Why next days are crucial to president’s health
President Donald Trump thanked Walter Reed National Military Medical Center staff and even cracked a joke about his age as he fights COVID-19.
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President Donald Trump’s battle with COVID-19 will come to a critical turning point in the next few days as the disease tests his immune system.
Saturday, White House physician Sean Conley said the illness is entering “phase 2.”
In a video statement released Saturday evening from Walter Reed National Military Medical Center, Trump said, “I’m starting to feel good. You don’t know over the next period of a few days, I guess that’s the real test, so we’ll be seeing what happens over those next couple of days.”
Several days after symptoms of COVID-19 appear, the body’s immune system must make an important switch to fight the virus with precision – or possibly face life-threatening consequences.
Watch: Dr. Sean Conley did not answer several questions regarding Trump receiving oxygen
COVID-19 patients can “look pretty good for a few days, then they go south,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University.
Rapid deterioration can occur when the body’s immune system, unable to target the virus, causes widespread collateral damage as it “brings in the troops,” Schaffner said.
President Donald Trump had his first presidential debate with Joe Biden in Cleveland. (Photo: Julio Cortez, AP)
A typical timeframe for patients’ decline is five to 10 days after the person starts getting sick, said Dr. J. Randall Curtis, a professor of pulmonary and critical care at the University of Washington school of medicine in Seattle.
Conley said Saturday that Trump was in his third day of fighting the virus.
During the early part of a patient’s COVID-19 illness, the body uses an “agnostic” immune response, said Dr. Greg Poland, director and founder of the Mayo Clinic Vaccine Research Group. It doesn’t know what it’s fighting but realizes something potentially dangerous is occurring. That’s called the innate immune system.
Key to a successful recovery is an adaptive immune system response that targets the coronavirus.
To avoid serious illness, a patient’s innate and adaptive immune systems must stay in balance, and the virus must not cause serious complications along the way.
Age is a risk factor. Older patients tend to be less successful in activating the adaptive response, according to Melissa Nolan, an infectious disease expert and professor at the University of South Carolina.
Trump turned 74 in June, putting him at 90 times higher risk of death than someone in their 20s, according to data from the U.S. Centers for Disease Control and Prevention.
The course of COVID-19 can be highly variable. The president’s VIP medical treatment and access to cutting-edge therapies make the trajectory of the illness tougher to predict.
Related: Supporters outside hospital where Trump is staying
Patients tend to see short-term fluctuations in their symptoms throughout their illness, so doctors often evaluate a COVID-19 patient’s progress over the course of days, said Dr. David Eisenman, a professor at UCLA Fielding School of Public Health. As of Saturday evening, the information released by the White House was not enough for him to evaluate Trump’s progress.
Curtis said the fact that the president’s fever is improving is a good sign but doesn’t necessarily indicate he’s out of trouble.
“We’re just going to wait and see,” he said.
Contributing: Karen Weintraub
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