Corona Daily 049: Nightmare Scenario

Next Tuesday, HarperCollins will publish a book “Nightmare Scenario”.  Written by two Washington Post journalists, Damien Paletta and Yasmeen Abutaleb, the book documents the behind-the-scenes panic over Trump’s covid-19 illness. Some excerpts and reviews of the book are out.

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On 1 October, Alex Azar, the health secretary, received a call from the White House requesting help with an experimental treatment “monoclonal antibody”. The drug was in clinical trials, not yet available to the public. Azar was not told who the drug was meant for. He speculated it was Trump’s advisor, Hope Hicks, who had tested positive.

A little later, Stephen Hahn, the FDA commissioner received a call. Could he please immediately sign off a “compassionate use authorization”? In life-threatening emergencies American doctors can apply to the FDA for unapproved medicines. But nobody directly calls the FDA commissioner. Hahn, just like Azar, did not know who the patient was.

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On the previous Saturday, 26 September, Trump had held a mask-less, distance-less party in the White House garden to announce Amy Barett as the Supreme Court Justice. The party had moved indoors. No mask was the unofficial policy. If the head of the house never wore a mask, how could others? Trump actually asked aides to take them off. In news conferences, he didn’t want any masked people behind him in the same frame.

On 27 September, Trump hosted military families at the White House. He complained to his security guards later. Why were they letting people get so close to him? “If these guys had covid, I’m going to get it, because they were all over me.” He said.

On 29 September, in the first debate with Biden, Trump was more incoherent than his usual self. By the following evening, he was terribly ill. His fever shot up, his oxygen level started falling, at one point dipping into the 80s. He was immediately given oxygen.

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Trump initially refused to go to the hospital. His aides gave him the two possible options: either he went that day while he could still walk on his own, or wait and let the TV cameras capture him in a wheelchair or stretcher. There is no easy way for the president to hide his condition.   

Few people in the White House knew the severity of Trump’s condition. Pence and his team were never informed the vice president may have to take up Trump’s job at short notice. By now, realizing who the exceptional patient was, Alex Azar and Stephen Hahn had authorized the unapproved drugs for compassionate use.

Trump was 74, never exercised, ate junk food, drank Coca-Cola and was medically obese. Ideal prey for the coronavirus.

After FDA’s sign-off, Trump was given an eight gram dose of two monoclonal antibodies through an intravenous tube. He was also given through IV the antiviral drug Remdesivir. (But not hydroxychloroquine, his pet). Remdesivir was in such short supply that ordinary Americans had no access to it.

On 3 October, on becoming worse, Trump was given dexamethasone. This is given when someone is extremely ill. Every hour, doctors consulted Fauci, Hahn and others whom Trump had openly hated, opposed and insulted.

The cocktail of medicines, available only to a single person on the planet, helped. Monoclonal antibodies proved to be a miracle.

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Fauci, Birx, Redfield and other health experts felt the illness was a blessing. The near-death experience would make the president change the course of his message. Now he would tell his millions of followers how dangerous the virus was. He could perhaps announce a mask mandate.

On his return, Trump faced the cameras from the balcony, and triumphantly pulled the mask off his face. He was heavily made up that morning, with additional orange colour added to his face. He made a military salute, and still contagious, entered his house without a mask.

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While reading the excerpts, I felt sorry the extraordinary, rare and expensive treatment which saved this undeserving man was not available to the 3 million+ victims of covid-19.

On the other hand, I am happy Trump didn’t die that week. America and the world needed his defeat and not death.

Ravi