President Trump leaving the White House for COVID treatment at Walter Reed HospitalSource: flickr, creative commons, not copyrighted

For many, the TV reports of the president’s treatment will be their first exposure to the detailed treatment for COVID-19, so it is important to understand that this is not, by any means, representative of the physical and psychological experiences others will face if they are stricken by this potentially deadly virus. Unfortunately, I can share this agonizing contrast from personal experience.

 

In July my son, who is in his mid-thirties, suddenly felt fatigued. Before this he was in outstanding condition, athletic, with no pre-existing conditions.  Over the next few days he developed a cough and a fever. As the cough became severe, and knowing that COVID-19 could be possible, he sought medical attention. But having relocated to a new job recently, he did not have a personal physician, and finding one that would take him as a patient immediately was futile.

 

His condition declined rapidly over the next few days, and so he sought medical treatment at an urgent care facility. They confirmed that he had a fever of 103 degrees, something he could not do himself, because medical thermometers were sold out everywhere. His vital signs were poor and his intense coughing was unlike anything he had suffered before. The health care workers recognized that his symptoms were consistent with COVID-19, but a simple, rapid COVID-19 test was not available. They were able to give him a common flu test. That result was negative, raising the stakes that he could be infected with the novel coronavirus, but the results of the COVID-19 test they gave him would not be available for at least ten days. They prescribed aspirin and cough syrup, and sent him home.

 

My son suffered miserably at home for another week. As he lay feverish, confined to bed, his wife cared for him, trying to improvise the isolation procedures that would protect health care workers from infection by COVID-19 patients in a hospital. Even though we had no clinical diagnosis, because test results were weeks away, we all feared the possibility that it could be COVID. Sometimes his fever showed some improvement, which gave us hope that he was going to get better, but then another wave of severe illness would wrack his body. My son and daughter-in-law live in a well-known city, not in an isolated rural area like so many Americans who do not always have good access to the best healthcare.

 

It reached the point where his coughing became so intense and his breathing so difficult, his wife rushed him to the emergency room early one morning. There ER doctors gave him a chest x-ray, which left no doubt. His lungs were savagely attacked by the tell-tale damage only COVID-19 can cause. He was admitted to the COVID ward in the hospital immediately.

 

Here is where the contrast continues to diverge between the horrible psychological trauma patients and their loved ones face in this dreadful disease with what Trump is experiencing. My son lives about a day’s drive from my home, and I wanted to rush to him immediately, but the hospital would not permit anyone inside, other than patients. There was no point in going there.

 

Isolation of the sick from loved ones is common practice at hospitals everywhere during the pandemic. People who were healthy only a few days earlier, suddenly find themselves ripped away from all of their friends, family, and familiar surroundings, and placed alone inside a hospital COVID ward surrounded by strangers in “space suit” personal protection equipment that leaves only the care-givers’ eyes visible. My son’s health care workers—truly selfless heroes, every one of them—had the best possible protection for themselves, with self-contained respirators that pumped filtered air into their protective clear plastic hoods. In going to the hospital, my son, like so many others, was living the reality that he was entering the hospital alone, with a real statistical probability of never seeing anyone in his life again and dying there alone.

 

Few people have the strength of psychological fortitude to endure this dire scenario. Many who experience pneumonia or other urgent medical conditions, refuse to go to the hospital for fear of entering that place, being placed in a COVID ward alone, and never coming out again. Having faced dicey situations together mountain climbing, I’ve seen my son’s ability to deal rationally, calmly and bravely with perilous situations many times, and I knew this strength of character would serve him now. He understood and accepted the situation, and he engaged cooperatively with the team working to help him. We all did our best to support him by cellphone text messaging.

 

The president is being treated with an experimental cocktail of monoclonal antibodies. This is not an approved treatment, and no one, outside people engaged in experimental trials, will receive this treatment.

 

After being admitted to Walter Reed Hospital, the president began treatment with the antiviral drug, remdesivir. This is not routine. At the time of my son’s hospitalization, the FDA permitted the use of this unproven drug for COVID patients, under “compassionate use” authority, meaning that the drug could be given under dire conditions when there was no other treatment. To obtain this drug, my son had to meet a number of specific clinical criteria, and he did.

 

The drug degrades rapidly inside the body, so the treatment requires intravenous delivery of remdesivir at a slow rate constantly over a 5-day period. If that is not effective, IV delivery of the drug is continued for a second week. IV delivery of the drug must be done in a hospital. Patients are confined to bed with a needle in their veins, leading from a dripping bag of saline hooked on a pole at their bedside. The president could not receive this treatment in the White House. Moreover Trump was able to receive remdesivir immediately after his COVID test detected the presence of virus in his system, not after he was on the verge of being put on a ventilator, as my son was facing. Obviously, the remdesivir IV treatment had to be interrupted to snap the publicity pictures of the president wearing a sport coat and working at his desk inside the hospital.

 

My wife and I and my daughter-in-law tried urgently to get COVID tests ourselves, having been in recent close contact with a suspected COVID patient. Although testing was touted as being widely available at drive-up locations, drug stores, and doctor’s offices, absolutely no testing was available within a 100-mile radius of my home, which is in a major city. Demand had outstripped testing capability as the president criticized and tried to limit COVID testing, because he believed this would increase the statistical data on infection rates, undermining his political and economic priorities. My doctor was unable to give me the test, and he knew of no place where the tests could be given. This is not a sophisticated test. It is a PCR test, which is a simple procedure that I, and most biologists, do routinely in our labs for experiments. But the cotton swabs, simple ingredients, and regulatory approval to conduct the tests were not available, even though small countries around the world were giving the tests to their citizens freely.

 

A medical test for an infectious disease that does not return a result for ten days is useless. That is not only obvious to me, my own doctor blurted out that statement in frustration during my visit to his office that left him powerless to help me. Ten days after the urgent care center sent my son’s nasal swab to the lab for analysis, the results came back positive for the novel coronavirus. He received that result after he had been inside the COVID ward for a week.

 

As politicians and the public are becoming aware of the inadequate resources available to diagnose and treat COVID patients in the United States, and awareness that health care workers lack adequate protective supplies has become widely known, the situation is beginning to improve. Testing and remdesivir are becoming more widely available in recent weeks to ordinary American citizens who become ill with this disease.  But how many of the 200,000 people who died of COVID in this country would have lived had the standard of care been something more than, “take aspirin and cough syrup; go home and we’ll see what your test results are in a couple of weeks?”

 

Like all of us, I sincerely hope the president and first lady recover fully from this illness, as my son did. It took him two months to recover to normal, and we are thankful that he is expected to recover completely.  Having experienced the psychological ordeal that this unique illness and the restrictions of the pandemic cause families, I feel great sympathy and concern for the young man whose famous parents are both sick with this frightening and potentially deadly illness.  Just as we commonly catch colds from our close family members, so too is COVID spread within families, sometimes tragically taking lives of both husband and wife, or parents, children, and close relatives in the same family. In fact, my daughter-in-law did contract the virus from caring for my son. Fortunately, she recovered from the illness without the need for hospitalization. This unpredictable targeting of some people for death while leaving others to spread the virus, is what makes COVID-19 so dastardly.

 

As an essential worker my son was diligent about always wearing a mask, hand sanitizing, and adhering to all the recommended precautions to avoid infection.  Contact tracing found that he became infected while caring for one of his clients. He wore a mask, but the elderly woman who was without symptoms at the time did not. Even as so many in the president’s circle have now become ill with COVID after not wearing masks, recklessly and irresponsibly risking getting and spreading the deadly infection, it is important to recognize an important fact about masks. The simple cloth masks scientists recommend everyone wear as minimal protection against spreading the illness, primarily protects other people from becoming infected by the person wearing the mask.  These are not the type of masks health care workers use to protect themselves from infection. They use N95 masks, because these are the only ones certified to filter out the virus effectively if worn correctly. Effectively, means that 95% of the viral particles are excluded by the filter in the mask. Why every person in this country is not supplied with these N95 masks is mind boggling. Now so many in government who followed the president’s example and refused to wear even a cloth mask are infected. They endangered themselves, their families, and our government.

 

After surviving his battle with COVID-19 my son says he now sees how anyone who is not in top physical condition before becoming infected, could not survive it. What will help is giving every single person in this country—regardless of race, zip code, or income—the same testing and medical treatment that our president is receiving.

 

Modified from article first published in Psychology Today

1 Comment

  1. Robert G Richards II on November 1, 2020 at 3:47 pm

    Dr Fields,

    First let me wish your son well and offer a hope he recovers fully in time.
    Secondly, you have a venue and a platform from which to inform and challenge public thought.
    In relation to your article, the president vs everyone.
    We have not conquered the virus, any virus. A bacteria, we give antibiotics to kill the bacteria and remove it from the body and then the body can heal. Not much different than a splinter. Remove the splinter and the body heals.
    But a virus. A virus incorporates itself into the body’s cells. To kill the virus is to kill the cell.
    To this date, the only cure for a viral attack is the body’s own immune system. Hence, vaccines which give the body a jumpstart in identifying and attacking an invading virus to stop it before the virus has incorporated into but a small number of cells.

    Hence my concern for the halfway measures taken by our government in combatting this corona virus.

    1.) If the object is to contain and limit exposure giving time to produce a viable vaccine, then interstate airplanes, trains and busses should have been shut down immediately upon recognition of the hazards inherent in this virus.
    International flights should have been quarantined 30days at the air force bases which were set aside for such purpose(and were never utilized)if allowed at all.
    Too late for all of that to stop the virus spreading, the virus is everywhere.

    3.) Not just He but any president would have received the same urgent attention as did President Trump. Hospitals delaying the antivirals cocktail are rendering said cocktail ineffective. Antivirals only inhibited reproduction of virus giving the immune system more time to respond to the invader. If a hospital waits until the body is already overrun, the antiviral now has minimal value if any. By now the body recognizes the virus but the body is overwhelmed and weakened. To give an antiviral to slow reproduction of virus if the viral infection has already matured.

    4.) The containment measures are halfway. People still get on airplanes to travel to vacation sites while others are out of work as non-essential. Should not a vacation count as non-essential.
    A very nasty characteristic of a virus is it’s tendency to mutate. People keep flitting about Ohio vacations in Florida. NY vacations in New Orleans. LA vacations in Tahoe. A group of men here in Richmond VA area are heading to a two week hunt in Colorado, half flying, half driving. By the time they have mingled in camp two weeks, all might as well have taken the plane.
    If all this mingling results in a Corona mutation, the vaccine developed for corona May be obsolete and ineffective by the time it is released to the public.

    My Suggestion,

    Everybody just stay home.

    Put everyone back to work. People have to eat.

    But… travel ?
    Travel is categorized as essential and non-essential.
    If you are identified in Orlando with a NY license, you best be military and stationed in Florida. Penalties should be same as a DUI. Lose your license, jail 30 days(can be suspended but over your head if you repeat), bail equal to the typical hospital bill for an ICU Covid patient with complications.

    People stay in your home state unless meeting govt dictated essential travel purpose.

    Again, I wish your son well.

    Be safe, Be healthy.

    Thank you for your time,
    Robert
    Richmond VA

Leave a Comment