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“Don’t be afraid of him. You’re going to beat him.”
This was the advice of the President of the United States, Donald Trump, to the public if they were concerned about contracting coronavirus.
He made the comments in a video message posted shortly after being released from the hospital on Monday, having received treatment since his own diagnosis.
But, as many have pointed out, it was about a man with a helicopter, large medical equipment, and experimental drug treatments at his disposal. How does the landscape change for Americans with Covid-19 who do not reside in the White House?
It’s hard to identify the “average American” in the midst of such a diverse country and complicated healthcare system, but here are some of the areas where the president received special treatment and a look at how this compares to the experiences of the General population.
A team of doctors and a luxury suite.
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Reuters
The president’s physician, Dr. Sean Conley, has led the treatment
The president has a medical center in the White House, but, as the country’s commander-in-chief, he also had access to the Walter Reed National Military Medical Center in nearby Bethesda, Maryland.
He was rushed there after his diagnosis and stayed for three days in the hospital’s presidential suite, one of six rooms reserved for high-ranking military officers and members of the cabinet. It included a dining room, office space, and sofas for entertaining.
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“VIP treatment is a characteristic of American medicine,” reads an article in the Washington Post, which discusses the president’s treatment. “Major hospitals across the country have private spaces for celebrities, the super-rich and the influencers – patients who want to be protected from the public and can make a big donation if they’re happy with their care.
Compare this to intensive care wards across the country, where beds have been running low at various times during the pandemic. Hospitals in Florida, Texas and Arizona have struggled to achieve maximum occupancy during the summer.
The Texas Medical Center in Houston, for example, set up a Covid “war room,” using various strategies to save space, such as reassigning staff, placing beds closer together, and using normal beds for emergency use.
Fiana Tulip, from Texas, lost her mother to the disease in July. She told the BBC that her mother was afraid of crowded Dallas hospitals at the time.
“My mother, a health worker who put her life at risk every day, did not want to go to the hospital because she was worse there, because it was full, because she would not receive the care she needed, and she knew it because she worked in a hospital” Tulip said.
Since then, the number of cases has fallen below this peak, but there are concerns that they could rise again during the winter.
The president was also fortunate to have the high-tech facilities of Walter Reed Hospital so close. People who live in rural areas of the US may have to travel long distances to receive medical treatment.
A study from the University of North Carolina showed that 120 rural hospitals closed in the last decade.
“Rural places have far fewer doctors to treat the virus (20 per 10,000 versus 70 per 10,000 in metropolitan areas), and smaller hospitals with less specialized service personnel and more uninsured (14%, compared to 7% in large metropolitan areas) “says David J Peters, professor of rural sociology at Iowa State University.
“The ability to use telemedicine to address this gap is limited, as nearly 55% of rural households do not have broadband Internet access (compared to 35% in metropolitan areas). Rural places are also vulnerable because they lack access to the interstate system, making transporting patients, healthcare providers, and supplies difficult and time-consuming. “
Traveling by helicopter
The president had no such concerns about transportation. He flew to the hospital in a private helicopter, Marine One, which took off from the White House lawn. The journey took 10 minutes. Even by car, it would only have taken about half an hour.
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Reuters
Tulip said it was difficult to see the president “get into a helicopter in his front yard” after his mother’s death.
She said her mother tried to persuade family members not to call an ambulance for her, because she didn’t want to bother them with insurance concerns.
Across the United States, many Americans fear calling an ambulance, in case their insurance does not cover the costs.
A man in rural Kansas told local radio station KCUR-FM that he received an $ 80,000 bill for an air ambulance when he became seriously ill with complications from the coronavirus in April. The bill was later resolved and he didn’t have to pay, but only after an extensive dispute between the provider and his insurer.
These stressful exchanges, often combining a lot of paperwork and phone calls, are common after a hospital stay in the US The president will not have had these concerns.
Hospital admission
The president was admitted to Walter Reed Hospital less than 24 hours after his test result was announced. Although there were some mixed messages about his condition, his doctor said he was experiencing “mild” symptoms.
“Patients are generally only admitted if they are potentially critical,” says Anthony Almojera, a New York City paramedic. “They are told to go home and only go to the hospital if they are short of breath.”
“During the height of the pandemic, we left at home people who did not meet certain critical criteria,” he adds. Though he says the pressure has since eased in the city, as the number of cases has dropped.
However, Dr. John Zurlo, an infectious disease specialist at Thomas Jefferson University Hospitals in Philadelphia, says that admission decisions can be a gray area.
“If you take a hypothetical 74-year-old man with underlying health problems and has a fever, hospitalization could be warranted,” he says. “But insurance companies look at all admissions. They might come back and ask, ‘Why did you have to come for three days?’ and the hospital has to justify it. “
“But a low level of oxygen in the blood is a reason to spare, even in a younger person,” he adds, and the president’s doctor referred to his levels having dropped twice.
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However, Dr. Zurlo cautions against using the phrase “sign up” when referring to hospitals.
“In consultation with my doctors, I checked into Morristown Medical Center this afternoon,” New Jersey Governor Chris Christie tweeted – a close associate of the president who also tested positive in the last week.
Dr. Zurlo says: “They are not hotels. You have to be admitted. An insurance company will not pay for unnecessary hospitalization. So unless you are very rich, and even Christie is not that kind of VIP, mere mortals cannot do this”. ”
One of those mere mortals, Juan Ríos, a medical worker in New York, says he had no trouble getting admitted when his breathing deteriorated and he experienced pneumonia along with Covid-19 earlier this year, but felt he was being expelled during your recovery.
“They wanted to discharge me on a low oxygen level and I didn’t feel comfortable going home, so I had to involve my private doctor to stay in the hospital for another day or two,” he says.
Experimental drugs
President Trump would not have been fired before he was ready. But what kind of treatment did you receive as an inpatient?
According to his doctors, he has been treated with several different medications:
- Dexamethasone, a steroid that saves lives by calming the immune system
- Remdesivir, an antiviral drug, was first developed as a treatment for Ebola
- Monoclonal antibody therapy, performed by the Regeneron company
Most people were surprised by the use of antibody therapy, as it is still classified as experimental. Clinical trials are ongoing and the president is one of the few people outside of those trials who undergoes treatment under what is known as “compassionate use.”
- Explanation of Trump’s medication
Robert Wachter, professor and chair of the department of medicine at the University of California, San Francisco, told the Washington Post that he was not surprised: “He is the president of the United States. May he receive the most vigorous therapies … even if not yet. We have reached the point where there is enough evidence to make it available to everyone in the country, it doesn’t seem strange to me. “
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But would these same treatments be offered to regular patients?
Dexamethasone is “cheap and available,” according to Dr. Zurlo. “We also have a lot of Remdesivir in our hospital. The company gave us a large free supply and we still have a lot. I imagine a lot of hospitals have it now too, at least in urban areas … And if you are sick enough to be hospitalized You will qualify for all of these treatments. “
The exception, he says, is the particular antibody treatment Trump underwent, which is not yet available to the masses. Instead, another therapy, convalescent plasma treatment, can be tried, he says.
The best of the best
“We have the best medical equipment. We have the best medications, all newly developed,” Trump said in his motivational post-discharge video.
Many of his followers said the speech was inspiring.
His optimism has some basis that medical research on Covid-19 is far more advanced now than it was at the start of the pandemic, but critics still feel the comments were muffled and did not show empathy for those who have had a much more difficult time. with the disease.
“While it may be correct to say that the United States has some of the best health care services in the world, it is not accessible to all Americans equally,” says Professor Peters. “The poor, minorities, and rural Americans have less access to health care and suffer worse health outcomes.”
Mr. Ríos, who has now returned to work after his own stay in the hospital, is also critical: “It is very easy for him to say that while receiving the best treatment in the world. He had everything at his disposal. he would like to receive the basic treatment, as would I and many others too. “
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