I'm a doctor, and I saw hundreds of covid patients in an outpatient setting back in April. Just watched the briefing Trump's medical team gave today (Sunday): totally agree that we're being given mixed messages. They have an upbeat tone & emphasize how he's improving, but they also report they're treating him with dexamethasone, which is reserved for patients sick enough to need oxygen support.
The medical team now reports that on Friday, he had a high fever, and an episode where his sat went below 94%, and he was on supplemental oxygen for about an hour. He apparently also had an episode where his sat went down to 93% yesterday (Saturday), and they were evasive about whether or not he received oxygen. If that second desat episode was real (more than a minute or two), of course he got oxygen again. Plus, why start him on dexamethasone, which actually showed a trend toward harm in patients not needing oxygen at time of randomization:
https://www.nejm.org/doi/full/10.1056/NEJMoa2021436#:~:text=The%20RECOVERY%20trial%20provides%20evidence,who%20did%20not%20require%20oxygen.
Note the CI crosses 1 for that group, so I say trend toward harm.
I do understand it's sort of a soft call, and the tendency of medical professionals is to do something rather than nothing, in case the patient later deteriorates. Still, I believe he probably had two real episodes of de-sating.
Remdesivir is an anti-viral originally designed to treat hepatitis C that has shown a statistically significant, though modest, benefit in days to recovery and a trend toward survival benefit.
The wildcard in my mind is how much the polyclonal antibody cocktail Trump received could benefit. Unlike pre-existing drugs such as dexamethasone, remdesivir, or hydroxychloroquine, this therapeutic was specifically designed to target covid (in the form of neutralizing antibodies), and has the potential to be a game-changer. We only have preliminary data on 275 patients released by the company Regeneron (not peer-reviewed) showing significantly reduced viral loads and faster time to recovery. It's a promising therapeutic with biological plausibility, but at this time the data is still being gathered, so we don't have a clear answer.
Some people have said that Trump looks pale and fatigued in videos. Lots of people with mild-moderate courses are fatigued, and that's not necessarily a warning sign. He's speaking in full sentences, and there's nothing about his appearance that's a red flag to me. What is concerning are the episodes of de-sating. The episode on Friday described by his doctors today did warrant hospitalization, especially in a 74yo man with BMI just over 30.
How are things going to play out in the next few days? I have no idea.