President Trump and the First Lady Test COVID Positive

[NRSKarenRN]

The News earlier tonight shared that Hope Hicks became ill Wednesday night, and tested today and COVID-19 positive --per President Trump's confirmed tweet tonight. A few hours later, he confirmed the First Lady and he tested positive and are now  in quarantine.

 

[NRSKarenRN, BSN, RN]

WH update: Steven Miller now positive

Miller's married to the VP's communications director, who tested positive in May

https://abcnews.go.com/Politics/live-updates/trumpcoronavirus/?id=73446513

Twenty-three persons COVID positive linked to the WH

 

[NRSKarenRN, BSN, RN]

Full PPE now worn by staff in  private residence section of White House.

Deep cleaning should have been done over the weekend, IMHO.

 

[Tenebrae, BSN, RN]

12 hours ago, macawake said:

Not in the U.S., but we give 6 mg once daily for 6-10 days. Generally for severe or critical cases requiring oxygen therapy or ventilation.

When I was working in palliative care we would give it as an means of helping someone increase their energy

[NRSKarenRN, BSN, RN]

Dexamethasone used a lot in oncology, especially for those with  swelling from brain tumors -- recommended it to many PCP's; monitored for side effects in my hospice and palliative care  home care patients to improve quality of life.

[toomuchbaloney]

11 hours ago, Kitiger said:

This is Vice President Pense, talking about President Trump. "He rallied the American people to embrace social-distancing guidelines. And the progress we’ve made is remarkable."

President Trump has, in fact, shown by his actions that he does NOT think social distancing helps. 

And don't get me started on his views on masks!

The gas lighting is persistent and unashamed.

Isn't it?

[toomuchbaloney]

13 minutes ago, NRSKarenRN said:

Dexamethasone used a lot in oncology, especially for those with  swelling from brain tumors -- recommended it to many PCP's; monitored for side effects in my hospice and palliative care  home care patients to improve quality of life.

Yes.

Until patients started behaving in irrational , impulsive or dangerous ways.  When they start taking their clothes of and standing naked in the street we intervene...unlike with Trump. Those military health professionals take orders from him.

We have numerous examples now of military folks willing to do just about anything requested by the IMPOTUS, regardless of political nature or wisdom. 

[Corey Narry, MSN, RN, NP]

On 10/5/2020 at 3:06 AM, GrumpyRN said:

This is on a medical facebook page I follow.

Donald Trump’s chest roentgenogram has been released.

Someone thought it wasn't his because it shows a backbone.

 

 

normal lungs...but yet it must be him, because there is no visible cardiac silhouette, hence, no heart. On the other hand, that is noticeably a fit person with a slim frame...not Trump's body habitus.

 

 

[Corey Narry, MSN, RN, NP]

On 10/6/2020 at 9:19 AM, subee said:

I did a quick search and couldn't find out what dosages are given to Covid patients routinely.  I do know that in the OR, we give a large dose of dexamethasone one time on most intubated patients.  From personal experience I was flying the day of the procedure and crashing the next day.  The half life of dexamethasone is up to 72 hours so he could start crashing at any moment.....not sure it will be a smooth transition from steroid psychosis to steroid withdrawal but it's never pretty.

The recommendation for dexamethasone was based on the RECOVERY trial in the UK that used a dose of 6 mg of dexamethasone daily for 10 days or until discharge and showed a benefit for mechanically ventilated patients and avoidance of intubation in those with oxygen supplementtion requirement.  It had no benefit in patients not requiring oxygen supplementation. Our institution follows the 10-day course. If discharge happens before that, the last dose is given on the day of discharge.

[londonflo]

1 minute ago, juan de la cruz said:

It had no benefit in patients not requiring oxygen supplementation.

I am sure he told them he 'wanted to be instantly better' said the slime

[toomuchbaloney]

1 hour ago, juan de la cruz said:

normal lungs...but yet it must be him, because there is no visible cardiac silhouette, hence, no heart. On the other hand, that is noticeably a fit person with a slim frame...not Trump's body habitus.

 

 

Stephen Miller perhaps...

[moriahcat]

On 10/6/2020 at 8:42 AM, hherrn said:

A lot of fuss has been made about the steroids.

I don't read much into it. 

<snip>

While I am sure this is accurate, what you are really looking for is deviations from baseline.

You're correct, and decoding this President's recent Tweets from his baseline Tweets would be difficult to make (hey, he's not threatening to bomb a foreign nation, and he's come very close to that when *not* on steroids). 

Many suggested it wasn't steroids, but something to distract from the Wray announcement (many wanted those arrested to get the death penalty), that caused his Tweetstorm last night, and the threats to cut off COVID-19 relief negotiations.  (And we fall for him using the platform as a distraction by paying it any mind.)

I really don't think there's much data on patients who have had the literal kitchen sink thrown at them so early after testing positive for the virus to know what's going to happen in the next few days -- the point at which most people with the infection either seem to get better, or get much worse. 

I also am not personally knowledgeable enough of the effects of remdesivir on accuracy of COVID-19 testing, so I'm glad there's another full week where he should have time off of the antiviral -- if it was going to be a 5 day treatment starting Friday, today'd be his last dose -- before he'd potentially be in a debate auditorium.

I'm also wishing more epidemiologic/contact tracing work could be done and made public, but I know there are national security concerns involved with combing through the President's schedule as well as pretty much everyone else in the WH.  Even if not made public, I hope someone is going to eventually examine the trove of last contact info/testing dates/positive test result dates, because as much as I hate that this virus is going through the WH and want everyone to be okay, this is also one of the only population where people are routinely getting any form of testing.

I'm particularly wanting it evaluated by someone sooner than a decade from now, because of the data it could give on what a "negative test result" actually means in the course of an outbreak.  We all know a negative HIV test only means the person wasn't exposed to HIV 3 months ago, but they could still have it, and could still potentially be infectious. 

Other groups have attempted to incorporate rapid non-nasal testing into their "bubbles", and knowing how long there should be isolation and repeat testing before admission to a "bubble" would help contain the virus, particularly if these rapid tests are being mass-produced and used by businesses or other non-governmental interests -- maybe eventually they'll make it to hospitals and patient care staff.  

[Corey Narry, MSN, RN, NP]

1 hour ago, moriahcat said:

I really don't think there's much data on patients who have had the literal kitchen sink thrown at them so early after testing positive for the virus to know what's going to happen in the next few days -- the point at which most people with the infection either seem to get better, or get much worse. 

I also am not personally knowledgeable enough of the effects of remdesivir on accuracy of COVID-19 testing, so I'm glad there's another full week where he should have time off of the antiviral -- if it was going to be a 5 day treatment starting Friday, today'd be his last dose -- before he'd potentially be in a debate auditorium.
 

I've only seen critically-ill COVID 19 patients who have received remdesivir and not once did they convert to negative in a week's time (we test every 7 days).  These are obviously the severe cases which the President does not fall under.  For employees who have tested positive with asymptomatic to mild to moderate symptoms, our policy is that the employee stays at home for 10 days since diagnosis or onset of symptoms (whichever came first) and can return if it's been 48 hours since last symptoms and symptoms have been improving over the course of 10 days.  That requires an employee health evaluation and clearance letter.  He clearly acts like he's above any protocol so what I said is probably irrelevant.