UCSF doctor warns what could be ahead for Trump

President Donald Trump checked out of Walter Reed Medical Center Monday evening, leaving many infectious disease experts concerned about his early exit.

Dr. Peter Chin-Hong, infectious disease specialist and professor of medicine at UCSF, said that typically for someone who is older and being treated with oxygen and drugs like Remdesivir and dexamethasone, you would want to monitor them longer in the hospital to ensure they’re stable. He said that steroid treatments like dexamethasone can cause mental health side effects and even trigger feelings of euphoria in a patient as they feel better, which could be a contributing factor in Trump choosing to leave early.

“He’s not yet in the second phase of COVID. We call it falling off the cliff,” Chin-Hong said. “It’s a 7-10 day honeymoon period and then suddenly you could need a trip to the ICU.”

He said Trump’s doctors likely know this is the case. “I think they know he’s in this honeymoon period, but they’re not saying that because they don’t want people to worry or panic.”

Dr. Bob Wachter, chair of the Department of Medicine at UCSF, tweeted Monday that he would make a patient in a similar situation as the president’s sign out against doctors’ orders because it would be so irresponsible.

“So Trump just said he’ll check out of hospital today. Based on what we know (which is uncertain) & even accounting for WH’s medical facilities, if it were my patient & he was adamant about leaving, I’d have him sign-out AMA (“against medical advice”). More irresponsible behavior,” Wachter wrote.

When Trump left the hospital Monday, it wasn’t his first time since being admitted. The president saluted supporters outside the hospital on Sunday afternoon from his motorcade, wearing a cloth mask while still contagious. His decision may have put his Secret Service detail, as well as anyone they encountered, at risk, especially since they were wearing masks with valves.

“There are so many things that are abnormal… You don’t put a patient with COVID with a cloth mask in a hermetically sealed space with no ventilation and recirculated air, and the other people in the car are wearing the wrong mask as well,” Chin-Hong said. “It’s like if you locked yourself in a closet with someone who had COVID and you only had cloth masks.”

Masks with valves may protect the wearer from catching the virus, but it does not prevent the person wearing the mask from transmitting COVID-19 to others.

Wachter later tweeted: “When I saw ‘Secret Service’ trending & read first tweet on Trump’s joy ride around Walter Reed, I thought, ‘This has got to be a joke.’ But nope, it’s real. So massively irresponsible.”

Chin-Hong cautioned that the worst could still be yet to come for Trump. UK Prime Minister Boris Johnson is a possible similar case, since he was also feeling fine initially after treatment and then ended up back in the hospital a week later.

Even after a patient has recovered, Chin-Hong warned about “post-COVID symptoms,” which can include anything from long-lasting fatigue to brain fog to permanent heart damage.

“COVID can affect so many people and it doesn’t matter who you are,” he said. “You’re not out of the woods yet.”

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