Posted on: October 2, 2020 Posted by: Jan Kopischke Comments: 0

Jan Kopischke, Student Publications Advisor

Breaking news overnight from the White House physician, Dr. Sean P. Conley, and President Trump’s personal Twitter feed indicate that both President Donald J. Trump and First Lady, Melania Trump, have tested positive for COVID-19. They are expected to quarantine in the White House residence for the next 14 days. Both were tested late Thursday after Senior Advisor to the President, Hope Hicks, tested positive Wednesday and was exhibiting symptoms. Hicks traveled with the President on Air Force 1 Tuesday to Cleveland for the first Presidential Debate, and again on Wednesday on Marine 1 (the helicopter which is used to transport the President and his advisors to Andrews Air Force base where Air Force 1 is housed). President Trump held a rally in Duluth, Minnesota on Wednesday and a fund raiser at his Bedminster, New Jersey golf club on Thursday. The future of his rallies is in doubt, with five scheduled over the next week.

Also in question is when Vice President Mike Pence last met with the President, though his press office did announce he and Second Lady Karen Pence were negative as of Friday morning, Oct. 2. Questions swirled Friday morning about how many people the President had been in contact with over the past three days. Fox News anchor, Chris Wallace and Former VP Joe Biden were on stage with Pres. Trump on Tuesday at the debate. The audience in attendance may have been exposed, even with negative tests for all those in the hall at Case Western University prior to the event. Those who attended the Duluth, Minnesota rally could be at risk, though footage appeared to show the rally outside on the tarmac, which could minimize some of the risk. Donors who were at the fundraiser could have been exposed. The contract tracing over the next several days will be a huge undertaking, and may need to include Trump’s senior staff, US Senators who attended the Supreme Court pick announcement, Amy Coney Barrett herself who has been in contact with the President, and Senators on the Hill, as well as the families of those who had close contact with either the President, Melania, Hope Hicks or the myriad of others listed above. Jared Kushner, Stephen Miller, and Dan Scavino also boarded Marine 1 on Wednesday, all without masks covering their mouths and noses.

Hope Hicks (L), Jared Kushner, and other top advisors travel on Marine 1 Sept. 30, 2020.

What’s next: Line of Succession in Presidential health instances

The president’s age and weight put him at greater risk for developing serious complications from COVID-19. Questions abound about what happens if the President becomes so ill that he needs to be hospitalized and cannot perform the functions of the Office. There are two provisions in the 25th Amendment to address the possibility and the line of succession. The 25th was added to the Constitution in 1967 following the assassination of President John F. Kennedy.

First, the President himself can sign a letter which is addressed to Congress and the Vice President that he is too ill, or will be incapacitated (such as during a surgery where the President is under general anesthesia). The Vice President temporarily becomes the Acting President until Pres. Trump submits a second letter stating that he is able to resume his duties. Second, should the President be so debilitated that he cannot sign a letter to temporarily hand over power to the VP, the Cabinet members and the VP can write a letter to Congress, and again, the VP becomes the Acting President until the the Commander-in-Chief’s health is restored. If both the Pres. and VP were to become so ill as they could not perform in the Chief Executive’s role, Speaker of the House, Nancy Pelosi would resign from Congress, and assume the role of the Acting President. The 25th has been enacted by Presidents Reagan and George W. Bush, incidentally when the men were in surgeries for respective colonoscopies. It has never been invoked for more than a couple of hours.

ABC News was reporting by early afternoon that the President and First Lady were experiencing “mild symptoms” of COVID-19.

President airlifted to Walter Reed Medical Center late Friday afternoon

The President was taken by Marine 1 to Walter Reed Medical Center “out of an abundance of caution” according to sources at the White House. Trump walked under his own power and from the helicopter, press covering the entire trip live. The President is at higher risk for complications from COVID due to his age, his weight and BMI placing him in the obese category, and potential heart disease. Previous medical reports on the Presidnet’s health indicate he is on a statin, a drug generally given to treat and control heart disease.

Mixed messages from communications team

Over the weekend, press conferences from President Trump’s medical team, led by Dr. Conley have left the media and the public with more questions than answers. Conley initially stated on Saturday that the President was 72 hours into diagnosis; he later tried to walk that statement back stating it was day three, with a positive test recorded as of late Thursday evening. He seemed to indicate that the President had not received supplemental oxygen at all, yet Chief of Staff, Mark Meadows contradicted that statement to the White House Press Corps that indeed the President had been given supplemental oxygen at the White House Friday when his blood oxygen levels dropped “rapidly.” Meadows was caught on video stating to some members of the WH Press pool, stating he wished to “go off-the-record” immediately following Dr. Conley’s Saturday press conference. Conley’s press conferences on Sunday and Monday did not provide much more information on the President’s health status, including when the President had lasted tested negative. President Trump released a video via Twitter non Friday prior to his flight to Walter Reed, another on Saturday afternoon stating he felt better, and a third video in which he indicated that they might have a surprise for the “patriots” outside the hospital. Approximately 5:30 p.m. ET, the “surprise” he’d hinted at was a slow-motion drive around the Walter Reed complex in a black Chevy Suburban with two Secret Service agents in the front seat and Trump waving to supporters from the back seat. He has received harsh criticism for the decision to leave his hospital room, potentially exposing others to the virus. Families of some of the 210,000+ victims of COVID were outraged that the President still did not seem to be taking the virus seriously when he tweeted that Americans should not let COVID “dominate your lives” as though by sheer will, those who have died from the virus should have fought harder. Many who died did not have access to the therapeutics and care given to the President this weekend.

Treatments and Therapeutics

The President is currently on a mix of therapeutics to help control the virus. Friday, his physician reported he was taking zinc, Vitamin D, famotidine, melatonin, and a daily aspirin. Zinc helps the natural immune system to fight off disease and is also used by many to shorten the length of the common cold. Vitamin D is essential for bone health and is appropriate for those who are deficit, but its use has not been linked to a cure for COVID. As a fat-soluble vitamin, it is important not to take too much, as it can build up to toxic levels of blood calcium, high levels of which can cause confusion, disorientation and heart rhythm complications. Famotidine (OTC name is Pepcid AC) is an acid-reducer used to treat ulcers, indigestion and heartburn. Melatonin is an herbal supplement to treat insomnia or shift-work disorders for people who work different during different times of the day, and have difficulty with adjusting sleep schedules. It is unclear why the President was taking this medicine, but studies have show low melatonin levels in patients with chronic metabolic disease and diabetes lead to increased severe infections. A daily aspirin is usually given to reduce blood clots, and COVID -19 has shown an increased clotting risk in some patients. A daily aspirin may have been part of the President’s daily routine prior to being infected, as it is often prescribed for heart health in low doses. Other therapeutics which have been administered since Friday include the following: an experimental monoclonal Regeneron antibody treatment which has not been approved by the FDA, nor been peer-reviewed, and which is still in small clinical trials; Remdesivir, which has shown promise in reducing the severity of the disease; and dexamethasone, a corticosteroid usually given to patients who require supplemental oxygen. It is not usually given to treat mild forms of the disease, so many were left bewildered as to why is was administered to the President, who was reported to have mild symptoms. He has received supplemental oxygen at least twice since Friday, Oct. 2 when his blood oxygen levels dipped below 98%. Once on oxygen, his levels returned to a normal range according to his physician.

Release from Walter Reed and back to the White House: inner circle cases on the rise

Despite being placed on a 5-day regimen of IV-administered remdesivir, the President was released at 6:30 ET on Monday evening, walking on his own to the Presidential limo known as “the Beast” which drove him to Marine 1. He was flown back to the White House, where he immediately removed his mask upon entering. Trump is scheduled to receive his last treatment of the IV drug sometime Tuesday, as the White House is equipped with state-of-the-art medical facilities to perform everything from First Aid for minor injuries to simple surgical operations and a variety or treatments for illness.

Keeping White House Staff safe

Several changes will be made in the residence and the West Wing as cases within the President’s inner circle continue to rise. Domestic staff in the residence will be gowned and masked, staff who interacts in any way with the President over the next several days will need to wear masks and eye protection. Many staffers, including daughter Ivanka, had already moved to working remotely, outside of the White House, “out of an abundance of caution.” As of Monday evening, 18 people who attended the Supreme Court nomination ceremony for Amy Coney Barrett on Sept. 26 had already tested positive. Some of those infected also helped with debate prep prior to the first Presidential debate last week. At least three GOP senators have tested positive for COVID, which potentially delays the confirmation vote on Barrett that Majority Leader Mitch McConnell has promised will take place before election day.

This story has been updated.