Thread by @DrDenaGrayson

As I warned, Trump’s condition was much more serious than revealed. His condition was deteriorating faster and earlier in the course of illness than is typical in #COVID19. Thus, the unproven antibody cocktail, #remdesivir (used for seriously ill patients), and now dexamethasone.

https://twitter.com/DrEricDing/status/1312782805852717056

Patients with @COVID19 are hospitalized a median of 9days after onset of symptoms. Trump’s became symptomatic on Wednesday at the earliest, so today is Day 5. Yet Trump needed oxygen and hospitalization by Day 2.

https://twitter.com/drdenagrayson/status/1312608054559543296?s=21

It’s VERY CONCERNING that Trump was treated with dexamethasone. As @DrEricDing points out, dex is NOT effective in patients NOT on O2. Biggest benefit is for patients on O2/ventilator, less so for O2 only.

#TrumpCovid #coronavirus

https://twitter.com/drericding/status/1312796093424578572

It’s possible that Trump became symptomatic earlier than Wednesday. Although he appeared well at the #debates on Tuesday night—he had no cough—he could have been suffering mild symptoms (low fever, fatigue, etc).

#TrumpVirus #TrumpCovid

https://twitter.com/trishgreenhalgh/status/1312841961179668481

In addition, it appears that Trump got a CT scan (or other test) last night. This would be unusual for a patient with “mild” #COVID19, even a president. although it is not unusual for a patient hospitalized with more severe #COVID19.

https://twitter.com/weijia/status/1312577872662589440

Lots of unknowns, but what seems clear is Trump’s condition deteriorated such that he:

▶️ Received O2, was hospitalized
▶️Got an unproven antibody cocktail
▶️Got #remdesivir—for seriously ill #COVID19
▶️Got dexamethasone—for critically ill on O2 (usually on a ventilator)

As Dr. @trishgreenhalgh notes: dex is typically reserved for EXTREMELY ill patients either on a ventilator or soon to be on one.

Dex can suppress the immune system & thus help the #coronavirus. That’s why it’s only used IF NECESSARY to avoid ventilation or death if ventilated.

https://twitter.com/trishgreenhalgh/status/1312843110104338434

Treatments and procedures have RISKS. That’s why doctors carefully consider the benefit-risk ratio *especially* for a POTUS.

Trump got an UNPROVEN antibody cocktail, #remdesivir—can cause renal complications—and DEXAMETHASONE (immunosuppressive reserved for extremely ill #COVID)

https://twitter.com/drdenagrayson/status/1312846213083996166

Now, the doctors have tried everything available to treat Trump’s #COVID19, including aggressive moves to use an unproven antibody, #remdesivir, and dexamethasone—justifiable if Trump was seriously ill, heading downhill rapidly, and they were concerned he’d need to be ventilated.

https://twitter.com/drdenagrayson/status/1312841020149817344

Trump may be starting to improve (or at least, his decline has stopped), possibly due to the antiviral and/or antibody treatments. If he remains afebrile (no fever) & no longer needs O2, his doctors may think it safe to discharge him to the WH, where he‘d get 24/7 care.

Unfortunately, the WH has not been transparent about WHEN Trump 1st was symptomatic, tested positive, and his last negative, so those potentially exposed could take appropriate precautions.

But we’d expect no better from the guy who holds maskless rallies during a #pandemic🤬