Craig Spencer MD MPH Profile picture
ER Doctor | Ebola Survivor | Public Health & Humanitarian Response | Historical Determinants of Public Health @Brown_SPH | Member @CFR_org | Emmy Award Winner🏆

Oct 3, 2020, 7 tweets

I’m getting a lot of questions about how fast COVID19 progresses:

I’ve seen 90 year olds test + and not have a sniffle for days.

I’ve seen 40 year olds come in stable and VERY rapidly decompensate.

There’s a lot of speculation right now. But the realm of possibilities IS vast.

I don’t know the specifics of the President’s case - but the American public should.

Maybe it’s all an abundance of caution? Or not.

Point being he could be stable. Or not. This virus is always fickle & sometimes ferocious.

I wish him a speedy recovery. And we need more info.

This timely transmission just in!

Reportedly not on supplemental oxygen.

Remdesivir started.

‘Doing very well’.

The initial FDA EUA in May limited remdesivir use to patients receiving supplemental oxygen.

This changed in the updated Aug 28 EUA: Remdesivir "may be effective for the treatment of suspected or laboratory-confirmed COVID-19 in all hospitalized adult and pediatric patients."

Again, I don't know that this tells us much.

It may be the kitchen-sink approach. Remdesivir isn't innocuous, but it's pretty well tolerated.

And every ER doc knows that VIPs don't always receive 'better care' - but they often get MORE care. More tests, more treatments.

If steroids are started in the coming days, that's an indication of more concerning moderate-severe illness.

Otherwise, it's still speculation until we have more details.

Let us wish him and everyone else struggling with this disease all over the world a peaceful rest tonight.

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