended events with Trump over the past week said that they had not received any official guidance on testing and quarantining, although some have sought coronavirus tests after seeing that the president tested positive. The CDC had a contact tracing team ready to go, but as of Saturday it had not been asked to mobilize. Meanwhile, health officials in Minnesota, Ohio and New Jersey, where Trump held recent events, reported that they had not heard from the White House and were largely on their own to track down people who may have been exposed.

“The crisis within a crisis is emblematic of an administration that has often mocked or ignored the coronavirus guidance of its own medical experts. In this case, the failure to move swiftly potentially jeopardized the health of their own supporters and those close to them, who might fall ill and unwittingly spread the infection to others,” Dawsey, Abutaleb, Becker and Achenbach write.

A second report from CNN suggested that the confusion over contact tracing extended into Sunday as well, with officials in New Jersey reporting that they still had not received contact tracing information from the White House as of Sunday morning.

It’s not just Trump

The Post is tracking people who had close contact with Trump or appeared at the same events.

Former senior advisor Kellyanne Conway and former governor of New Jersey Chris Christie both had extensive contact with Trump and both tested positive, although it is unknown if Trump transmitted the virus to them. Christie, who helped Trump prepare in the days leading up to Tuesday’s debate, checked into a hospital on Saturday.

At least eight people who attended the White House’s event to celebrate Trump’s nomination of Amy Coney Barrett have tested positive. Among them are two Republican senators, Mike Lee of Utah and Thom Tillis of North Carolina.

Both senators sit on the Judiciary committee, and their positive tests results have raised doubts about Republicans’ plans to fast-track Barrett’s re-nomination before Election Day. Democrats are waging a pressure campaign to postpone the hearing, insisting that moving forward with the judiciary committee’s hearings in person would be dangerous, and that a remote hearing would be inadequate, The Post’s Seung Min Kim reports.

But Senate Judiciary Committee Chairman Lindsey Graham (R-S.C.) has insisted that the hearing will go forward as scheduled.

Three in four Americans think Trump did not take appropriate virus precautions, according to an ABC/Ipsos poll.

“In two separate questions, an identical 72% said that Trump did not take the ‘risk of contracting the virus seriously enough,’ nor ‘the appropriate precautions when it came to his personal health,’” ABC News’s Adam Kelsey reports. “In each of the two questions, over 2 in 5 (43%) Republicans hold the negative sentiments about Trump’s mind-set and preventive actions regarding the coronavirus, compared to 95% and 94% of Democrats, respectively.”

The poll, released Sunday, also found that more Americans are worried about the risk of the virus to themselves or loved ones after the president’s diagnosis, with the increase almost entirely driven by greater concern among Republicans and independents.

Trump, who rarely wears a mask in public, claimed he had little choice but to take the risks he did. 

“I had no choice,” he said in a video message published on his personal Twitter on Saturday. “Because I just didn’t want to stay in the White House. I was given that alternative. Stay in the White House. Lock yourself in. Don’t ever leave. Don’t even go to the Oval Office. Just stay upstairs and enjoy it. Don’t see people. Don’t talk to people. And just be done with it.”

Many Trump supporters continued to rally over the weekend at events where few wore masks or observed social distancing recommendations.

More than a thousand Trump supporters gathered on the Mall in Washington on Saturday. While some wore masks, most did not. In Iowa a “Team Trump on Tour” bus made several stops, including at least one indoor event where few wore masks. Meanwhile, several Republican lawmakers also continued to question the effectiveness of masks or appeared at events without them over the weekend, The Post’s Jenna Johnson, Dan Morse, Amy B Wang and Brent D. Griffiths write.

On the Hill

There’s still no deal on a coronavirus relief package.

While negotiations over a coronavirus relief package continued over the weekend between House Speaker Nancy Pelosi and Treasury Secretary Steven Mnuchin, there was little sign of an imminent breakthrough, despite encouragement sent from Trump, while in the hospital for covid-19, The Post’s Erica Werner reports.

On Saturday, Trump tweeted his support for more stimulus funding, writing, “WORK TOGETHER AND GET IT DONE.”

Pelosi indicated on Friday that new language about money for testing and tracing remained a sticking point, while also suggesting that Trump’s positive diagnosis could help speed an agreement. The speaker asked airlines to hold off on impending furloughs for workers in the hope that economic relief would be imminent.

“House members left Washington on Friday for what was supposed to be a recess through the election, but if a deal does emerge, they could be called back to vote on it,” Erica writes. “Moderate House Democrats in tough races are pushing hardest for a deal, and helped prod Pelosi to re-engage in talks with Mnuchin, which had broken down in early August.” 

Coronavirus latest

  • At least 33 states and Puerto Rico report rising coronavirus cases since August. At least a dozen states are also seeing rising hospitalizations in recent days. The trend is deeply concerning to public health experts who hoped that transmission would be at low levels before the arrival of colder weather, which often gives a boost to respiratory illnesses, The Post’s Brady Dennis and Joel Achenbach write.
  • Joe Biden’s campaign has said that it will disclose the results of all of the candidate’s coronavirus tests in an effort to increase transparency. Joe Biden tested negative for the coronavirus on Sunday, his third negative test since debating Trump on Tuesday, The Post’s Annie Linskey and Matt Viser report.
  • Health and Human Services Secretary Alex Azar is reviewing a $300 million ad campaign aimed at boosting confidence in the Trump administration’s coronavirus response. The campaign has struggled to attract celebrity collaborators and has drawn the ire of Democratic lawmakers, who have called it a propaganda operation, Politico’s Brianna Ehley and Rachel Roubein report.

Sugar rush

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