A: Not quite. The drugs that Donald Trump received after contracting COVID-19 are either still in clinical trials or available in limited quantities for people with serious infections.
Trump received a level of treatment that is not available to the general public yet. While scientists have developed lots of new knowledge to better manage infections, experimental treatments like two of the drugs he received are not widely available at this time.
First of all, most people do not get tested daily like Donald Trump and his staff. Most people would not have known they were COVID-19 positive before they have symptoms. The turnaround for test results in the White House is in a matter of hours. The availability and turnaround times of testing varies widely within the United States, but it ranges from a few days to a week or more. Only some major hospital systems with in-house testing are able to provide test results within hours.
Based on the timeline of events, Donald Trump received Regeneron monoclonal antibody therapy at the White House soon after he first received a positive test result and before he was believed to be symptomatic. Since most people do not know when they are pre-symptomatic because they do not have daily tests for COVID-19, starting treatment before symptoms emerge is not usually possible. Also, there are NO approved therapies available for pre-symptomatic patients at this time.
The monoclonal antibody “cocktail” that the president received is still in clinical trials and has not been approved by the FDA for general use. On September 29th, Regeneron released a statement that interim data demonstrated reduced viral load and reduced associated symptoms in infected COVID-19 patients. These results are currently not published. At this time the only way to receive the therapy is to enroll in a clinical trial or to receive it through compassionate use authorization. Compassionate use is meant to provide experimental therapy to a limited number of patients when no other life-saving therapies are available. This is the authorization on which Trump received the Regeneron drug. It is determined on a case by case basis, and fewer than 10 people in the world have received the drug outside of clinical trials. So, no… at this time the Regeneron monoclonal cocktail is not available to you or to us.
If someone was experiencing mild symptoms of COVID-19, they would not be admitted to the hospital or treated. There is no such thing as “checking yourself” into a hospital “as a precaution”. Clinicians and staff determine the best use of resources to aid in patient care. At this time the general public does not have access to preventative hospital care for COVID-19.
Donald Trump was admitted to the hospital on Friday October 3 for a 5 day course of Remdesivir. Remdesivir is a drug that has emergency use authorization from the FDA for hospitalized patients for COVID-19. The research that led to the discovery of Remdesivir began in 2009, and was originally targeted at other viruses. It was found to have antiviral activity against other viruses, including SARS-1. It was first tested in clinical trial for Ebola starting in 2014. Although it did not work for Ebola, the drug was found to be safe in patients. The manufacturer, Gilead, was ready to test the therapy for COVID-19 relatively quickly because it had been discovered, formulated and tested in patients previously–unlike other therapies still in clinical trials.
The availability of Remdesivir at this time is limited because the demand greatly exceeds the supply. Remdesivir availability varies from hospital to hospital. Another option to obtain Remdesivir is to enroll in a clinical trial. The clinical trials for Remdesivir are randomized to placebo vs Remdesivir. Therefore, half of the people on the trial will be assigned placebo (no Remdesivir) while half of the trial participants will receive Remdesivir.
Donald Trump also received a steroid, dexamethasone. This therapeutic is widely available (yay!). However, dexamethasone weakens the immune system response. It cannot be given too early in the course of infection because it would stop your immune system from fighting off the virus. It is given to moderate to severe COVID-19 patients to stop the immune system from overreacting and causing additional damage to the lungs. It is not typically used in presymptomatic or mildly symptomatic people.
As clinicians have treated COVID-19 patients they have learned more about the disease and developed knowledge and best practices for treatment. Everyone has access to the new medical knowledge of clinicians — as long as they have healthcare. The treatment that Donald Trump received demonstrates the disparities of healthcare. The level of care he received is not available to the general public.
It remains critically important that our hospitals are not overwhelmed with COVID-19 patients, as it was and still is in some areas. Hospitals are continuing to care for patients with cancer, heart attacks, strokes, orthopedic issues, and lots of other urgent medical problems–and patient care can be seriously compromised when the healthcare facility is overwhelmed.
The best way to protect yourself is not to rely on the hospital system or the “really good drugs,” but to be proactive to prevent COVID-19. Follow the SMART principles: Space, Mask, Air, Restrict your circle, and Time.
And get your flu vaccine.
