‘You Worry About the Side Effects’: Doctors Discuss Trump’s COVID Treatments
NBC 10 – October 5, 2020
Adam Stern, MD (Psychiatry, BIDMC) discusses the possible side effects of dexamethasone and cautions that they should be constantly monitored.
Videos and photos of President Donald Trump during his treatment at Walter Reed Medical Center show very little sign of his COVID-19 symptoms.
“I came here, wasn’t feeling so well, I feel much better now,” Trump said in a video from Walter Reed before he left the hospital Monday.
But information released by White House physicians about his treatment show that over the past few days, doctors have administered supplemental oxygen, the antiviral drug Remdesivir, an experimental antibody cocktail being tested by Regeneron and the steroid dexamethasone.
Boston University medical school professor Dr. David Hamer says it’s clear to him VIP syndrome is playing a role in Trump’s medical care.
“This is a term for basically when somebody who’s really important gets super special treatment that goes above and beyond what the normal public would get,” said Hamer. “He’s receiving very aggressive treatment that the average person entering the hospital would be unlikely to receive.”
Dr. John Herman, associate chief in the Department of Psychiatry at Massachusetts General Hospital, says doctors are trained not to be influenced by a patient’s status because it can have negative consequences. Herman said VIP syndrome “sways your judgment away from standard protocols.”
“Sometimes VIPs actually do not get the best treatment because there’s a tendency to overtreat and give them everything that might be available,” said Dr. Robert Finberg, Professor and Chair of Medicine at UMass Medical School and UMass Memorial Healthcare.
It’s important to note Finberg is not involved in the treatment of Trump. He says traditionally, dexamethasone is only given to patients in the second more dangerous phase of COVID to prevent the body’s own immune response from causing damage.
“There’s a caution about giving dexamethasone, one would not want to give dexamethasone to everyone,” Finberg said.
“It was really like nothing I had ever experienced before,” said Dr. Adam Stern, a psychiatrist at Beth Israel Deaconess Medical Center.
Stern has had not only clinical experience with dexamethasone, but also personal experience with the steroid when it was prescribed to him during cancer treatment last spring.
“Like a lot of people on this medication, my behavior had actually changed,” he said.
Stern, who is also not involved in the president’s treatment, says the side effects of a drug like dexamethasone can be extreme and should be constantly monitored.
“Dexamethasone can have a number of neuropsychiatric effects like insomnia, hyperactivity, mood dysregulation, irritability,” said Stern. “You worry about any of these side effects.”
Beyond that, medical experts from around the country and at Walter Reed were highly critical of the president’s decision to leave the hospital briefly Sunday, in an enclosed vehicle with Secret Service members, to thank supporters, despite his positive COVID status.
“We usually recommend people that are positive for COVID restrict their visiting because we don’t want to try to infect others,” Finberg said.
Some also worry the president’s care will mean people get the wrong idea about COVID 19.
“The experience and the treatment that he has gotten, in no way, is reality,” said Boston resident Lauren Nichols, who helps run an online forum for COVID-19 survivors. “We didn’t have the luxury of getting a hospital bed, getting care because we felt our symptoms getting worse, we had to manage at home.”
Finberg said he hopes that the best possible COVID treatments will be available to everyone.