User:Feoffer/sandbox11

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Donald Trump and the 25th amendment

Trump infected with SARS-CoV-2 and hospitalized[edit]

At 12:54 a.m. EDT on October 2, Trump announced via Twitter that both he and the first lady had tested positive for the SARS-CoV-2 virus that night.[1][2] The afternoon of the same day, the White House announced that Trump would be hospitalized at Walter Reed National Military Medical Center in Bethesda, Maryland.[3]

Trump was given oxygen at the White House.[4]After Trump "had a fever and his blood oxygen level had dropped rapidly",[5] he was evacuated by helicopter to Walter Reed.[6]

Trump administered experimental treatment regime[edit]

Trump was administered an extremely aggressive drug combination that was described as "uncharted territory"; Trump is believed to be the first individual to ever undergo all three COVID treatments simultaneously.[7]

REGN-COV2 (experimental monoclonal antibodies)[edit]

On October 2, afternoon, physicians revealed Trump had been given an experimental course of monoclonal antibodies from drug maker Regeneron Pharmaceuticals,[8] which further confirmed that Trump had received an "8 gram dose of REGN-COV2".[9]

Remdesivir (experimental antiviral)[edit]

On the night of October 2, Trump received his first infusion of remdesivir, an antiviral drug that disrupts virus replication. Remdesivir has not been approved by the Food and Drug Administration, but has been used as an emergency treatment for hospitalized COVID-19 patients.[10]

The most common adverse effects in studies of remdesivir for COVID‑19 include respiratory failure and organ impairment, including low albumin, low potassium, low count of red blood cells, low count of platelets that help with clotting, and yellow discoloration of the skin.[11][unreliable medical source?] Other reported side effects include gastrointestinal distress, elevated transaminase levels in the blood (liver enzymes), and infusion site reactions.[12]

Other possible side effects of remdesivir include:

  • Infusion‐related reactions. Infusion‐related reactions have been seen during a remdesivir infusion or around the time remdesivir was given.[13] Signs and symptoms of infusion‐related reactions may include: low blood pressure, nausea, vomiting, sweating, and shivering.[13]
  • Increases in levels of liver enzymes, seen in abnormal liver blood tests.[13] Increases in levels of liver enzymes have been seen in people who have received remdesivir, which may be a sign of inflammation or damage to cells in the liver.[13]

Dexamethasone (steroid)[edit]

On October 3, Trump's was given the steroid dexamethasone, which works by reducing inflammation in the lungs,[14] but can have significant mental health side effects, including psychosis, delirium and mania.[15][16]

Among patients administered dexamethasone, about 30% develop "moderate psychiatric symptoms like anxiety, insomnia, mania, or delirium". About 6% develop psychosis.[17]

One expert commented: "Some patients may develop psychiatric symptoms after being treated with steroids including euphoria, mood instability, rage or psychosis."[18][19] Professor of Emergency Medicine Esther Choo warned "we tell people that it can make them feel really hyper. It can make them behave very strangely."[20][21][22]

Behavior during treatment[edit]

After Trump began undergoing treatment, he exhibited controversial behavior which led to speculation about his capacity to execute his duties.

Post-hospitalization motorcade excursion[edit]

Trump greets supporters from inside an SUV on October 4.

Later in the day, Trump left the hospital in order to ride past a gathering of supporters at the medical center, waving from the back seat of an SUV, before returning to the hospital.[23] Medical experts stated that the outing recklessly endangered the Secret Service agents inside the car by exposing them to the virus.[24][25] The stunt drew sharp criticism from James Phillips, doctor of emergency medicine at George Washington University and an attending physician at Walter Reed, who called it "insanity" and wrote: "That Presidential SUV is not only bulletproof, but hermetically sealed against chemical attack. The risk of COVID-19 transmission inside is as high as it gets outside of medical procedures. The irresponsibility is astounding. My thoughts are with the Secret Service. ... Every single person in the vehicle during that completely unnecessary Presidential 'drive-by' just now has to be quarantined for 14 days. They might get sick. They may die. For political theater. Commanded by Trump to put their lives at risk for theater."[26][27]

Within the Secret Service, some agents expressed outrage or frustration with Trump's behavior.[24][28][29] One anonymous agent told journalists, "He's not even pretending to care now."[28] Joseph Petro, a former veteran Secret Service agent and senior official, wrote in a Washington Post op-ed that Trump's behavior was part of a longstanding pattern of endangering others; he criticized Secret Service management for an "inexcusable lack of concern" for the health of agents and their families, writing: "The Secret Service cannot protect the president from himself, but its management has a solemn responsibility to protect those agents who put their lives on the line every day to protect him."[30]

All-caps tweets[edit]

 Esther Choo, MD MPH Twitter
@choo_ek

So my guess is they’ve started dexamethasone

Oct 3, 2020 12:30 PM[31]

Donald J. Trump Twitter
@realDonaldTrump

OUR GREAT USA WANTS & NEEDS STIMULUS. WORK TOGETHER AND GET IT DONE. Thank you!

Oct 3, 2020 10:46 PM[32]

After Trump left the hospital for a motorcade excursion and posted over a dozen all-caps tweets, it was speculated that the president was suffering from "steroid-induced psychosis".[33] Megan Ranney, an emergency physician and professor at Brown University, told CNN's Wolf Blitzer: "I would never want to say the president is experiencing steroid-induced psychosis, but it is certainly concerning to see some of his actions today in the wake of this potentially deadly diagnosis and infectious disease."[34]

Early release from hospital and return to White House[edit]

Stimulus enthusiasm, unexpected withdraw from negotiation, and reversal[edit]

On October 3, Trump tweeted "OUR GREAT USA WANTS & NEEDS STIMULUS. WORK TOGETHER AND GET IT DONE". However at 2:48 p.m. EDT on October 6, Trump unexpectedly announced on Twitter that he was halting negotiations on a coronavirus stimulus bill. The announcement caused another sudden drop in the stock market, and Speaker Pelosi questioned if his steroid use was affecting his decision-making.[35][36] Trump reversed this decision in another tweet sent at 10:18 p.m. EDT on the same day.[37]

Calls for indictments[edit]

Fitness concerns about Trump[edit]

White House internal response[edit]

According to Vanity Fair, Donald Trump Jr. expressed concerns on October 4 that the president was "acting crazy".[19] Privately, White House aides had concerns about the effects of medications up Trump's on "animated mood".[17]

Experts[edit]

After Trump left the hospital for a motorcade excursion and posted over a dozen all-caps tweets, it was speculated that the president was suffering from "steroid-induced psychosis".[38] Megan Ranney, an emergency physician and professor at Brown University, told CNN's Wolf Blitzer: "I would never want to say the president is experiencing steroid-induced psychosis, but it is certainly concerning to see some of his actions today in the wake of this potentially deadly diagnosis and infectious disease."[39]

Congressional response[edit]

On October 8, Speaker Pelosi announced plans for a meeting the following day to discuss the 25th Amendment.[40]

  1. ^ Cite error: The named reference liptak was invoked but never defined (see the help page).
  2. ^ Herman, Steve (October 2, 2020). "Trump, First Lady Test Positive for COVID-19". Voice of America. Archived from the original on October 3, 2020. Retrieved October 3, 2020.
  3. ^ Stolberg, Sheryl Gay (October 4, 2020). "Trump's doctor delivers confusion instead of reassurance, experts say". The New York Times. Retrieved October 6, 2020.
  4. ^ Lemire, Jonathan; Colvin, Jill; Miller, Zeke (October 3, 2020). "Trump was given oxygen before his admission to hospital". Associated Press. Archived from the original on October 3, 2020. Retrieved October 3, 2020.
  5. ^ "Mark Meadows: Trump's blood oxygen level "dropped rapidly", but he's doing well". Axios. October 4, 2020. Archived from the original on October 4, 2020. Retrieved October 4, 2020.
  6. ^ Liptak, Kevin (October 2, 2020). "Trump taken to Walter Reed medical center and will be hospitalized 'for the next few days'". CNN. Archived from the original on October 2, 2020. Retrieved October 2, 2020.
  7. ^ Kolata, Gina; Mandavilli, Apoorva. "'Uncharted territory': Trump's COVID-19 treatments — the antiviral drug remdesivir and an experimental antibody therapy — suggest a serious condition". The Baltimore Sun.
  8. ^ Thomas, Katie; Kolata, Gina (October 3, 2020). "President Trump Received Experimental Antibody Treatment". The New York Times. Archived from the original on October 4, 2020. Retrieved October 4, 2020.
  9. ^ Hackett DW (October 3, 2020). "8-Gram Dose of COVID-19 Antibody Cocktail Provided to President Trump". www.precisionvaccinations.com. Archived from the original on October 3, 2020.
  10. ^ "Trump Is Taking Remdesivir. Here's How It Works To Control The Coronavirus". NPR. Archived from the original on October 4, 2020. Retrieved October 4, 2020.
  11. ^ Cite error: The named reference Wang 2020 was invoked but never defined (see the help page).
  12. ^ Cite error: The named reference Mehta2020 was invoked but never defined (see the help page).
  13. ^ a b c d Cite error: The named reference EUA FAQ was invoked but never defined (see the help page).
  14. ^ Egan, Lauren (October 4, 2020). "Doctors say Trump on steroid therapy, health improving after brief 'episodes'". NBC News. Archived from the original on October 4, 2020. Retrieved October 4, 2020.
  15. ^ Amatulli, Jenna (October 5, 2020). "Doctor Warns Trump's Coronavirus Treatment Can Cause Psychosis, Mania". Huffpost. Huffpost. Retrieved October 6, 2020.
  16. ^ Warren KN, Katakam J, Espiridion ED (August 2019). "Acute-onset Mania in a Patient with Non-small Cell Lung Cancer". Cureus. 11 (8): e5436. doi:10.7759/cureus.5436. PMC 6797013. PMID 31632882.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  17. ^ a b https://www.nytimes.com/2020/10/08/us/politics/trump-calls-to-indict-political-rivals.html
  18. ^ Bruggeman, Lucien; Abdelmalek, Mark (October 5, 2020). "In information vacuum, experts say Trump's steroid treatment may hold clues to health status". ABC News. Retrieved October 5, 2020.
  19. ^ a b Sherman, Gabriel (October 5, 2020). ""Don Jr. Thinks Trump Is Acting Crazy": The President's COVID Joyride Has the Family Divided". Vanity Fair. Retrieved October 5, 2020.
  20. ^ https://slate.com/technology/2020/10/donald-trump-steroids-brain.html
  21. ^ https://www.nytimes.com/2020/10/04/health/trump-covid-treatment.html
  22. ^ https://www.albawaba.com/news/trump-fires-string-tweets-hospital-bed-walter-reed-reminding-people-vote-him-1384755
  23. ^ Cite error: The named reference jacksonmotor was invoked but never defined (see the help page).
  24. ^ a b Zolan Kanno-Youngs & Michael S. Schmidt, For the Secret Service, a New Question: Who Will Protect Them From Trump?, New York Times (October 5, 2020).
  25. ^ Davey Alba, Far Right Sees ‘Miracle’ in Trump’s Outing. Medical Experts See Recklessness., New York Times (October 5, 2020).
  26. ^ Luscombe, Richard (October 5, 2020). "'This is insanity': Walter Reed physician among critics of Donald Trump drive-by visit". The Guardian.
  27. ^ Seipel, Brooke (October 4, 2020). "Walter Reed attending physician swipes at Trump for motorcade visit to supporters". The Hill. Archived from the original on October 4, 2020. Retrieved October 4, 2020.
  28. ^ a b Leonnig, Carol D. (October 4, 2020). "Secret Service agents outraged by Trump's drive outside hospital". The Washington Post.
  29. ^ Martin Kaste, Secret Service Agents Frustrated With Trump's Unnecessary Coronavirus Risks, NPR (October 6, 2020).
  30. ^ Joseph Petro, I'm a former Secret Service executive. The willingness to put agents in danger is inexcusable., Washington Post (October 6, 2020).
  31. ^ Esther Choo, MD MPH [@choo_ek] (October 3, 2020). "So my guess is they've started dexamethasone" (Tweet) – via Twitter.
  32. ^ Donald J. Trump [@realDonaldTrump] (October 3, 2020). "OUR GREAT USA WANTS & NEEDS STIMULUS. WORK TOGETHER AND GET IT DONE. Thank you!" (Tweet) – via Twitter.
  33. ^ Levin, Bess. ""Steroid-Induced Psychosis": Trump Follows Up Sunday Night Joyride With Extra-Crazy Monday (Even for Him)". Vanity Fair.
  34. ^ Guzman, Joseph (October 5, 2020). "What are the side effects of Trump's coronavirus treatment regimen?". TheHill.
  35. ^ Pound, Fred Imbert,Jesse (October 5, 2020). "Dow closes more than 300 points lower after Trump calls off stimulus, causing sudden drop in stocks". CNBC. Retrieved October 7, 2020.{{cite web}}: CS1 maint: multiple names: authors list (link)
  36. ^ Wu, Nicholas; Hayes, Christal. "Pelosi questions whether Trump taking steroids for COVID-19 impacted decision to halt coronavirus stimulus bill". USA TODAY. Retrieved October 7, 2020.
  37. ^ Trump, Donald J. [@realDonaldTrump] (October 7, 2020). "If I am sent a Stand Alone Bill for Stimulus Checks ($1,200), they will go out to our great people IMMEDIATELY. I am ready to sign right now. Are you listening Nancy? @MarkMeadows @senatemajldr @kevinomccarthy @SpeakerPelosi @SenSchumer" (Tweet) – via Twitter.
  38. ^ Levin, Bess. ""Steroid-Induced Psychosis": Trump Follows Up Sunday Night Joyride With Extra-Crazy Monday (Even for Him)". Vanity Fair.
  39. ^ Guzman, Joseph (October 5, 2020). "What are the side effects of Trump's coronavirus treatment regimen?". TheHill.
  40. ^ Axelrod, Tal (8 October 2020). "Pelosi: 'We're going to be talking about the 25th Amendment'". TheHill. Retrieved 8 October 2020.
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