President Trump And First Lady Test Positive For The Coronavirus

deirdre

Senior Member.
Conley is Trump's doctor


"The chief and I work side by side, and I think his statement was misconstrued. What he meant was that 24 hours ago when he and I were checking on the president, that there was that momentary episode of a high fever and that temporary drop in the saturation, which prompted us to act expediently to move him up here," Conley said.

Conley also said on Sunday that he decided not to say the president was given oxygen on Saturday because he wanted to "reflect the upbeat attitude of the team."


Content from External Source
https://thehill.com/homenews/admini...s-at-meadows-for-contradicting-doctor-reports
 

deirdre

Senior Member.
walter reed doctors give briefing on his symptoms, timeline (kinda) and treatments. oxygen dropped briefly twice but since sat am oxygen good without support (brief drop saturday morning to 93% but no oxygen given) and no fever since sat am. oxygen was never below 90<reporter asked if below 90.


Source: https://www.youtube.com/watch?v=yI_iaXtlOWY
 

deirdre

Senior Member.
Trump's "Spin doctor" ...too.
...getting details out of him is like pulling teeth, so he's a dentist also.
YEA THE SECOND DOCTOR AT ABOUT 2:40 was talking about his heart, liver, kidney tests and said "continued normal finding or improving findings".

the third doc says in regards to remsdevir side effects "his liver and kidney function remains normal".

Conley said there were some "expected findings but nothing of concern" in his lung ct scans. and they are making sure he is up and moving around which is a technique to help ward off pneumonia. obviously mucus in the lungs even with a normal cold is to be expected somewhat. But i like the term "spin doctor" ..fits in this case.
 

TEEJ

Senior Member.
YEA THE SECOND DOCTOR AT ABOUT 2:40 was talking about his heart, liver, kidney tests and said "continued normal finding or improving findings".

the third doc says in regards to remsdevir side effects "his liver and kidney function remains normal".

Conley said there were some "expected findings but nothing of concern" in his lung ct scans. and they are making sure he is up and moving around which is a technique to help ward off pneumonia. obviously mucus in the lungs even with a normal cold is to be expected somewhat. But i like the term "spin doctor" ..fits in this case.

I concur with "spin doctor" but you have to see it from his perspective. Conley is not just a doctor but a US Navy Officer. Trump as his commander-in-chief was no doubt controlling him completely during the initial stages. A very difficult position for Dr Conley, but Trump would no doubt have used that absolute power over him.

No doubt WH Chief of Staff Mark Meadows felt the wrath of Trump after his Friday statement to the press.

This was Meadows during the Sunday briefing by Dr Conley. Somehow I think that he is feeling the pressure :)

meadows.jpg
 

Mick West

Administrator
Staff member
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Mick West

Administrator
Staff member
Rudolph Giuliani was on Good Morning America (ABC) today, seemed somewhat short of breath. Seems VERY likely that he has it, given his very close recent contacts with multiple carriers.

Pence also seems at risk. See this map of connections.


It seems to me that the desire to control the narrative is continuing to override reality. I'm not sure it's going to change until someone gets dangerously ill. That's likely going to be one of the older people, like Giuliani (76) or Trump (74). Chris Christie is also in particular danger has he's obese and has asthma.
 

Z.W. Wolf

Senior Member.
https://www.kiro7.com/news/trending...reakdown-symptoms/YRC3CCK2NFD2THIYJHT35447AU/


Two studies from China, where the virus is believed to have first been transmitted to humans, paint a picture of the progression of the symptoms those who have contracted COVID-19 suffer.
The analysis includes adults with COVID-19 admitted to Jinyintan Hospital and Wuhan Pulmonary Hospital after Dec. 29, 2019, who had been discharged or died by Jan. 31.
Doctors in the United States report seeing very similar disease progression where those who have a milder form of the virus begin recovery from fever, cough and shortness of breath about two weeks after the onset of symptoms.
In those with a severe form of the virus, hospitalization, a move to the intensive care unit in a hospital and being placed on a ventilator followed closely the pattern of those who had suffered from the illness in China.
Here are some takeaways from the studies in the U.S. and China:

Day 1 (the first day symptoms begin): Most of those infected – 88% – will have a fever and feel tired. Many also have muscle pain and a dry cough.
Some people, around 10% according to the study from China, experience nausea or have diarrhea in the days just before the fever begins.
Day 2-4: The fever persists as does the cough.
Day 5: Breathing difficulty begins on day 5. It is especially likely to happen if the person has a preexisting condition or is older.
Day 6: Breathing difficulty, cough and fever persist. Some people describe chest tightening or having a feeling that a “band” is around their chest.
Day 7: It is on this day that people who have been experiencing persistent chest pain or pressure, shortness of breath and bluish lips or face are admitted to the hospital.
People who are suffering less severe symptoms will likely see those symptoms begin to get better.
Day 8: According to the Chinese Center for Disease Control and Prevention, about 15% of people with COVID-19 will develop symptoms of ARDs, or acute respiratory distress syndrome.
According to the Mayo Clinic, ARDs “happens when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.”
Day 10: If breathing difficulties worsen, it is on this day that patients who are in the hospital will tend to enter the intensive care unit.
Day 12: In the Wuhan study, fever ended for most people on Day 12. Many still had a cough.
Days 13-14: For those who will survive the virus, breathing difficulties are generally ending on these days.
Day 18: For those who do not survive the virus, the average number of days from onset of symptoms until death is 18 1/2 days.
Content from External Source
This is day five.
 

Mendel

Senior Member.
It may be day 5, but everyone is different, and infections don't follow a schedule, and that average schedule wasn't put together from patients who received remdesivir and antibodies. Trump's health is what it is.
 

Z.W. Wolf

Senior Member.
It may be day 5, but everyone is different, and infections don't follow a schedule, and that average schedule wasn't put together from patients who received remdesivir and antibodies. Trump's health is what it is.

Infections kind of do have a typical progression. There are different tracks, and this one can take an extraordinarily sharp turn for the worse.

These experimental drugs have the potential to make things worse. He's going all in on dosages. A narcissist's way of doing things.

He's trying to impose his will on reality. He's cured... because he says he is. And what he says, goes. Reality won't dare to argue.

Downplaying Covid so he'll be less wrong about it. Repairing his Strongman image, which has taken a big hit late in the campaign.
 
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Z.W. Wolf

Senior Member.
President Trump's medical team once again held a briefing outside Walter Reed National Military Medical Center on Monday for an update on the president's COVID-19 treatment.


REPORTER: Now you had said that seven to 10 days was a window that you'd be concerned about. I don't think we're there yet. So do you have concerns about potential worsening or reversal? And what are your plans for addressing that if it were to happen?

CONLEY: You're you're absolutely right. And that's why we all remain cautiously optimistic, um, and on guard, because we're in a bit of unchartered territory when it comes to a patient that received the therapies he has so early in the course. So we're looking to this weekend, if we can get through to Monday with him remaining the same or improving better yet, then we will all take that final deep sigh of relief. But as I said, 24/7 world class medical care surrounding him down there. We're not going to miss anything that we would've caught up here.
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REPORTER: Have you seen any evidence of pneumonia? Or any inflammation in his lungs at all?

CONLEY: So we we've done routine standard imaging. Um, I'm just not at liberty to discuss.

REPORTER: So you're actively not telling us what those lung scans show, just to be clear.

CONLEY: So there are HIPAA rules and regulations that, uh, restrict me in sharing certain things, uh, for his safety and his own health ...
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REPORTER: Was there anyone on the president's medical team that who recommended against the president leaving here and going back to the White House today?

REPORTER: Or any White House staffers?

CONLEY: [looks around at his colleagues] No.
Content from External Source
Okay, is that because they don't think they should... or because they don't dare?
 

Mendel

Senior Member.
Okay, is that because they don't think they should... or because they don't dare?
As long as he's not on oxygen, he won't need to suddenly be intubated; an O2 meter isn't that big and can be pretty mobile. They've done the general diagnostics; they're probably having a helicopter on standby. If you see Trump in Mar-a-Lago, then he's really back to full health; to be in the White House, he just needs to be in stable condition. (I'm not a doctor, this is just my guess.)
 

Z.W. Wolf

Senior Member.
Source: https://youtu.be/ZApWTnkpS0U



[00:00:00] Dr. Samir Gupta has lots to say about these issues. He's our regular Wednesday guest, but because he's a researcher, allergist, and this is very much the issue that we want to know about the president. He is here for a bonus visit. And we thank you very much. Hi, Dr. Gupta. Good morning again. The question of discharge. Why don't we start right there with you meeting with his team today, still hoping to be heading back to the White House and discharged from hospital later today. How prudent does that seem to you?


Dr. Gupta: It seems very imprudent. I would not discharge a patient like this. Obviously, there's a lot of conflicting information here in terms of how sick he was. But we do know that he, for some period of time required oxygen. They talked about a CT scan showing expected findings. To me, that means he probably has some pneumonia on the CT scan and he's a high risk patient on three drugs. So this is a person who obviously they're worried about even just practically, you know, the Remesvider. for example, is a five day course and that's meant to be given in hospital. So what's the idea here? Are they going to stop that treatment early? It just really doesn't make sense for him to be able to go home this quickly.


[00:01:11] Ok, you've raised three separate areas that I'd like to probe further with you. And as I watch your facial expressions, I feel a little bit relieved because the whole thing has been very confusing from a layperson's perspective, getting these medical briefings. And so I'm hoping that you as a for allergies can help us understand a little bit more clearly the drops in oxygen level. We know that he was receiving supplemental oxygen on two occasions, but just how low it went. They weren't they would not specify below 90 for. So how what is important in that?


Dr. Gupta: Well, I think, you know, Dr. Connelly kind of said we started oxygen because he dipped below ninety four or dipped to ninety four. But the reality is that a normal oxygen saturation in someone the president's age is actually ninety three percent. So that really doesn't make any sense. And we don't typically administer oxygen unless and until someone saturation drops significantly below that. So below 88 percent is where we would start oxygen. So obviously, either they're trying to hide something or they're they just have completely different thresholds for treatment, which really doesn't make any sense. I think we have to assume that his oxygen levels went substantially lower than 90 for at some point during the press conference, he kind of admitted that they didn't go into the low 80s. So I'm thinking they probably had saturations in the mid-80s, which would have justified that one important.


[00:02:33] What is what would that be? That would show that the illness is progressing in his lungs if they it was if it went to that level.


Dr. Gupta: Absolutely. You know, if he's at ninety three, ninety four percent, that's within normal. If he's in and below 88 percent, that really does suggest that the illness is preventing his lungs from being able to absorb oxygen, which is what this illness does. And that's a red flag that would be an indication for starting him on oxygen and that would indicate that he's sicker than they're letting on right now.


[00:03:00] Now, there were questions of the doctors in terms of what the chest scan or the X-ray revealed. And as you said, they would say, well, they were the expected findings, but it wasn't clear whether that was in a normal patient or in a covid-19 patient. So what information is in a chest scan or an X-ray that would be important to know about?

Dr. Gupta: Many patients who have this infection will have an abnormal CT scan, and many of the patients in some studies that are asymptomatic or minimally symptomatic will have an abnormal CT scan. So, you know, in the context of him having had low oxygen levels, almost certainly he has an abnormal CT scan. And what we're looking for is some haziness in the lungs, some what we call infiltrates in the lungs or density in that lung tissue that suggests that there is inflammation and infection. And those would be the same kinds of abnormalities that would lead to the low oxygen levels and cough and shortness of breath and the various symptoms associated with the infection onto the drugs.


[00:04:00] As you mentioned, he's on three. There is the new Regeneron therapy, which is a cocktail of a couple of antibodies. It's not yet approved by the FDA. We should say there is Remesvider, which is the antiviral we've talked about before for the most severely ill patients. And then there is the steroid Dr. Gupta dexamethasone shown to be effective in severely ill cases, but not recommended at all in mild cases of covid-19. So those are the three. What are the red flags in there for you?



Dr. Gupta: Again, it really doesn't hold together. Probably no one on the planet has received this cocktail of medications. They really are throwing the kitchen sink at him. You talked about regenerations, product. That's something we were going to talk about last week, but we didn't because we don't have the study. All we have is a press release. And as lax as the FDA has been with approving medications, even the FDA hasn't approved this medication. All we have is phase two data. So. It's a monoclonal antibody, it's promising, and it's one of the only ones that would have been hopefully if we see the data might have been shown to reduce the effect of this infection before people get really sick. So first he gets that, and that's meant to keep people out of the hospital. Then he gets a drug, as you mentioned, Remesvider , which really is only effective in sick patients on oxygen. And then he gets a drug, which I would say is even more aggressive in the form of dexamethasone, which we really reserve for our sickest patients. The biggest benefit from that drug is in patients who are on a ventilator, although it also benefits people on oxygen. So he's getting the kinds of drugs you would give your your sickest patient patients that you're very worried about. But at the same time, he's giving a four minute address without oxygen on TV, seemingly really not breathless during that address. So not sort of matching what I would have thought for someone on those drugs. And then he's doing this tour in his vehicle around the hospital again without oxygen. Really bizarre. And it doesn't fit with this picture of how he's being treated.


[00:06:03] So as I listen to this, I mean, three as far as covid-19 patients could go, may be considered experimental to varying degrees, three drugs together in combination. I mean, would there be concerns about interaction? I'm thinking of the steroid, Dr. Gupta, that is pretty know, reaching deep into the arsenal here. Are there any particular side effects of that in terms of behavior, in terms of mind, in terms of thinking all of this happening? Should this man be really in a position of authority right now? Because there are questions about whether he should transfer the power of authority to the vice president. But as I listen to all of the things that you're talking about, he's really being blasted with with things that we don't know how they'll work together.


Dr. Gupta: I mean, I would start with the Regeneron product. We again, we haven't seen the data, so we don't know what the safety data are around that product. We also don't have phase three trial, so we don't have a large number of people who have been exposed to it. So just that drug, what are the potential side effects? We don't know. The combination of these various drugs is uncharted territory, so we don't know. And then you mentioned specifically dexamethasone being a steroid at a high dose. Steroids can certainly have side effects, all sorts of side effects. A concerning one for the commander in chief would be neurocognitive side effects, we call them, so people can get confused, people can become agitated. Some would argue that that was already the case before any of this happened. So how would this drug affect him? And so there's that question. But then there's also the question, should he be carrying on if he's sick enough to even require these three drugs and if his oxygen levels were low, if someone's oxygen levels are low, that does affect their ability to process information, their ability to make decisions. So just the illness itself would raise questions around how fit he is to leave the country.


[00:08:00] Dr. Gupta, really appreciate your expertise on this this morning. And we'll be seeing you again doubtless on this. But thank you for today. My pleasure.
Content from External Source
A possible resolution to everything that doesn't make sense in this case is to assume the patient has been in charge of treatment.
 
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Mendel

Senior Member.
REM disappear and rent a center. Ha ha.
Youtube's automatically generated (by AI) subtitles.

The interview is a lot of speculation out of very little actual information. I don't trust any of its conclusions.
 

Z.W. Wolf

Senior Member.
Source: https://youtu.be/lzOiY7LJ7LI

Sunday
How severe is President Trump’s COVID-19 illness? Does he have COVID-19 Pneumonia? As a pulmonary & critical care doctor, I’m watching President Trump's medical team, including Dr. Sean Conley, give a press conference. His medical team includes 3 pulmonary & critical care doctors, 2 infectious disease doctors, & more. It’s obvious that Dr. Conley is choosing to withhold certain medical details.

So in this video, I am going to take what he is saying, with what information is being given, & do my best to read between the lines, so that people can have a real understanding of what is going on here with President Trump. We want to know, does he have COVID-19 pneumonia? And I will also try to classify the severity of his COVID-19 illness. Then, at the end of this video, I am going to talk about what this means for President Trump’s health moving forward. What constitutes mild illness, vs moderate illness, vs severe illness, vs critical illness, is still very much a grey area.

Generally speaking, someone who has symptoms, but is not short of breath, & does not have low oxygen levels, this is mild COVID-19. Moderate illness is characterized by shortness of breath, and/or lower oxygen levels, with evidence of viral pneumonia seen on chest x-ray or CT scan of the lungs, or even ultrasound of the lungs. Severe illness is characterized by someone who is having trouble breathing, & consistently requires extra oxygen, & or ventilatory support. Then there is a critical illness, which is when patients have either ARDS, or hypotension, & require either high-flow oxygen or mechanical ventilation.

Defining the severity of illness is hard to do. And this also makes it tricky in terms of what medicine to give. For example, these studies show dexamethasone, a type of steroid, reduces mortality in moderate and severe disease, but not a mild disease. But, what defines mild vs moderate vs severe disease? The rationale behind giving dexamethasone is that it can suppress inflammation within the body, so the hope is that it will suppress the inflammation that takes place within the lungs. For COVID-19, we give dexamethasone in either IV or pill form, and its 6 mg once a day, and we give it for a total duration of 10 days.

One of the side effects that always occurs with steroids, is that patient’s blood sugar levels become higher, so hyperglycemia. And that is why we usually have to counteract that by giving patients insulin. And when you give insulin, sometimes the patient’s blood sugar, meaning blood glucose, drops too low, and this is known as hypoglycemia. Typically, when we give dexamethasone, we check blood sugar levels, by doing fingerstick, every 4 or 6 hours. At the press conference, they mentioned nothing about this. But if his blood sugars are out of whack, they would not be talking about discharge planning.

But stepping back, and looking at this from a bird’s eye view, where does Trump lie on this spectrum of COVID-19 illness. Right now he is not requiring supplemental oxygen. What would the progression of his illness look like, if he were to have clinical deterioration? Well typically this entails stepping up his oxygen therapy, so 2 L NC, maybe 3, 4, or 5 L NC. If that is still not enough oxygen, maybe an oxygen face mask or something called a high-flow nasal cannula. These devices provide a lot more oxygen than a nasal cannula. If these are still not enough, that’s when you start talking about mechanical ventilation. Either non-invasive mechanical ventilation, meaning a Bipap mask, or bilevel mask. Or the patient might need invasive mechanical ventilation, meaning a breathing tube, that is connected to a breathing machine.

And lots of times these patients require vasopressor support, meaning IV medications that are given when the blood pressure is too low. So that would be the sickest of the sick. It’s the patients who are on mechanical ventilation, a breathing tube, requiring 100% oxygen. Sometimes though, even that is not enough, and that is why some patients get ECMO, which is the extreme of the extreme. And sometimes, despite us doing all of these things, patients still die. That is just the reality of this disease. Currently, President Trump has is saturating 98% on room air, which is good. And this is to be believed because you see him in that in the video of him, he is not in respiratory distress, not requiring supplemental oxygen, he is not cyanotic.

But the important thing to keep in mind is that patients with COVID-19 can look like they are doing fine. They can have an improvement in their symptoms. They can have improvement with their oxygenation, and then within hours, clinically deteriorate to the point of requiring mechanical ventilation, especially when the inflammatory phase of the illness becomes very prominent, meaning the cytokine storm that develops. Typically around 7-10 days.
Content from External Source
Source: https://youtu.be/OqGnQkpV1lU

After the White House "modified stress-test" (climbing those stairs)

Anybody that comes in with shortness of breath and we think they are high risk for Covid-19... But I want to know, especially if they're gasping for breath, the way the President looked... like he was audibly gasping for breath after he did what we call a modified stress test - walking up a flight of stairs - I would want to know with somebody like that is... I want to see a chest x-ray and a high-resolution CT scan of the chest. Let me take a good look at his lungs. We use the term an infiltrate or ground-glass opacities... What we want to know is there any evidence of pneumonia; something going on in his airways and his lungs. The answer probably is, "Yes, absolutely" because they gave him Remesvider and dexamethasone - there would be no other reason to give him those medications - there's no FDA-approved reason to give those medications unless it was Covid-19 pneumonia.
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Trump is a sick man pretending to be a cured man. His symptoms are moderate enough to do so. Dexamethasone has physical and cognitive effects; making people feel much better than they are. Wednesday, Thursday and Friday are the days there might be a crisis and re-hospitalization.

In the meantime he is acting recklessly.
 
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Z.W. Wolf

Senior Member.
Source: https://youtu.be/M_6AOS0fot8?t=324

Having suffered from asthma and bronchitis I can say this is absolutely reduced lung capacity/fighting for breath. One giveaway is lifting the shoulders while breathing in. Lifting the chin and stretching out the neck. Swallowing hard. Lifting up on the toes. Done that.

After the salute, the grimace and suffering look... and the little spasmodic movements... all come from trying not to cough. I can feel exactly what's going on.
 
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Mendel

Senior Member.
Sorry for the multiple posts, I'm sending these as I find them.
Having suffered from asthma and bronchitis I can say this is absolutely reduced lung capacity/fighting for breath. One giveaway is lifting the shoulders while breathing in. Lifting the chin and stretching out the neck. Swallowing hard. Lifting up on the toes. Done that.

After the salute, the grimace and suffering look... and the little spasmodic movements... all come from trying not to cough. I can feel exactly what's going on.
Dr Wachter agrees.
Source: https://twitter.com/Bob_Wachter/status/1313341075621208070
 

deirdre

Senior Member.
I can say this is absolutely reduced lung capacity/fighting for breath.

what does he normally look like walking up those stairs at that pace? Don't get me wrong i think it's silly for him to leave the hospital before the critical period, but we can't determine much from your video without comparisons.
49676525177_71e1024a10_o_t800.jpg
 

Z.W. Wolf

Senior Member.
I grew out of the asthma (mostly), and I've done a lot of weight training. I have experience with the two different ways of being out of breath.
Asthma/Bronchitis is a completely different experience from breathing hard, even really hard, from exercise.
 

Mick West

Administrator
Staff member
Watch the full video of him from exiting the helicopter to going into the building, starting around 4:00. While he does seem to grimace a few times, It does not really seem that inconsistent with an overweight older man having just walked up some stairs. Lots of speculation here, but we've really got to wait and see.

Source: https://youtu.be/M_6AOS0fot8?t=247
 

Z.W. Wolf

Senior Member.
There are physiological signs. If you're familiar with them, they're obvious. How many patients do you think Dr. Wachter has observed? If a musician says, "That first note was A sharp and the second one was B major," and you say, "I don't hear the difference." What's happening?

In any case there are a number of likely tracks this can take. One of them includes ongoing cognitive problems. What do we do then? Especially when obvious signs are ignored or denied?
 
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Mick West

Administrator
Staff member
There are physiological signs. If you're familiar with them, they're obvious. How many patients do you think Dr. Wachter has observed? If a musician says, "That first note was A sharp and the second one was B major," and you say, "I don't hear the difference." What's happening?
Probably less than Dr Talmadge King (who Wachter quotes in support), and King just says Trump was very out of breath after going up 30 steps.

I think he's sicker than he says, I think it's quite likely. But I don't think this video really shows that. A couple of awkward breaths, but he seems mostly normal, and then stays around to give a long statement without any noticeable breathing issues. This is just a few minutes later.
Source: https://www.youtube.com/watch?v=pf_2u3WT1Rg


More of an immediate issue is the nonsense he's saying.
 

DavidB66

Active Member
If a musician says, "That first note was A sharp and the second one was B major," and you say, "I don't hear the difference." What's happening?

I think what's happening is that the musician is pulling your leg. There is no such note as B major. There is a note called B flat, but on most instruments (piano, guitar, etc) it is exactly the same as A sharp. (Pedantic note: in tuning systems other than equal temperament there might actually be a small difference, but I'll leave that to the experts.) In reading or writing music it may be more convenient to choose one or the other. For example in the key (not note!) of B major the note before B in the scale is a semitone lower, so it would normally be written in the 'A' space with a sharp symbol in the key signature. If you choose to write it as B flat you would have to put it on the 'B' line with a flat symbol next to it, so that it is not confused with B natural. This would be less convenient for the user.
 

Z.W. Wolf

Senior Member.
I think what's happening is that the musician is pulling your leg. There is no such note as B major. There is a note called B flat, but on most instruments (piano, guitar, etc) it is exactly the same as A sharp. (Pedantic note: in tuning systems other than equal temperament there might actually be a small difference, but I'll leave that to the experts.) In reading or writing music it may be more convenient to choose one or the other. For example in the key (not note!) of B major the note before B in the scale is a semitone lower, so it would normally be written in the 'A' space with a sharp symbol in the key signature. If you choose to write it as B flat you would have to put it on the 'B' line with a flat symbol next to it, so that it is not confused with B natural. This would be less convenient for the user.
Heh. I'm not a musician... so I'll take your word for it.
 

Z.W. Wolf

Senior Member.
Probably less than Dr Talmadge King (who Wachter quotes in support), and King just says Trump was very out of breath after going up 30 steps.



You're right that he's referencing King. I hadn't noticed that. He's referencing King's text:
President Trump very dyspneic walking ~60 paces (stop 2x) and up ~30 steps. ? was O2 sats w/ walking before he left WRAMC? His “energy” not real, probably side effect of steroids. Vitals Q2h. Check O2 sats. Give O2 during sleep. Lots of other concerns.

Translation of his text:
Trump walking with very heavy, pathological, breathing. (Or maybe: Trump is displaying pathologically heavy breathing as the result of the stress of walking, and it's pretty extreme.) He stopped twice after (only) 60 paces, or so, and went up (only) 30 steps, or so; (which is not a challenging stress test). What was the result of his pulse oximetry oxygen saturation with the six minute walk test before he left Walter Reed Army Medical Center? His "energy" is not real, but is probably due to side effects of dexamethasone. I would take (or I would prescribe taking) his vitals every 2 hours including his oxygen saturation. I would give him (or I would prescribe) oxygen during sleep. Lots of other concerns.

A dictionary definition of dyspnea includes shortness of breath due to exercise, but that's not the way an "expert in interstitial lung disease" is going to typically use this word.
 
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Mick West

Administrator
Staff member
You're right that he's referencing King. I hadn't noticed that. He's referencing King's text:
President Trump very dyspneic walking ~60 paces (stop 2x) and up ~30 steps. ? was O2 sats w/ walking before he left WRAMC? His “energy” not real, probably side effect of steroids. Vitals Q2h. Check O2 sats. Give O2 during sleep. Lots of other concerns.

Translation of his text:
Trump walking with very labored breathing. He stopped twice after (only) 60 paces and went up (only) 30 steps.

I'd translated that as I said earlier "Trump was very out of breath after going up 30 steps" - and that's really the only observation he makes.

Trump stopped twice before he reached the steps to pose briefly for photos. Those were not rest stops, they were two seconds of: stop, turn, wave, turn back, continue. It would have been less tiring to keep going. He then went up the stairs without stopping. He did seem a little winded at the top.
 

Z.W. Wolf

Senior Member.
I've got the more complete translation done. Yes, he's not saying that Trump can't walk more than 60 paces and so on; he's saying that his breathing is the result of walking 60 paces, and so on.
A modified "stress test." And a really wimpy one compared to the 6 minute walk. (When I was a kid, the stress test was running in place for god knows how many minutes.)

I can see that you've never had asthma/bronchitis. Or done a stress test, or the "breathing out test" as I called it as kid. My mother was a pulmonary RN (during the last stage of her career) and I've talked with (too) many Allergists etc., so I know some of the lingo.

You may be able to talk normally when standing, but exercise really gets to you quick. You can recover fairly quickly and talk normally... or not... it all depends on how tight your chest is. It's largely about breathing C02 out... emptying out the lungs... but that's not what it feels like. There was one episode when I was teaching in Japan... I was really on the ragged edge. Should have gone to the ER but stubbornly didn't. I wonder how close I was to dying that night. My whole torso was sore for days. Muscle soreness from all the exercise of fighting for the next breath... and the next.

Thanks to goodness I grew out of this by the age of 30. Mostly.
 
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Agent K

Senior Member
Stephen Miller tested positive, months after his wife.
Article:
White House senior adviser Stephen Miller has tested positive for COVID-19 and is currently self-quarantining, The Hill has confirmed.
Miller said he began a period of self-isolation several days ago before receiving a positive test for the coronavirus on Tuesday.
"Over the last 5 days I have been working remotely and self-isolating, testing negative every day through yesterday. Today, I tested positive for COVID-19 and am in quarantine," Miller said in a statement.
...
Miller's wife, Katie Miller, tested positive for COVID-19 in May. She is the communications director for Vice President Pence and at the time was the highest-profile White House staffer to contract the virus.

Edit: I think the article and Miller got "self-isolation" and "self-quarantine" backwards. He's self-isolating now, after self-quarantining over the last 5 days.
 
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deirdre

Senior Member.
Over the last 5 days I have been working remotely and self-isolating, testing negative every day through yesterday. Today, I tested positive for COVID-19 and am in quarantine,"
thats useful. i was wondering how long it took for tests to show up. i think alot of my state's contact tracing testing was done too soon. (we're still doing fairly well.. )
 

Z.W. Wolf

Senior Member.
"One giveaway is lifting the shoulders while breathing in. Lifting the chin and stretching out the neck. Swallowing hard." - is the way I put it.

Breathing hard because your chest is tight is a different experience from breathing hard from exercise. When I saw Trump I could feel what he's doing.

Something they don't mention in this article is trying not to cough after the salute. I can feel that too.

NYT

https://www.nytimes.com/2020/10/06/...action=click&module=Spotlight&pgtype=Homepage

Lacking crucial details from the president’s medical team, some outside doctors tried another tack — evaluating the patient themselves. On Monday, in a highly choreographed event that was covered live on some cable channels, Mr. Trump was flown to the White House, where he left the Marine One helicopter, crossed the lawn and walked up a set of stairs, to what looked like an illuminated stage set. At the top, he removed his mask, placed it in his pocket and flashed two thumbs up.

For many, it was a political stunt. For Dr. King of UCSF, who was watching on C-SPAN, the return to the White House was an opportunity to observe how the president breathed.

“As a pulmonologist, he did two things for me: He did a walk test, and he did a stair-climbing test,” Dr. King said, adding that even with the availability of sophisticated technology, lung doctors still rely on these old-fashioned tests “to just get a picture of how the patient’s doing.”

Dr. King said what he saw concerned him. Mr. Trump paused twice while walking across the lawn — whether to wave to cameras or to catch his breath, he said was not clear — and then appeared to be gasping for breath at the top of the stairs. He and others said Mr. Trump used his neck muscles to help him breathe, a classic sign that someone’s lungs are not taking in enough oxygen.

“This suggests that something’s going on, I don’t know what or to what extent,” Dr. King said. “Any pulmonologist, I think looking at that would give them pause. And you’d say, well, what else do I not know about his condition that I would want to know?”

Dr. Ilan Schwartz, an infectious disease doctor and assistant professor at the University of Alberta, agreed. “As a physician, I would refrain from commenting on somebody whom I haven’t examined,” he said. “But in this case, the clinical signs are so obvious that it can be seen from a distance, even on a short two- or three-second clip.”

Source: https://twitter.com/GermHunterMD/status/1313278384303149058?s=20

Content from External Source
“I don’t need to get in the president’s business,” said Dr. Talmadge E. King Jr., a specialist in pulmonary critical care and the dean of the UCSF School of Medicine. However, he said, “if their goal is for us to understand more completely what is going on, they have left a lot of very useful information off the table.”

Several medical experts said that based on the incomplete information Mr. Trump’s medical team had provided, the president appeared to have at least at some point experienced a severe form of Covid-19, with impairment of the lungs and a blood oxygen level below 94 percent, which is a cutoff for severe disease.

“We go crazy when it gets to 88 percent,” Dr. King said.
Content from External Source
I'm seeing this same point over and over.

Some experts said that the decision to give Mr. Trump dexamethasone could be a sign that he was struggling with more serious Covid-19 than his doctors were revealing, or that his doctors had inappropriately prescribed him the drug.

“Does he have lung involvement? My guess is yes, because they did give him a lot of medications that they would only give to someone who did,” said Dr. Mangala Narasimhan, a pulmonologist and director of critical care services at Northwell Health in New York.

Guidelines from the World Health Organization and the National Institutes of Health recommend that dexamethasone be given only to people who need mechanical ventilation or supplemental oxygen.

A large study of the drug in the United Kingdom found that it benefited Covid-19 patients who fell into those two groups and might be risky for patients with milder symptoms, tamping down an immune system that was effectively fighting the infection rather than quieting one that had gone dangerously into overdrive.
Content from External Source
Taken all in all, I don't think there's reasonable doubt that Trump has had COVID-19 Pneumonia.

This is not to say Trump is going to go on to a medical crisis. He'll probably recover rather undramatically... with minimal lasting damage. There's always some damage.

But it is to say that he is lying. Knowingly. Egregiously.
 
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Z.W. Wolf

Senior Member.
The next three days are the classic days 7-10 when he might go into a severe phase. Only a chance.

But what is inevitable is that his doctors are going to take him off the dexamethasone sometime. When that happens the elevated mood goes away too. Sometimes there's a crash into depression.

Meanwhile dexamethasone can do more than elevate your mood.

https://globalresearchonline.net/journalcontents/v43-2/43.pdf
Steroid treatments are usually associated with psychiatric symptoms which include mania, psychosis, depression, and delirium. A metaanalysis report in a study states that severe psychotic reactions occurred in 5.7% of patients taking corticosteroids and mild-to-moderate reactions in 28% of patients.

Most corticosteroid-induced symptoms start during the first few weeks after treatment initiation but their onset can also be in the first 3–4 days. Corticosteroid induced psychosis involves a series of psychological changes that can occur at any time during treatment with symptoms of agitation, anxiety, insomnia, irritability, and restlessness, mania, depression, and psychosis.
Content from External Source
We may already be seeing this. People are already noting a bizarre energy.
Of course he's always been a bit bizarre... but there's room at the top.

I can see him not wanting to give up the "energy." So he continues to take it, takes larger doses... It's not a pretty picture.
 
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derwoodii

Senior Member.
The next three days are the classic days 7-10 when he might go into a severe phase. Only a chance.

But what is inevitable is that his doctors are going to take him off the dexamethasone sometime. When that happens the elevated mood goes away too. Sometimes there's a crash into depression.

Meanwhile dexamethasone can do more than elevate your mood.

https://globalresearchonline.net/journalcontents/v43-2/43.pdf
Steroid treatments are usually associated with psychiatric symptoms which include mania, psychosis, depression, and delirium. A metaanalysis report in a study states that severe psychotic reactions occurred in 5.7% of patients taking corticosteroids and mild-to-moderate reactions in 28% of patients.

Most corticosteroid-induced symptoms start during the first few weeks after treatment initiation but their onset can also be in the first 3–4 days. Corticosteroid induced psychosis involves a series of psychological changes that can occur at any time during treatment with symptoms of agitation, anxiety, insomnia, irritability, and restlessness, mania, depression, and psychosis.
Content from External Source
We may already be seeing this. People are already noting a bizarre energy.
Of course he's always been a bit bizarre... but there's room at the top.

I can see him not wanting to give up the "energy." So he continues to take it, takes larger doses... It's not a pretty picture.


you seem to be on to something here as his erratic nature now is even more bizarre..


People close to Donald Trump are reportedly concerned his judgment is being affected by COVID-19 drugs, with his son saying he was “acting crazy”.
https://www.news.com.au/finance/wor...t/news-story/c971ec3a1b2a60514256b4bb4a4dc04c

People close to President Donald Trump are concerned his judgment is being affected by the one of the drugs used to treat his coronavirus infection, according to news reports citing anonymous sources.
 

Leifer

Senior Member.
Any word on the other 30+ White House infections, or the more recent Pentagon infections ?
Is the Covid virus just a mild Flu there also ?

https://www.nj.com/coronavirus/2020...rump-took-to-battle-covid-19-report-says.html
Former New Jersey Gov. Chris Christie, who has been hospitalized for COVID-19 for nearly a week, told CNN that doctors have prescribed him remdesivir, an anti-viral drug that President Donald Trump took while he was recently hospitalized with the coronavirus.

It’s unclear when Christie told the news network about the prescription. But the network report late Friday has one of the few details known about his condition or treatment since he entered Morristown Medical Center last Saturday after becoming another person in Trump’s inner circle to test positive for the virus.
 
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