| Many well-documented risks go along with Donald Trump’s recent emergence as the best-known Covid patient on the planet—from his ongoing refusal to observe basic public health protocols to the distinctly manic turn his mental state has taken while under the influence of the powerful steroid dexamethasone. A less appreciated hazard of Trump’s contraction of the virus, however, is his unprecedented treatment regimen. As New Republic contributor Melody Schreiber writes, the president is on a highly experimental cocktail of monoclonal antibodies, furnished by the drug giant Regeneron. Trump received the Regeneron treatment under a special dispensation usually reserved for patients experiencing severe, potentially life-threatening symptoms after other treatments haven’t yielded results. Trump’s swift adoption of the treatment has fueled speculation that his condition is far worse than he’s let on—but that’s just the most immediate potential red flag here. Granting the treatment to such a high-profile patient while it’s still in its trial phase risks upsetting the basic protocols that scientists need to follow in order to determine the effectiveness of the Regeneron cocktail. |
| In essence, Schreiber explains, this danger presents itself in either the best- or worst-case scenario. If Trump embarks on a robust recovery—as he is already claiming, with virtually no publicly available evidence, is in fact the case—the cocktail may be hyped as the latest Trump-sanctioned wonder drug, and that may produce the perverse effect of depressing participation in control-group trials, since Covid-19 patients would not want to receive a placebo treatment in its place. And of course, if Trump’s condition takes a sudden turn for the worse, would-be trial participants in clinical trials might be scared off ingesting the cocktail on the basis of the presumed harm it might do. As Columbia University virologist Angela Rasmussen told Schreiber, monoclonal antibodies are usually safe but can produce adverse reactions in some patients, ranging from mild fevers and rashes to anaphylactic shock. “Either way,” Rasmussen observes, “if fewer people are willing to enroll in a randomized controlled trial, it will make determining efficacy very difficult”—a state of affairs she describes as “unprecedented.” These cautions apply not only to Regeneron’s trials-in-process but to all companies now working to test and produce monoclonal antibodies to treat Covid-19. And if these firms follow the same risky course that Regeneron has followed—plunging ahead with uncontrolled treatments on emergency or compassionate bases—“researchers might never learn in a randomized controlled trial what the best dose is, or whether it treats mild or severe illness better, or the best time to take it,” Schreiber writes. “That could have major consequences for treating and preventing the virus—especially among high-risk populations, in whom a vaccine may not work as well.” The other major hazard in all this is, of course, Donald Trump. The president’s dismal track record in boosting untested treatments for the Covid-19 virus does not exactly comport with the conduct of sober clinical drug trials, either. Trump-branded misinformation and chaos surrounding his own treatment regimen could well compound the confusion and squalor of the country’s lamentable response to the Covid crisis: By touting an unproven treatment, whether directly (as he did with hydroxychloroquine for months) or indirectly (by receiving the preliminary treatment soon after announcing his diagnosis), Trump also leaves room for pharmaceutical companies to dominate the narrative when it comes to safe, effective Covid-19 medications. It’s not the first time the administration has prioritized businesses over safety regulations. Yesterday, the White House blocked new rules from the U.S. Food and Drug Administration for evaluating SARS-CoV-2 vaccines. The FDA released the new guidelines anyway, but as an appendix. Trump says his health is rapidly improving and that he’s never felt better. He’s even suggested that Americans shouldn’t be afraid of Covid-19 or “let it dominate your life.” Trump also falsely implied that the flu is deadlier than Covid-19, in a post that Facebook deleted and Twitter hid on the grounds that it was spreading medical misinformation. In other words, regardless of the ultimate fate of the Regeneron trials, Trump will almost certainly continue spreading untruths and reckless misinformation about what the virus does and doesn’t do, and how it might be treated, in deus ex machina fashion. It’s a lethal cocktail of positive-thinking and executive-class hubris that’s already cost us more than 210,000 lives. —Chris Lehmann, editor |
