Sunday, October 04, 2020

Trump's approach to his Covid condition is exactly right

OK, Donald Trump and his wife got their positive test some two days ago. At some level, it was almost unavoidable that a man who is exposed to so many other people would get infected, soon or later, and his history of "protection against the virus" may be said to be futile by now! ;-) Fine, he contracted it (unless it is a giant theater). He could have locked himself at the top of the White House but he decided to go on the offensive – by picking an army hospital he considers great.

You can see he is doing very well, speaking carefully, as a loving leader of the whole world, not just the U.S., and praising the drugs he is receiving: Regeneron's REGN-COV2 (8 grams, already on Saturday) and Gilead Sciences' Remdesivir (see recommended doses). I first promoted the latter on March 3rd; it is still not quite approved in the U.S. which is rather incredible after those 7-8 months of hysteria, given the clear evidence that it helps.

These companies' stocks will probably jump tomorrow (here are the drugs that the world's most powerful man is getting, so should you, the meme will say); Trump has stocks in both. Gilead Sciences is planning to make 2 million doses of the Czech American antiviral drug (and a close cousin of the most effective, Czech, treatment of HIV in the world) by the end of 2020. Some chronology would have to be investigated to see whether there is anything immoral or illegal about this position in his portfolio. At any rate, Regeneron's drug is a pair of artificial antibodies. I wasn't really aware of this achievement and yes, it is in some ways even better and safer than natural antibodies from a convalescent plasma which would be my #1 choice. Remdesivir would be the #2 choice.

Here, NPR explained how Remdesivir works. Viruses can't replicate themselves, they use the ribosomes, the "protein factories" inside our cells. There are millions of ribosomes in each cell. The replication creates mutations or errors, there are methods to fix the errors, and Remdesivir disables the error correction, therefore suppressing the proliferation of viable viruses.

These drugs really represent the cutting-edge treatment of the disease, they are results of science par excellence. Remdesivir was known to be effective "in the testtube" for a long time. Some experiments show that it tends to cure "in the real life" as well. But it is no miraculous, super-reliable cure. Only some 3/4 of the deaths are avoided. The percentage could be increased by a better choice of doses, frequency, or place where it is injected. (Also, a double-blind trial showed that REGN-COV2 reduces viral loads, eliminated all sypmtoms after ~7 days instead of 13 with placebo.) Now, Remdesivir is normally served to "serious enough patients". But what is the actual reason?

First, the drug has a risk of inducing hepatotoxicity, a drug-induced damaged of the liver, and a not quite credible EU screaming body claims that the drug causes an acute kidney injury now, too. It may be a temporary state... or a dangerous one, with other drugs. But I still think that it's obvious that the main reason why most people with positive tests don't get Remdesivir is that it is a damn expensive drug, like $3,100 for the 5-day protocol. The normal people simply aren't expected to spend $3,100 whenever "something like flu", and Covid-19 undoubtedly is something like flu, arrives. Well, I think that even folks at Gilead used to expect that "normal people wouldn't be willing to pay $3,100" in such situations but the hysteria is so intense that the assumption may be incorrect and they could actually sell the drug to most (or a big fraction) of the Covid-positive people LOL.

On the other hand, $3,100 shouldn't be an issue in the case of the president of the United States of America. It is just 4 times what he paid on taxes in a year. ;-) So I believe what happened is the following: He told his doctors: I don't want to passively sit in the White House, I want to aggressively fight this virus. So tell me the best things you have that prevent the disease from deteriorating. You have that HCQ, right? And the doctors told him "our beloved president, we don't really believe that the HCQ is very good" (I think that the promotion of the HCQ-based treatments are snake oil that wasn't scientifically controlled sufficiently to see that it actually helps, especially the selection of the patients could have been fishy; and I have my doubts about the very basic integrity of the doctor who made those claims, too) and gave him the aforementioned drugs instead, as something that is "morally similar" to HCQ but that actually has a solid enough scientific basis to work.

So he took those things (he is also receiving zinc, vitamín D, aspirin to prevent pain & fever & inflammation, famotidine against stomach acids, and melatonin for a better sleep cycle) and started to feel better right away (Melania didn't need any of those drugs because, as Donald admitted, she is a tiny little bit younger than he is). I find it extremely unlikely by now that his condition will dramatically deteriorate in coming days. In fact, it makes a perfect sense to expect that the artificial antibodies always work to simplify the fight against such infections; and Remdesivir works as a prevention, too. Why wouldn't it? It just slows down the proliferation of the virus, at a point when the body's immunity system (enhanced by the artificial antibodies) is already actively working to remove the intruder, the Chinese illegal micro-aliens within Trump's body, in this case. ;-)

I think it was right for him to be active, to demand some cutting-edge prevention, and the protocol has shown the right balance between the opinions of his own – I do think that the patient himself should ultimately be the main person who makes the "big decisions" about his body and treatment – and the views of the medical professionals. On Tuesday, he will get the last, fifth dose of Remdesivir. I believe that sometime in the next week, he could already get a negative test. He should return to his full-time job soon afterwards. And I think he should finally make it a standard rule that the Covid alumni don't have to wear face masks anymore (or follow any other restrictions). They could have a green chain around their necks saying "I am a Covid alumnus" instead. The number of people on Earth who can already demonstrate their immunity towards Covid-19 is nontrivial, it's a big waste to impose the restrictions on all these people.

Even in this context, many people annoyed me with their complete misunderstanding what the scientific method is. It's surely just a cultural construct to believe that Remdesivir works. Sorry but it is not a social construct and everyone who believes that science is about some randomly propagating group think is a scientifically illiterate, left-wing, Gr@tinist brain-dead pile of feces. Such people typically project their own wrong approach on others: they say such things because they only have opinions they just blindly copied from others. But when they are doing this stuff, it doesn't mean that others are doing the same. For example, I am following a rather rigorous scientific protocol to validate statements and that's why my comments are gold while the comments of the people who just disagree with me are objectively šit, whether they call themselves left-wing or right-wing.

P.S.: At the top, Trump calls the drugs miracles from God but his actual views on religious miracles are probably close to mine. ;-)

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