President Donald Trump is given an experimental antiviral drug for Covid-19 called Remdesivir as he remains hospitalized at Walter Reed National Military Medical Center in Bethesda, Maryland. The drug is given as part of a two-barrel treatment plan that contains a cocktail of antibodies designed to give the president’s immune system a boost to fight the coronavirus.
The president received the first dose of remdesivir on Friday night and will take a five-day course on the IV drug, said his doctor Dr. Sean Conley during a press conference on Saturday.
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Remdesivir, made by Gilead Sciences, works by lowering the amount of virus in the body. Clinical trial data released in May found that the drug reduced patients’ hospital stay by about four days from 15 days to a median of 11 days.
In July, additional data showed that remdesivir may reduce the number of deaths.
“It’s not really a treatment in the sense that it will cure people,” said Dr. Irwin Redlener, director of the Pandemic Resource and Response Initiative at Columbia University’s National Center for Disaster Risk Reduction, on MSNBC on Saturday. “It will hopefully lower the death rate and reduce the course of the disease.”
Remdesivir is generally used in patients who need supplemental oxygen, though Conley said Trump did not need help breathing Saturday morning. When Conley pressed on whether the president had ever received supplemental oxygen during the briefing, he insistently said the president did not receive oxygen on Thursday or during his time with Walter Reed on Friday and Saturday.
It was unclear whether the president would need oxygen at any other time.
We are maximizing all aspects of its care and we are attacking this virus with a multi-faceted approach.
Conley told reporters on Saturday that Trump is “very well”, but the coming days will be critical to the president’s recovery.
“With the disease progressing from day 7 to day 10, we are very concerned about the inflammatory phase, phase two,” said Conley. “Given that we offered some of these advanced therapies this early in the course, a little earlier than most of the patients we know and follow, it’s hard to tell where he is on this course.”
Not the usual care
In addition to remdesivir, the president has received combined antibody treatment. It is a cocktail made from two monoclonal antibodies. Antibodies recognize certain germs – in this case SARS-CoV-2, the virus that causes Covid-19 – and use the immune system to fight them off.
“We are maximizing all aspects of its care and attacking this virus with a multi-faceted approach,” said Conley. “He’s the president and I didn’t want to hold anything back. If there was a way that it would upgrade his care and speed his return, I would take it.”
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The two-barrel approach is not a common treatment for presidential patients, especially since both treatments are still in clinical evaluation.
In theory, however, the two would work “synergistically,” said Dr. Hugh Cassiere, director of intensive care at Sandra Atlas Bass Heart Hospital at North Shore University Hospital, part of Northwell Health, on Long Island, New York.
“The remdesivir is supposed to stop the virus replicating, but if there was a virus that was replicating the monoclonal antibodies would wipe it up,” Cassiere said, adding that both drugs appear safe.
It is unclear when, or even if, the Food and Drug Administration will ultimately approve either treatment. The FDA issued an emergency approval for remdesivir, and the monoclonal antibodies were administered under what is known as compassionate use.
Given what was known so far about both treatments, Cassiere predicted that one day they would become the standard.
The President, he said, “receives a standard of care months before anyone else.”