COVID-19: The President’s Infection (Part 2 of 4)
Columbia University Professor Emeritus, Dr. David Figurski
Donna O’Donnell Figurski
(Disclaimer: The World Health Organization <WHO> has officially named the new coronavirus as SARS-CoV-2 and the disease it causes as COVID-19. Because the majority of people, including much of the press, commonly refer to the virus as “COVID-19,” to avoid confusion I use COVID-19 as the name of the virus in this post.)
Dr. Griffin labels Week 1 of the infection as the “viral phase.” During Week 1, the virus is multiplying and is present in abundance. A test for COVID-19 would easily be positive. Because the President first felt symptoms on Wednesday, it’s likely that the President was infected for several days before the positive result on Friday, October 2.
Other data suggest that the President was at the end of Week 1 of the infection or at the beginning Week 2.
Week 2 of the infection is called the “cytokine storm phase” by Dr. Griffin. Cytokines are molecules released by some cells that cause an action by other cells. When certain immune system cells sense a problem (like a virus-infected cell), they release cytokines to get other immune cells to multiply, to make attack molecules, or to come and help eliminate the cause of the problem. Normally, the immune system works well, but sometimes the immune system overreacts and causes severe problems or even death. “Cytokine storm” refers to an overreaction by the immune system. A steroid (for example, dexamethasone, which the President was given) is effective because it will dampen the immune response, a potentially beneficial effect when the immune system is overreacting. But, dexamethasone is considered harmful if the drug is not needed. (For example, dexamethasone is not given in Week 1 <the viral phase> because a normally functioning immune system is needed to reduce the amount of virus in the body.)
The President began taking dexamethasone while he was at Walter Reed. Dr. Griffin said that dexamethasone is not usually given in Week 1 because studies have shown that doing so can make COVID-19-disease outcomes worse. National Institutes of Health guidelines for physicians state that dexamethasone should only be given to patients with moderately severe or serious COVID-19 disease. The White House acknowledged that the President received oxygen before he was taken to Walter Reed. Supplemental oxygen is consistent with the President’s being given dexamethasone. Dr. Griffin said that oxygen, if needed, is usually given in Week 2, further indicating that the President’s infection may have started several days before Friday. October 2nd.
Doctors have found that COVID-19 has a third phase – a “clotting phase,” which starts at the end of Week 2 and extends at least through Week 3. COVID-19 infection can trigger clots, which can sometimes (albeit rarely) lead to strokes. Aspirin is routinely given at the end of Week 2 because it helps prevent clotting. Some patients had already been discharged from the hospital (having had two negative COVID-19 tests over two consecutive days and having agreed to self-quarantine for 14 days as a precaution) when a problem-clot occurred.
(To Be Continued)
(Clip Art compliments of Bing.)
(Photos compliments of contributor.)
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