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There Are Many Questions About Trump's Unique Treatment For COVID-19

NOEL KING, HOST:

President Trump, infected with coronavirus, left Walter Reed Hospital last night. His doctors gave him the go-ahead to continue his recovery at the White House. The president seemed in good spirits. He wore a mask as he left the hospital. He pumped his fist into the air and got into a motorcade. A few hours later, though, he took the mask off and turned to nearby aides to tape this video.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: We're the greatest country in the world. We're going back. We're going back to work. We're going to be out front. As your leader, I had to do that. I knew there's danger to it, but I had to do it.

KING: NPR science correspondent Joe Palca is with us now. Good morning, Joe.

JOE PALCA, BYLINE: Good morning.

KING: So in another part of that video, the president said don't be afraid of COVID, essentially said I've beaten it. Has he beaten it?

PALCA: Well, I hope so. I mean, I don't think anybody wants to see the president sick.

KING: No.

PALCA: And - but the truth of the matter is he may have beaten it. This is a funny disease, and sometimes people feel great a few days after their symptoms appear. Everything's fine. And then boom - they crash, and things get worse rapidly. Don't know if that's going to happen. It could.

KING: But the president's doctor has actively cautioned about that in this case.

PALCA: Yeah. I mean, he said the fever's gone and the oxygen is good, but he's not out of the woods yet. And the other thing is - I mean, the president is saying, you know, don't let this scare you, this virus thing. But, you know, it's killed more than 200,000 Americans, and the president isn't like most people; he doesn't have a team of doctors waiting at his beck and call. He doesn't have a - you know, not everybody has a helicopter to fly them off to the hospital.

And he's getting drugs that not everybody has access to. Whether they work or not is an open question, unfortunately. But, you know, he's getting them. One's remdesivir. You've probably heard of that. It's an antiviral. The other's a monoclonal antibody cocktail. That's all brand new, not approved by the FDA. And he got dexamethasone, which is a steroid. Now, that's been around for a while, but it seems like an odd choice because, supposedly, he's healthy or reasonably healthy and didn't have a serious case, and yet dexamethasone is for people who are crazy sick, usually. So go figure.

KING: Go figure. Could that unique treatment regimen cause him problems?

PALCA: Well, a lot of doctors worry about this syndrome they call VIP syndrome. Here's Mitchell Levy, chief of critical care medicine at Brown University.

MITCHELL LEVY: The VIP syndrome is not just that VIPs demand therapies; it's simply that they're treated differently. And this is really the case for doctors' spouses and their family. And so their loved ones are often treated in a way that's outside the usual standard of care, which is never good.

PALCA: So, basically, people say, oh, give me everything. I mean, I'll try anything. It's all good. It's all good. But, you know, there's a downside to experimental drugs because they're experimental - or there could be a downside. That's why they're being tested. But in the - specifically in the case of dexamethasone, this is a drug that suppresses the immune system. So good - if your immune system's going crazy and causing internal damage to your lungs, that's not good. But if you're trying to fight off a virus and it's still lurking in your system and your immune system is suppressed, that's bad.

KING: We know, Joe, that the White House would like a vaccine before the election. They've made that very clear. Let me ask you for a bit of analysis. The New York Times is now reporting that White House officials are trying to block guidelines that the FDA has drawn up for the emergency authorization of a coronavirus vaccine. What is going on here?

PALCA: Well, I can't really speak to what the White House is doing. I can tell you what the FDA has been doing.

KING: Sure.

PALCA: The career scientists have been saying, look - here's what we're going to need to see before we're going to approve a vaccine. Now, these guidelines might lay that out very explicitly, and they may be at odds with the ability to get a vaccine through as quickly as the White House might like. So that may be where the tension is coming from.

KING: OK. NPR's Joe Palca. Thanks, Joe.

PALCA: You're welcome. Transcript provided by NPR, Copyright NPR.

Joe Palca is a science correspondent for NPR. Since joining NPR in 1992, Palca has covered a range of science topics — everything from biomedical research to astronomy. He is currently focused on the eponymous series, "Joe's Big Idea." Stories in the series explore the minds and motivations of scientists and inventors. Palca is also the founder of NPR Scicommers – A science communication collective.
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