The
President Is Not Well
Americans
need an accurate account of Trump’s condition. They do not have one.
OCTOBER 3, 2020
In a
24-hour period between Thursday and yesterday evening, the world learned a
week’s worth of news about President Donald Trump. None of the news was good.
Information came as if in a time lapse: The president has had a high-risk
exposure, the president has tested positive for the coronavirus, the president
has symptoms, the president has received an experimental antibody treatment,
the president has left the White House to spend several days at Walter Reed
National Military Medical Center.
The
degree of urgency and necessity behind the decision to hospitalize Trump
remains unclear, and the order of events is shifting. This morning, Trump’s
physician, Sean Conley, suggested that Trump was sick earlier than the White
House had previously shared. At the same press conference, another doctor,
Brian Garibaldi, said that Trump had received the antibody cocktail on Thursday
afternoon—a day before the American people were informed that Trump had even
been diagnosed. (The White House then insisted that both doctors misspoke, and released a statement from Conley clarifying
that the president had received the cocktail yesterday.)
The
president is not well. His health could quite feasibly take a turn for the
worse as the weekend progresses. The wide variability—and the consequences—of the
disease’s course mean that small details about his condition will be analyzed
intensely, and must be carefully and transparently communicated. The
geopolitical order hangs in the balance, waiting for incremental updates on
Trump’s pulmonary function.
During
the press conference today, Conley said that Trump was “doing very well,” but added
that he had been experiencing symptoms as far back as Thursday, including a
fever and a cough. They were severe enough that Trump inquired as to whether he
should be lying on his stomach in a prone position (which has shown to help
some COVID-19 patients breathe more easily). In response to questions, Conley
declined to comment on when the president had been infected, or when he’d last
tested negative. And in three separate exchanges with reporters, Conley dodged
the question of whether Trump had ever required supplemental oxygen—which would
be a sign of early stages of respiratory failure—emphasizing only that he does
not require oxygen at the moment.
By the
few available objective measures, Trump was not himself on Friday. He went
almost an entire day without tweeting, one of the few such days in his
presidency. As he exited the White House and boarded Marine One for the trip to
the hospital, he gave only a meager thumbs-up to the press. He climbed the
stairs into the helicopter unassisted, but used both handrails. The White House
has indicated that he “will be working from the presidential offices at Walter
Reed” out of “an abundance of caution.” Today, his doctors confirmed that he
was an admitted patient.
The
disease is known to take sudden turns for the worse, within a matter of hours.
So being monitored in a hospital is not an unreasonable move, especially for a
person in a high-risk demographic, like Trump. It would be unsurprising to
learn later today that Trump requires oxygen, or to learn tomorrow that he has
moved to the intensive-care-unit bed in his presidential suite. But it would be
equally unsurprising to learn that he is indeed working from the hospital and
will be home on Monday, and back on the campaign trail within the week.
By
midnight yesterday, Conley had reported that the president had received
yet another experimental drug, the antiviral remdesivir. The news that Trump
has received these two drugs does not give any meaningful clue as to how sick
he is. Often when a person receives experimental therapies, it suggests that
their condition is at least more than a mild cold. But Trump is inclined to try
out novel medicinal approaches. He said that he was taking hydroxychloroquine
and azithromycin in May, despite a lack of evidence that these would have any
bearing on whether he would contract the coronavirus. That same mentality could
lead him to request antibodies and antivirals like remdesivir at the first sign
of illness. Both have shown mixed results in trials so far, but both
seem unlikely to make a person worse off.
What
would be meaningfully objective news is if Trump starts requiring oxygen
regularly, or if imaging studies suggest that he’s developing pneumonia. It is
crucial that there be transparency and honesty when reporting such basic facts
in a moment like this. The false reassurance that has defined Trump’s response
to the pandemic stands to destabilize the world in an entirely new way if
people are unclear on the president’s functional status. If his own doctor
can’t share an honest account of the president’s need for supplemental oxygen,
he loses the credibility to offer reassurance in a more dire scenario. People
may rightly assume the situation is worse than they’re being told.
JAMES HAMBLIN,
M.D., is a staff writer at The Atlantic. He is also a
lecturer at Yale School of Public Health, co-host of Social Distance, and author of Clean: The New Science of Skin.
