Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Medicine / Infectious Disease / Epidemiology / @KFF @CBSNews @NYUGrossman @BellevueHosp doc / Threads @drcelinegounder / BSky @drcelinegounder

Oct 3, 2020, 7 tweets

1/ What was POTUS' lowest oxygen saturation in the past week? Why was he transferred to Walter Reed. WE STILL DON'T KNOW. Given there still hasn't been a transfer of power to VP Pence, President Trump owes the American people an explanation.

2/ It now appears that the president required supplemental oxygen prior to arrival at Walter Reed. (We're having to read between the lines based on Qs answered and not answered).

3/ POTUS was given remdesivir. *Assuming* evidence-/guideline-based use of remdesivir, this would indicate that the president has SEVERE COVID (i.e. oxygen saturation less than or equal to 94% on room air, requiring supplemental oxygen/ventilator/ECMO).

4/ But we know the president doesn't abide by evidence and guidelines, so it's hard to know for sure if that's what his receiving remdesivir means.

5/ Dr. Sean Conley, the president's personal doctor, ended the press conference when asked whether the president had received dexamethasone. Dexamethasone is indicated in severe/critical COVID, but not mild/moderate COVID.

6/ There are reasons NOT to give dexamethasone if COVID is not severe enough: high blood sugar, psychiatric side-effects (e.g. agitation, confusion), suppression of adrenal glands, risk of bacterial/fungal infection.

7/ The questions Dr. Conley is avoiding / refusing to answer (highest temperature, lowest oxygen saturation, requirements for supplemental oxygen, need for dexamethasone) would tell us something about the president's prognosis.

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