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Sunday, October 04, 2020

Opinion | The medical briefing on Trump’s health was an insulting exercise in obfuscation - The Washington Post

Opinion | The medical briefing on Trump’s health was an insulting exercise in obfuscation



"Saturday’s briefing by President Trump’s medical team was a deliberate exercise in obfuscation, insulting to the public and unbefitting the seriousness of the moment.

Every first-year medical student knows that you can’t describe a patient’s condition without including the exact vital signs. We heard that the president has no fever, but not what his temperature has been — and whether he’s fever-free because of fever-reducing drugs. We heard that he has an oxygen saturation of 96 percent — but not what it’s been throughout his illness. Was a low oxygen saturation part of the reason he was transferred to the hospital?
White House physician Sean Conley volunteered that the president was not on supplemental oxygen at the time of the news conference and that day, but repeatedly evaded questions about whether Trump had been on oxygen since he became ill.
This kind of too-clever-by-half, rosy-scenario briefing neither reflects well on Conley nor serves the public interest — especially when Conley’s happy talk was contradicted in short order by White House Chief of Staff Mark Meadows, who said Trump went through a “very concerning” period Friday and is “still not on a clear path yet to a full recovery.”
There was also no accounting of test results. Another physician cited cardiac, kidney and liver tests as being normal, and Conley referred to the president as having received “ultrasounds.” For covid-19, a respiratory disease, it’s inconceivable that lung studies of X-rays or CT scans weren’t conducted. What did they show? Without a full description of which diagnostic tests were performed, we are left to wonder whether other test results weren’t revealed because they were abnormal.
Then there are major questions raised about the timeline of the president’s diagnosis. Conley reported that Trump developed a fever Thursday. Fever is usually a later sign that follows other symptoms of covid-19. Conley said Trump had other symptoms, such as cough, congestion and feeling run-down. When did the first of these symptoms start?
The answer is important because those with the virus are most infectious 48 hours before symptom onset. Public health officials need to know in order to trace back the president’s steps and find out who else could have been exposed.
In addition, Conley stated at the briefing that the president was “72 hours into the diagnosis." That would have put the time of diagnosis —presumably when there was a confirmed positive test — to be Wednesday morning. Conley has since issued a statement saying that he misspoke and that he meant Saturday was “day three,” with a diagnosis given Thursday evening.
The president and White House officials are said to have daily tests. These are the rapid, less accurate tests. Presumably, Trump had a positive rapid test that came back within minutes, then his doctors conducted a confirmatory test with a more accurate test that took hours to provide results. So when was the first positive test? The public needs to know: Was the president still continuing his activities after that initial positive test?
It raises alarms that Conley refused to answer a related question: When was Trump’s last negative test? If the president is in fact being tested daily, that’s one thing. But if he hadn’t been tested for a full week, say, we’d have much less information about how contagious he has been and for how long.
The physicians at the briefing refused to directly address contact tracing, saying that other entities were handling this. But contact tracing is crucially impacted by when the president tested positive and showed symptoms. We now know that at least five people who took part in debate preparations with Trump have tested positive. Former New Jersey governor Chris Christie is among those who found out that he was positive on Saturday morning, but has said that he didn’t know he needed to be tested until Friday. Had these individuals known about the president’s diagnosis and therefore their own exposure earlier, they could have self-quarantined to avoid infecting others.
There are others who had lower-level exposure but may still face some risk, including former vice president Joe Biden, who faced off with Trump at the debate Tuesday evening. Biden and debate moderator Chris Wallace were about 12 feet away from Trump. There was no handshaking or other physical contact. The debate venue was large and presumably well-ventilated. However, Trump was speaking loudly and not wearing a mask, and a number of audience members on Trump’s side — some of whom could have also been contagious — were maskless. The risk to Biden is low, but not zero, especially as Trump was likely at his most infectious state then. Why wasn’t there immediate outreach to Biden and, indeed, the other attendees at the debate?
With emerging positive cases coming to light among our country’s top officials, it now appears that the White House itself is the epicenter of a large outbreak. We need a full briefing around the president’s health. We deserve it."
Opinion | The medical briefing on Trump’s health was an insulting exercise in obfuscation - The Washington Post

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