“I want everybody to be given the same treatment as your president because I feel great. I feel, like, perfect,” Trump said. “I think this was a blessing from God that I caught it. This was a blessing in disguise.”
Two months later, Trump has helped some people receive the experimental treatments his doctors administered him while ill: his close friends and associates, many of whom contracted the virus while ignoring recommendations to mitigate its spread.
The presidential involvement has not extended to millions of other Americans who contracted the virus as well, straining hospitals and requiring health professionals to decide who can receive the most promising treatments, supplies of which are severely limited.
While Trump has pressed the US Food and Drug Administration to approve the treatments quickly, he has not yet ensured that “everybody” can receive them for free. As he remains consumed by his election loss, the President has barely mentioned the surge in cases, and did not comment on Wednesday when the US death toll reached its highest daily count.
He’s been more active when people he knows get sick.
Trump personally intervened to ensure Housing and Urban Development Secretary Ben Carson received the same monoclonal antibody therapy that he did during his stay at Walter Reed National Military Medical Center.
“President Trump was following my condition and cleared me” for the drugs, Carson wrote on Facebook upon recovering. “President Trump, the fabulous White House medical team, and the phenomenal doctors at Walter Reed have been paying very close attention to my health.”
“I didn’t really want to go to the hospital, and he said, ‘Don’t be stupid,'” Giuliani recalled in an interview with WABC Radio this week of his conversation with Dr. Sean Conley, the White House physician. “We can get it over with in three days if we send you to the hospital.”
Another of Trump’s close allies, former New Jersey Gov. Chris Christie, also received an experimental antibody treatment ahead of its emergency use authorization by the FDA.
All four men — Trump, Carson, Giuliani and Christie — fall within high-risk categories for people more likely to suffer severe symptoms of Covid-19. And all have at times ignored recommendations on masks and social distancing that Trump himself has downplayed as the pandemic ravages the country.
“It’s wrong. It’s flat-out wrong, it’s unethical and it shouldn’t be going on,” said Art Caplan, the founding head of the Division of Medical Ethics at New York University School of Medicine. “We could make the case the President is an essential worker and we’ll bump him or her up to the top of some list. But when you have people rationing scarce drugs, antibodies, when you have people rationing beds in certain places around the country — and that’s going to continue — being a celebrity shouldn’t count. Being a highly visible politician shouldn’t count. It shouldn’t count who you’re connected to. What should count is need.”
Like Trump, who received the Regeneron antibody cocktail while at Walter Reed, his associates received drugs that aren’t yet widely available to the American public, despite the President’s vow to make them free to anybody who needs them.
That has left health officials in states with the task of deciding who can receive the treatments that, by his own admission, saved Trump’s life and likely helped his close associates recover.
In November, the FDA granted an emergency use authorization for Regeneron’s antibody cocktail to treat high-risk patients with mild to moderate disease. But the company’s chief executive said in a statement at the time that demand may initially exceed supply.
The company said it would have enough doses for 80,000 patients by the end of November, and 200,000 patients by the first week of January. Since then, however, cases have spiked. This week, more than 200,000 new cases have been identified daily.
More than 278,000 courses of the two antibody treatments that have received emergency use authorization to treat Covid-19 have gone out to medial facilities, Secretary of Health and Human Services Alex Azar told reporters on Wednesday.
Azar, who spoke at an Operation Warp Speed briefing, said that the administration is working to send out more.
For now, with the limited number of doses, states that have a larger share of the country’s total number of confirmed Covid-19 patients, as well as those regions with a larger total of confirmed hospitalized patients, will be given priority in distributing the treatments.
The logistics of distributing the antibody treatments are complex. Patients get the treatment through an infusion that takes an hour and needs to be done at a health care facility that has access to emergency treatment in case there are problems. The patient then needs to stay for another hour for observation.
Federal officials have acknowledged the distribution of these treatments won’t be easy.
“We anticipate that initially, there’ll be challenges for the health care system in administering IV infusions to infected patients,” Dr. Janet Woodcock, the head of therapeutics for the administration’s Operation Warp Speed, said at a briefing in November.
She said the government had developed and distributed a playbook in conjunction with the drug’s manufacturers to help health care providers think through the challenges, and figure out the best way to set up infusion centers.
But concerns linger about the inherent inequities in distributing a treatment that is in short supply as cases surge around the country. Already, coronavirus has exposed deep rifts in how Americans access health care that have fallen along existing racial and socio-economic fault lines. The openness with which Trump and his allies have used their influence to access promising but scarce treatments only exacerbates the impression that quality health care is easier to access for powerful people.
“You know we have an unfair system. Jimmying the resources brings out how unfair the system has actually been all along,” Caplan said.
For his part, Giuliani seemed unconcerned that his status as a well-known figure might have influenced his care. Instead, he leaned into it.
“Sometimes, when you’re a celebrity, they’re worried if something happens to you they’re going to examine it more carefully, and do everything right,” he said in his radio interview this week.