In his latest twitter video tweet, The United States President Donald Trump states that he is feeling much better after taking what he considers a group of ‘Miracle Drugs’ to treat and control his symptoms of Coronavirus. Trump was transported by helicopter last Friday night to the Walter Reed medical centre in Maryland in what his physicians described as a ‘cautionary move’ and has since been receiving a cocktail of ‘experimental treatments’ that were released for special use for Trump from Regeneron Pharmaceuticals on the grounds of ‘Compassionate Use Request’ which allows the usage which is normally confined to clinical trials and generally involves a lengthy and challenging process.
HOW DO POLYCLONAL ANTIBODIES FIGHT THE CORONAVIRUS?
Prior to his hospital transfer, Trump received ‘a single 8 gram dose of Regeneron’s polyclonal antibody cocktail’ confirmed his White House physician Dr Sean Conley. ‘The goal of the infusion is to decrease the amounts of virus in the body and function as a (blocking agent).’
In a study on its effectiveness published by the New England Journal of Medicine in May, Dr Marc Siegel explains ‘It decreases the recovery time from 14 to 11 days. The goal here is to decrease the risk that he’s going to develop inflammation (and) blood clotting, (which are) the more severe problems of COVID-19’ ‘Polyclonal antibodies are made up of heterogeneous cells which are generally produced by different B cell clones in the body’ according to Creative Diagnostics a company that specializes in the research and manufacturing of antibodies. They are produced in live beings, whereas monoclonal antibodies are produced using tissue-culture techniques. The creation of polyclonal antibodies is achieved by injection to elicit an immune response. An immunization is then injected to ‘produce higher titers of antibodies against the particular antigen.’ The as yet labelled ‘experimental treatment‘ uses an antibody made by Pharmaceutical company Regeneron, as well as one isolated from patients who have survived COVID-19. The goal is for the two antibodies to bind to the coronavirus protein therefore limiting the ability of viruses to escape. This treatment has shown effectiveness in decreasing the amount of virus in the body and severity of symptoms.’ claims infectious disease doctor, Matt McCarthy. Trump is also taking Gilead Pharmaceuticals ‘Remdesivir’ which has been authorized for COVID-19 patients by the FDA under an emergency use declaration. Current trials show effectiveness under some circumstances. It has also been confirmed that the president had already been taking doses of zinc, vitamin D, famotidine ( used to treat and prevent ulcers in the stomach) melatonin (a hormone often used for the short term treatment of insomnia, such as from jet lag or shift work) as well as a daily aspirin tablet.
HOW DOES REMDESIVIR FOOL CORONAVIRUS?
‘Remdesivir is basically faking the virus into thinking it’s a building block of viral genetic material’ explains infectious disease specialist Peter Chin-Hong. Remdesivir is an antiviral drug administered by IV. It’s known as a nucleoside analog, meaning it mimics a component of viral ribonucleic acid RNA that the virus needs to replicate itself. The virus utilizes an enzyme called RNA-dependent RNA polymerase to construct chains of RNA piece by piece. As the RNA polymerase picks up the drug instead, the RNA assembly line is blocked and viral replication is shortly afterwards halted. It’s not an immediate stop’ explains Kathy Yang (PharmD, MPH) because the virus has a powerful proofreading function that it will use to try to undo the mistake. But it won’t be able to fix it, and the replication will stop.’ Experts are encouraged by the moderate benefits achieved in clinical studies so far but agree more studies need to be done to test the efficacy of the drug and at what point in the virus’s diagnosis it is best administered. ‘Likely the benefit of any antiviral is when you give it early in infection to stop viral replication’ said Yang. Similar to Tamifl, remdesiver may have greater impact when given earlier in a diagnosis of COVID-19. The sooner the viral load is lessened not only is the threat of transmission to others greatly decreased, but it also helps to reduce the inflammatory complications that commonly manifest later on in the disease’s progression. Gilead agreed to donate the current supply of Remdesiver it had which was a total of 1.5 million doses – 607,000 doses to the United States and the remainder to be distributed on a worldwide basis. Each patient is required to take between six to 11 doses. The NHIs second trial regarding Remdesiver combined it with the anti-inflammatory drug baracitinab. This drug which is already approved for the therapy of rheumatoid arthritis, could help to calm the aptly named ‘cytokine storms’ that lead to dangerous inflammation of the lungs and other vital organs that can be severely damaged by cases of COVID-19. Some are already referring to Remdesivir as the new ‘standard of care’ for COVID-19, and many ongoing clinical trials will likely have to alter their design and approach to provide Remdesivir to all patients.
HOW MUCH FAITH SHOULD WE PUT IN THESE NEW WEAPONS AGAINST CORONAVIRUS?
The development of Remdesiver has come a long way. ‘But Remdesiver is not the end of the story.’ said Chin-Hong. And all these new treatments have their limitations. The malaria drug ‘hydroxychloroquine’ (another drug that Trump has admitted to previously taking for its alleged prophylactic effect) has shown activity against the coronavirus in vitro, but can cause cardiac toxicity in some patients. Until an effective vaccine is developed these medications are what we have to fight the virus and even though the results do not point to a unified cure and reduction of symptoms for all, their median results are a better alternative than waiting for the virus to replicate and potentially kill its victim.
WHAT ARE TRUMP’S CHANCES OF BEATING CORONAVIRUS
Donald Trump and the First Lady Melania have both simultaneously contracted the Coronavirus. However Melanis’s younger age at 50 puts her in a lower risk category than her husband who is 24 years older at 74. Trump who his physician reported in April 2020 weighs 244 pounds and is 6 feet, 3 inches tall brings his body mass index to 30.5 putting him into the ‘mildly obese’ category. Being a male Trump has statistically a greater chance after being infected with the Coronavirus of succumbing to a serious illness due to its effects or even of dying. However the President does not reportedly suffer from chronic conditions such as cancer, diabetes or kidney disease, or any other illnesses that would propel him into a higher risk group. According to pulmonologist and intensive care physician Qanta Ahmed who has treated COVID-19 patients at NYU Langone Health ‘I know full well that the disease caused by the Coronavirus can be quite serious – and fatal in some cases. But importantly I also know that the vast majority of COVID-19 patients recover from the disease.’ A revision of the statistics confirms her statement. The U.S death toll stands at 214,280 deaths (at time of writing) which is acknowledged as a tragic toll. But taking into account the more than 7.6 million confirmed cases of the disease in the country it overwhelmingly shows that the vast majority of infected patients have fully recovered from the Coronavirus. As president of the United States Trump also has the distinct advantage of access to the best medical treatment and care possible. His oxygen levels would be continually monitored as many COVID-19 patients can become extremely ill if their oxygen levels decrease even before symptoms of this effect are apparent. It does seem that despite his age and girth the odds of a complete recovery for Trump are promising taking into account three very important factors these being: The early detection of the disease enabled due to frequent testing. His unparalleled access to the best medical care and treatments available including the Regeneron cocktail of antibodies and the fact that prior to prognosis he was reported to be fit and in general good health.
PRESIDENTS FULL RECOVERY COULD MAKE LIFE SAVING TREATMENTS AVAILABLE TO EVERYONE.
The as yet classified ‘experimental treatments’ that Trump is receiving are not currently readily available to many patients afflicted by COVID-19. If President Trump can make a full recovery with the aid of these therapeutics there is hope that this could pave the way for these drugs to be made readily available to everyone in need. This could provide a stop gap approach of first line treatment before an effective and save vaccine is available. His doctors have warned that the next 48 hours are crucial in observing his condition and to see how his condition responds to the mixture of drugs he has been given. Trump himself appears upbeat and does not give the depiction of a sick person who is on his last legs. He twittered from his makeshift hospital office as he thanked his supporters for their well wishes and seems keen to return to his gruelling work schedule as soon as he possibly can.
GLOATING ANTI TRUMP HATERS OVERJOYED WITH THE PRESIDENTS DIAGNOSIS
Many opposing Trump have bombarded social media gloating over his Coronavirus diagnosis and blaming Trump and his administration for not wearing masks. Some have even written that they would rejoice in his death with high profile personalities such as Former Democratic Party spokeswoman Zara Rahim stating ‘its been against my moral identity to tweet this for the last four years, but I hope he dies.’ (since deleted) and actor Dominic West, a former spokeswoman for Hilary Clinton telling Good Morning Britain on Friday that he felt ‘joy’ at the news of Trump’s illness. Some even promoted conspiracy theories including vocal Trump opposer Michael Moore who called Trump ‘a professional liar’ and accused him of trying to increase his election poll ratings by faking his diagnosis. MSNBC’S Joy Reid backed Moore’s opinion up and said, ‘he lies so much and could be using the virus to get out of the debates.’ There are still two further Presidential debates scheduled to take place before the November 3rd election. Currently it is unsure whether they or other future scheduled events will eventuate and will be dependent on the President’s recovery from COVID-19. In light of the many vicious statements regarding the President, Twitter has threatened to suspend accounts of those involved which has drawn some criticism as to why opinions on the President are in their view being censored as opposed to other examples of derogatory opinion statements that are not being threatened by removal. However not all Trump’s adversaries are (at least not publicly) relishing his health condition. Former President Barack Obama tweeted: ‘Michelle and I hope that the President, First Lady and all those affected by the coronavirus around the country are getting the care they need and are on the path to a speedy recovery, obviously we’re in the midst of a big political battle right now, and while there’s a lot at stake, let’s remember that we’re all Americans. We’re all human beings. And we want everyone to be healthy, no matter our party.’ Even Democratic Presidential candidate Joe Biden who was recently involved in the first Presidential debate that proved to be a heated and conflicting get together sent his best wishes to his opponent. ‘We will continue to pray for the health of the president and his family.’ he tweeted last Friday.
PRAYERS, ADVANCED MEDICAL TREATMENTS AND A HUGE DOSE OF DETERMINATION.
As Trump received the best of medical care while continuing to work from his hospital base seemingly intent on jumping back as soon as he could into his round of presidential duties and events prior to the November 3rd presidential election, a huge contingent of his supporters rallied in front of Walter Reed Hospital on Saturday evening. The event hosted by ‘Women for America First’ hosted a prayer vigil displaying prominent ‘Trump 2020’ signs as visual documentation of their belief in Trump’s vision for America. With the powerful combination and strength of the support of his followers, access to the best care and medications available world wide and maybe most importantly his dogged determination to get back to the job, the probability is very high that Trump will be successful in overcoming the Coronavirus and jump back onto the campaign trail quicker than the average patient who gets infected with COVID-19.