The Skeptics Guide #796 - Oct 10 2020
Today is Wednesday October seventh twenty twenty and this is your host Steven Novella joining me this week or Bob Novella. Hey everybody Cara Santa Maria howdy drain Avella Guys Evan Bernstein June leaving folks. All right. So what happened in the last week that was newsworthy okay. Something about someone came down with something someone or someone's the president called covert nineteen and was basically a super spreader event at the White House and ton of the people in his orbit also came down with covered nineteen. I think it was one, thousand, nine, hundred, Steve Count messed I heard. Wow, ironical. So it highlights the fact that this pandemic it's still ongoing it's very infectious agent. You have to be extremely careful one of the things that came out of this though. So again, we're not trying to pick on trump, but this is something we have to talk about. There was a lot of confusion surrounding pretty much everything to do with with the president's infection. He went to Walter Reed Hospital which which is a military hospital and it's where the president would go when he gets sick and. The care that he received there was was odd it's not how would a regular person would have been treated that way there is something by the way if I could back up for a second in medicine, we do refer to recall VIP medicine where if you have a very high profile VIP patient, sometimes they get special treatment but the thing is it's usually not better than standard care. It sort of VIP care can often be worse because any. That biases, the decision making if you think about it, the clinical decision making should already be optimized to risk versus benefit and all that stuff. And anything that biases that is going to deviate from optimal it could only be good. That's the only. Time where where it's better medicine is obviously in the superficialities Tad. Service when a a Saudi prince, a literal Saudi prince basically bought the entire floor of the hospital. For him to stay yes. You get that kind of treatment but the actual medical care unless like you can't pay for things well, and that's the real problem in our country. Right? Is that some people are getting not optimal care simply because they can't afford not optimal care right and actually. To be honest with you if you're sick, you know most people are getting the care that they need enshrining for to the. Hospital just does it and worries about getting paid for it later to be honest with you and they are sort of baking into the whole system taking a loss. But regardless of how you feel about trump like he is the president, which means he needs to be well as soon as possible. Be Getting. The best care should. Carry that we can deliver. But where the VIP care deviates from optimal is when they do things like give experimental treatments you know. I think drugs that usually only give people when they're. Right he got he got one experimental treatment, a monoclonal antibody. He received the rent. Vir, which is pretty standard but again usually. Given in severe cases, but the the real the real curious thing was that he was given steroids and steroids are usually reserved for people in the later stages the people who have the WHO get the immune reaction after the first week or so that sick when they're immune reaction like a really negative immune reaction kicks in then we give them steroids to sort of tamp that down you don't necessarily want to give them initially because they the steroids suppress the immune system, right might suppress your ability to fight off the virus earlier. So there's no prophylactic kind of benefit to. Perhaps he was sicker than they let us. Yeah. So there's a mismatch between what we're being told about how was and what we were being told about what he was getting and I tell you I'll say when I become a super VIP and I go to the hospital and by a floor whatever I do I will say give me the standard of care but add on demand. Foot massages. Treat. Strategy that's your VIP tree. That's fine. But he got steroids and so pretty evasion oxygen. Actually Multiple Times Oxygen Standard Your. Drop you're right but but that's what I'm saying like maybe he was sicker than we thought because within the first lake apparently, he got oxygen while he was still at the White House before they decided to bring him in and then the doctor was really cagey about whether or not he was still needing oxygen supplementation. You correct we're kind of talking about two different things. So you're correct in that there's a mismatch between the different things that we're being told. When did he contract it? When did he know? Was He? When did it become symptomatic? How sick was he did he require oxygen? Did he have pneumonia the his doctors being cagey about all of these things but we did learn that he did on two occasions. Occasions was temporarily given supplemental oxygen because Oh two's rations dropped, which means there was some pulmonary involvement but the steroids is a different issue I. Don't think that's a manifestation of him being sicker than we were told because he would not be out of the hospital now if that were the case. That's a manifestation I. think of them throwing everything at him to get him better as quickly as possible even if it's not necessarily the best thing. It could backfire sicker. Yeah. I I don't know what's going on behind closed doors but. Wouldn't give that at this stage of the illness and I've read multiple articles of of of covert nineteen treating doctor saying just doesn't make any sense this. There's no scenario where he should be getting steroids at this at this point in his care what if he's been sick for a week Steve? Well, yeah he would have to think that but again, he wouldn't wouldn't have bounce back that quickly it when you're when you're at the point that you need steroids, you're probably intimated or your close to being. On there's no way I mean, even if you sick slightly longer, we all saw him at the debates. He was well enough to hit a lot of energy that he was not somebody who needed steroids. Is the only way that makes sense of it in my opinion is.