特朗普打一针花掉230万，药品还包含脑白金？！一文为你解读懂王治疗方案（附视频&解说稿）

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自从10.2号特朗普在公众平台宣布他和他夫人患新冠肺炎开始隔离以来，关于特朗普与新冠的话题就一直是各大媒体讨论的对象 ，高居各大话题榜榜首，可以说，特朗普比国民明星还令人关注！

自从特朗普接受治疗以来，到底特朗普用了什么药，接受了什么治疗方法，一直广泛受到大众关注，毕竟美国可是世界上医疗最为发达的国家之一，特朗普所能接受的治疗，应该就是全球顶尖水平的治疗了，那么让我们关注一下，这个世界顶尖的治疗团队，是怎样治疗这个70多岁的老人的呢？

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-The changing accounts from President Trump's doctors about his coronavirus treatment has created a credibility crisis for the White House.

-He has not received any supplemental oxygen?

-He's not on oxygen right now, that's right.

-In his lungs. Are there any [indistinct] - are there anything?

-Why were you so reluctant until today to disclose that the President had been administered oxygen.

-It's a good question.

-Thank you.

-I was trying to reflect the upbeat attitude of the team.

-And Sunday, Trump's medical team reported that his blood oxygen level dropped suddenly. It was the second time in recent days. A day later, however, the President's doctors said he was being discharged from the Walter Reed Medical Center and that he was continuing his treatment at the White House.

-Though he may not entirely be out of the woods yet, the team and I agree that all our evaluations - and most importantly his clinical status - support the President's safe return home where he'll be surrounded by world -class medical care 24/7.

-The President has an aggressive mix of treatments, including a five-day regimen of an anti -viral medication as well as monoclonal antibodies, and experimental treatment still in clinical trials. He also receives steroids, vitamin B and Zinc, and an over -the -counter drug to reduce stomach acid. Howard Greller, a toxicologist who has seen many COVID patients, explains what each means. 

The first is Remdesivir, which is basically an antiviral agent. The best analogy to it would be something like Tamiflu, which is I think a drug that people are familiar with with influenza. It's still being studied. And here's where it gets tricky. It's primarily been used in patients who have been sick - hospitalized and sick. 

And part of the reason for that is because access to the drug has been limited. And part of it is we're still trying to figure out when is best to give the drug and who is best to give the drug to. You may have heard of that previously called convalescent plasma. So basically, people that survive having COVID, you then take out the antibodies from their blood and then use them to treat people who are actively combating the disease. This is something where it is a lab -created antibody -

- I believe it's two, which is why they're calling it a cocktail. They're looking at it in order to see whether or not it can both prevent and/or treat COVID. Dexamethasone is a drug that we've used therapeutically for decades. It's used in a host of inflammatory conditions ranging from asthma to different allergic conditions to arthri - a whole host of things, and it's a potent steroid. This is by no means a cure -all. 

It's an additional tool to fight the virus but one that seems to have good data to support its use in sick people. Its effectiveness is questionable and certainly, it has some negative side effects to it, and it can have some significant side effects if too much is given. Yeah, I mean, vitamin D is an important vitamin, and it's an important thing, especially in people who are lighter skinned and who do not have regular sun exposure. And so, typically in winter time, Caucasian individuals are vitamin D deficient. It's PEPCID, to use the brand name. It's an antacid. 

There was an associating that was noticed that patients that were admitted with COVID that got Famotidine or were on Famotidine prior to hospitalization did a little bit better. But that association is not proof that Famotidine is a therapy. Adding more drugs, adding more therapies is not always better. I think that that's a really important point because the more you add, the more chance there is that you're gonna have an interaction or a problem amongst the things that you're adding. And when things have not been studied that say "A" goes with "B" really well, right, you're potentially introducing risk rather than benefit. That's why knowing a little bit more would be helpful in trying to parse this out.

10月5日特朗普总统医疗团队发布会

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Dr. Sean Conley: Good afternoon, everyone. Thank you for being here.

Dr. Sean Conley: Over the past 24 hours, the president has continued to improve. He’s met or exceeded all standard hospital discharge criteria. He’ll receive another dose of remdesivir here today, and then we plan to get him home. It’s been more than 72 hours since his last fever, oxygen levels, including ambulatory saturations and his work of breathing are all normal. Though he may not entirely be out of the woods yet, the team and I agree that all our evaluations, and most importantly his clinical status, support the president’s safe return home, where he’ll be surrounded by world-class medical care 24/7.

Dr. Sean Conley: I’d like to bring Dr. Dooley up to review some more specifics.

Dr. Sean Dooley: Good afternoon, just a brief update this morning. As Dr. Conley mentioned, the president continues to do very well. His vital signs this morning were notable for a temperature of 98.1, his blood pressure was 134 over 78, and a respiratory rate of 17 respirations per minute, and his heart rate was 68 beats per minute. His last oxyhemoglobin saturation was 97% on room air. He currently does not endorse any respiratory complaints, and aside from our evaluation with the multi-disciplinary team this morning, has maintained a full schedule, ambulating and working on the White House medical unit.

Dr. Sean Dooley: I’ll now turn it over to Dr. Garibaldi to again discuss therapeutics. Thanks.

Dr. Brian Garibaldi: Hi, good afternoon. Again, I just wanted to echo the sentiment of what an honor it is to be part of this wonderful team here at Walter Reed. Yesterday evening the president received his third dose of remdesivir and he tolerated that infusion without difficulty and his kidney and liver function continued to be normal. Our plan is to give the fourth dose of remdesivir this evening before he goes back to the White House. We’ve made arrangements to deliver the fifth and final dose of his treatment course at the White House tomorrow evening. He continues on dexamethasone and, again, the plan for today is to continue to be up and out of bed, eat and drink, and work as he is able.

Dr. Brian Garibaldi: I’d like to turn it over to Dr. Jason Blaylock, who’s an infectious disease specialist and the chief of medicine here at Walter Reed to give some updates on infection control. Thank you.

Dr. Jason Blaylock: Good afternoon, everyone. First of all, I just want to say what an honor it’s been to be part of this medical team behind me and to care for the president.

Dr. Jason Blaylock: Since the president’s arrival at Walter Reed, he’s received medical management that remains in line with national, clinical, societal guidelines for treatment of COVID-19 infection. In addition, both myself and Dr. Wes Campbell have worked very closely with various laboratories in the area, state-of-the-art facilities, to include USAMRAA and [RAR 00:03:10] on obtaining advanced diagnostic testing to really inform the White House medical team of both the status of the president, as well as his ability to transmit virus to others. Also, we have worked very closely with the Walter Reed team to ensure that we are looking very closely at infection control prevention strategies and the right posture so that the president can safely return to his residence.

Dr. Jason Blaylock: With that, I’m going to turn it over to Dr. Conley, who will answer any final questions?

Dr. Sean Conley: Thanks, Jason.

Dr. Sean Conley: I mentioned it Saturday, but I’d like to reiterate myself just how grateful the president and I are to the men and women of Walter Reed, our colleagues at Johns Hopkins, as well as the many federal, private institutions that we’ve received support from. So long as everything continues on the track that we’re experiencing right now, at this time, as the president already tweeted out, is to get him home later today. With that, I’ll take a couple questions.

Speaker 5: Dr. Conley, how can the president be discharged back to the White House when he was given steroids. You’ve said that he’s still on those steroids. Those are medicines, as you know, that are usually given to COVID patients who are on ventilators or with low oxygen, so did you over-treat him? If he’s still on that medication, how is it safe for him to return to the White House?

Dr. Sean Conley: We send patients home with medications all the time. In fact, yesterday afternoon, he probably met most of his discharge requirements safely from the hospital. He’s returning to a facility, the White House medical unit, that’s staffed 24/7, top-notch physicians, nurses, PAs, logisticians. The unit here, the team here behind me, is going to continue to support us in that nature.

Dr. Sean Conley: Yes?

Speaker 6: Dr. Conley. Dr. Conley, what are infection control measures are you taking and how was it safe for him to drive around in a cloth mask yesterday? How is it safe for him now to return to the White House where there’ve been so many cases? How’s any of this safe?

Dr. Sean Conley: The president has been surrounded by medical and security staff for days wearing full PPE. Yesterday, the US Secret Service agents were in that same level of PPE for a very short period of time. We’ve worked with our infectious disease experts to make some recommendations for how to keep everything safe down at the White House for the president and those around him. We’re looking at where he’s going to be able to carry out his duties, office space. I’ll just say that it’s in line with everything we’ve been doing upstairs for the last several days.

Speaker 7: Can you tell us please, on testing, can you tell us when he had his last negative test? Was it Thursday? Was it Wednesday? Do you remember when he had his last negative test?

Dr. Sean Conley: I don’t want to go backwards.

Speaker 7: It helps for contact tracing for people who were around him to know when he was positive.

Dr. Sean Conley: I understand. The contact tracing, as I understand it, is being done. I’m not involved in that.

Speaker 8: [crosstalk 00:06:19] that he leave or was this something he pushed for?

Dr. Sean Conley: No. We try to get patients home and out of the hospital as quickly as is safe and reasonable. Every day a patient stays in the hospital unnecessarily is a risk to themselves. Right now there’s nothing that’s being done upstairs here that we can’t safely conduct down home.

Speaker 9: You had said that seven to ten days was a window that you’d be concerned about. I don’t think we’re there yet. Do you have concerns about potential worsening or reversal? What are your plans for addressing that if it were to happen?

Dr. Sean Conley: You’re absolutely right. That’s why we all remain cautiously optimistic 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. 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 have caught up here.

Speaker 10: Where is he physically going to be in the White House? What does that look like? How do you keep him safely quarantined?

Dr. Sean Conley: I wish I could go into that more, but I just can’t.

Speaker 6: Doctor, why did you begin dexamethasone treatment?

Dr. Sean Conley: Yesterday, we talked about that, the several little temporary drops in his oxygen, and we had discussed that as a team and elected to start it early in case that persisted or worsened. The potential risks and side effects, we all discussed. We looked at the data and decided that we’d rather, push ahead on it then hold and risk the opposite.

Speaker 6: What about CT scans and X-rays? What have you seen on his chest X-rays?

Speaker 11: [crosstalk 00:08:18] resume his campaigning?

Dr. Sean Conley: As far as travel goes, we’ll see.

Speaker 12: Dr. Conley, on his mental status, can you talk about whether he has any neurological symptoms? Does he have any side effects from his medications, any fogginess from the virus?

Dr. Sean Conley: No. I think you’ve seen the videos and now the tweets and you’ll see him shortly. He’s back. Yeah.

Speaker 6: What about his chest X-rays and CT scans?

Speaker 13: Have you seen any evidence of pneumonia or any inflammation in his lungs at all?

Dr. Sean Conley: We’ve done routine standard imaging, I’m just not at liberty to discuss.

Speaker 6: Doctor you were on board Air Force One.

Speaker 14: You’re actively not telling us what those lung scans showed, just to be clear.

Dr. Sean Conley: There are HIPAA rules and regulations that restrict me in sharing certain things for his safety and his own health and reasons.

Speaker 15: You said his oxygen dropped several times. Can you share how many times he was on oxygen? You said you would check with the nursing staff yesterday.

Dr. Sean Conley: Yeah. Yeah. Yes. Yes. Two episodes, like we talked about yesterday, and both times that he received a little bit of oxygen and recovered immediately.

Speaker 15: Was it required? Was that oxygen required?

Dr. Sean Conley: No, it wasn’t required. He wasn’t short of breath. He wasn’t looking ill. It was more of us trying to anticipate needs and see how he’d respond. In both cases, he came right off. He didn’t need it for very long at all.

Speaker 6: Doctor, you were on board Air Force One for multiple trips, are you at all concerned about your own exposure and exposure to the medical team?

Dr. Sean Conley: I am concerned, but as the CDC says, there are caveats for essential employees that as long as you continue to test negative, you remain symptom-free and you keep a mask on when you’re out and about, which we do inside the hospital, 24/7, then you can carry on your duties.

Dr. Sean Conley: Yeah?

Speaker 10: We all know the president’s an impatient man, has he been itching to get out of here?

Dr. Sean Conley: The president has been a phenomenal patient during his stay here. He’s been working hand in glove with us and the team. Today it got to the point, he’s holding court with those of us around him, the whole team, going over all the specifics, the testing, what the future is, and we have been back and forth on what’s safe, what’s reasonable. He has never once pushed us to do anything that was beyond a safe and reasonable practice that we all first wanted.

Speaker 16: Was there anybody on this medical team, who recommended against the president leaving here and going back to the White House today?

Speaker 16: Or any White House staffers?

Dr. Sean Conley: No.

Speaker 6: The president said, “Don’t be afraid of COVID.” Do you agree with that? Should we not be afraid?

Dr. Sean Conley: I’m not going to get into what the president says.

Speaker 17: You said his heart, liver, and kidney function was normal or improving. Improving, does that mean that there were effects and is it all normal? What’s up with that?

Dr. Sean Conley: Yeah. It’s all normal right now. I would say he appeared to be a little dehydrated Friday. He was able to just drink and recover from that. Yeah, everything looks great.

Speaker 18: Doctor, what would you like to see before he starts, resumes campaigning out in the country? What sort of things do you want to see?

Dr. Sean Conley: Yeah. The big first thing that we need to do is that there is no evidence of live virus still present that he could possibly transmit to others, and that’s what the infectious disease experts and some of our partners, military, civilian entities doing some of these advanced diagnostics just to see, as soon as we can identify that routinely. We talk about a 10-day window, CDC guidelines, but we’re checking him more routinely than just waiting 10 days. There’s a possibility it’s earlier than that. There’s a chance that it’s a little bit later, but we will know as soon as possible. Then we will look at him clinically. How are you feeling? How are you doing?

Speaker 19: Why have you decided not to use, administer hydroxychloroquine to the president during his time here?

Dr. Sean Conley: I’m not going to go into all of our debates about specific medicines and therapies. There are dozens of therapies that we were made aware of that we considered, that we discussed and debated and looked at the existing literature on. This is the regimen we chose.

Speaker 19: [crosstalk 00:12:44] hydroxychloroquine.

Dr. Sean Conley: Yeah?

Speaker 20: On the symptoms of COVID, is he’s having some of the muscle aches? Has he lost his sense of taste and smell?

Dr. Sean Conley: No. We were just talking about that, what symptoms he has left. Even the slight cough that he used to have, he doesn’t really complain of at all. He hasn’t ever complained of a muscle aches. Yeah, he’s up and back to him old self, predominantly.

Speaker 10: You talked about next Monday, just to be clear, how long will he still be actively shedding the virus?

Dr. Sean Conley: This morning, I believe there was even an accounting by Dr. Fauci referencing a five day, the first five days of illness that people are most likely to shed live virus. There’s a reason there’s the 10 days. It’s because most people, by that time, after seven days, most folks don’t have culturable live virus. They put it to 10, just to give some extra space. It’s never 100% between everybody, so we’ll see. I’m not going to put a specific number, but we look at that window is all I will say.

Speaker 21: Doctor, will the president be confined to his residence or will he be allowed to return to the Oval Office?

Dr. Sean Conley: We’re going to do whatever it takes for the president to safely conduct business, whatever it is he needs to do within the residence and White House.

Speaker 22: Is he on blood thinners? Also, has he been using, have you been giving him Tylenol, Advil, anything to bring his fever down?

Dr. Sean Conley: Oh, that came up. I would like to say, he has not been on any fever-reducing medications for over 72 hours.

Speaker 22: But what about the blood thinners?

Dr. Sean Conley: Yeah. He’s on a routine regimen of COVID therapy. I’m not going to go into specifics as to what he is and is not on, but …

Speaker 23: You said, I’m going to read this here, that the president had a mild cough, some nasal congestion and fatigue on Thursday. Now back to my colleague, John Jacobs question, the reason knowing when the president’s last negative test is important for that reason, your words, what you said, and also for the contract tracing, but would you’ve recommended that given those symptoms that he go, that the president go to that Bedminster fundraiser?

Dr. Sean Conley: It’s not up to me, necessarily, the president’s schedule, but I would say that it wasn’t until after he returned that we really sat down, then knowing the news of the day that we really dove into, how are you feeling? What’s going on?

Speaker 23: But how was that safe given that those were the symptoms he was experiencing on Thursday?

Dr. Sean Conley: I’m not going to get into operations.

Speaker 6: Doctor, one last time, when was his last negative test and what was his viral load?

Dr. Sean Conley: I know everyone wants that.

Speaker 6: We’ve been exposed. [crosstalk 00:15:24]

Dr. Sean Conley: Yeah. I I don’t have his viral load. Those are some of the diagnostics that we’re sending out that will really tell us when it’s safe for him to get back out and around people.

Speaker 6: You’ve never had his viral load?

Speaker 24: Why is it [crosstalk 00:15:37] say when the last negative test was?

Speaker 25: Did he have any abnormal tests? Were any of his lab tests abnormal?

Dr. Sean Conley: Again, HIPAA kind of precludes me from going into too much depth on things that I’m not at liberty or he doesn’t wish to be discussed. At some future point, maybe. But today, I’m sorry. I think that’s it. Yeah.

Speaker 26: Thank you, guys, so much.

Dr. Sean Conley: Thank you.

Speaker 26: Thank you.

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-This morning, the president is doing very well. Just 72 hours into the  diagnosis now, the first week of COVID and in particular days 7 to 10 are the most critical in determining the likely course of this illness. Thursday he had a mild cough and some nasal congestion and fatigue, all of which are now resolving and improving.

-We have monitored his cardiac function, his kidney function, his liver  function. All of those are normal. And the president this morning is not on oxygen.

-About 48 hours ago, the president received a special antibody therapy directed against the coronavirus, and we're working very closely with the company to monitor him. Yesterday evening, he received his first dose of IV remdesivir, and our plan is to continue a 5-day treatment course for remdesivir.

-The president's been fever-free for over 24 hours. We remain cautiously optimistic, but he's doing great.

-Do you have an estimated date when he might be discharged?

-Well, I don't want to put a hard date on that. Given that we provided some of these advanced therapies so early in the course, a little bit earlier than most of the patients we know and follow, it's hard to tell where he is on that course. We are maximizing all aspects of his care, attacking this virus in a multipronged approach. It's the president. I didn't want to hold anything back. If there was any possibility that it would add value to his care and expedite his return, I wanted to take it.

-Has he ever been on supplemental oxygen?

-Right now he is not on oxygen.

-I understand. I know you keep saying "right now." But should we read into the fact that he had been previously?

-Yesterday and today, he was not on oxygen.

-When was the president's diagnosis made? You said 72 hours. That would put it at Wednesday.

-So, Thursday afternoon, following the news of a close contact, is when we repeated testing and given kind of clinical indications to add a little bit more concern, and that's when late that night we got the PCR confirmation.

-In addition to his weight, does he have any other risk factors that make him more at risk for sort of a severe case?

-Well, not particularly. He's 74. He's male. And he is slightly overweight.

-So, why was the decision made to transfer him here?

-Because he's the president of the United States.

-Why wasn't the first lady admitted, as well?

-The first lady's doing great. Thanks for asking. She has no indication for hospitalization, advanced therapy. She's convalescing at home. Thank you.

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