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Trump had access to experimental treatment within hours of diagnosis. Here’s how presidential medical care works

President Donald Trump walks from Marine One towards Air Force One at Andrews Air Force Base, Md., Wednesday, Sept. 30, 2020. Fresh off the first presidential debate, Trump is returning to the battleground state of Minnesota for a rally and fundraiser.  (Susan Walsh)

Being the president has its perks, including 24-hour access to state-of-the-art medical care. And when COVID-19 came for President Donald Trump, he was given experimental treatment just hours later.

The president not only has a hand-picked physician but an around-the-clock team of health care providers at the White House, on Air Force One and on hand everywhere he goes.

As former White House physician Dr. Connie Mariano, who treated George Bush, Bill Clinton and George W. Bush, told CNN in 2004, “You essentially shadow the president.”

Archived presidential websites describe a White House Medical Unit, which employs a team of doctors and nurses, under the White House Military Office. The unit provides 24/7 medical care to the president, vice president and their families.

This could help explain the rapid sequence of events on Friday, after the president announced very early on Twitter that both he and the First Lady had tested positive for the novel coronavirus.

Later that day, the president reportedly had “mild symptoms,” but his physician Sean Conley treated him with a dose of an experimental antibody cocktail. Conley reported in his memo that the President was “fatigued” but in good spirits.

The cocktail drug is not yet approved by the Federal Drug Administration, although its trial so far shows it reduces viral load in some patients and alleviates symptoms, according to a news release from Regeneron, the company that makes it.

Because the drug is still in early trials, researchers don’t know just how effective it is yet.

“There are data indicating that monoclonal antibodies might have a role in people with COVID-19 who are not yet seriously ill. Hopefully more data from trials will be forthcoming,” Dr. John Lynch, medical director at Harborview Medical Center, said in a statement to the Spokesman-Review Friday.

Later on Friday, after a short video announcement in which Trump said, “I think I’m doing very well,” he was flown to the Walter Reed National Military Medical Center, a military hospital in Maryland, at the recommendation of his physician and medical experts.

The First Lady was not transferred to the medical center, however. Conley’s memo indicates that Melania Trump had a mild cough and headache.

Mild symptoms from COVID-19, like fevers, coughs, aches and chills, are typically treated with over-the-counter medicine as necessary, Lynch said in prepared and recorded remarks on Friday.

Lynch said it was likely that the physicians attending the president and first lady were keeping a close eye on their oxygen levels. If the president was to be hospitalized, Lynch said, two treatment types for COVID-19 are the most common.

The first is the antiviral drug remdesivir, which is used nationwide for coronavirus patients who are hospitalized. The second treatment, especially for patients who require more oxygen, is a steroid called dexamethasone.

While former Vice President Joe Biden tested negative for the virus on Friday, health experts told science writer Ed Yong on Fridaythe negative test doesn’t mean he’s in the clear.

Negative tests are not necessarily reliable, as often times a person can test negative initially then eventually test positive. This is exactly what happened to Trump aide Hope Hicks, who tested negative before experiencing symptoms on Wednesday, the Washington Post reported.

Lynch said the fact that Hicks, the president and the first lady all tested positive within a day of one another points to the potential for an outbreak.

“We’re looking at potentially more infections going forward,” Lynch said in prepared remarks Friday.

According to the Centers for Disease Control and Prevention, a person with COVID-19 can be contagious even before they begin displaying symptoms. Additionally, a person might not display symptoms until two to 14 days after exposure to the virus.

While Trump, who is 74, is considered at higher risk for developing complications with COVID-19, his most recent medical exam performed this summer indicated that he was healthy.

Trump is expected to stay at the hospital for “the next few days,” according to a statement from the White House on Friday. By late Friday, Trump’s doctor released an update stating the president was being treated with remdesivir but did not require supplemental oxygen.

Conley told reporters Saturday morning that Trump’s cough and fatigue are improving, and he had remained fever-free for more than 24 hours. But a White House source reportedly later said the president’s symptoms had been “very concerning,” leading to confusion and speculation.

Doctors plan to continue a five-day treatment of remdesivir for the president, but they would not put a firm date on his discharge. On the seventh to tenth days of the coronavirus, patients can enter a more inflammatory part of the disease, so providers are going to continue to monitor the president and evaluate whether he needs to stay at the hospital.

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.