President hospitalized after testing positive for COVID-19

President Donald Trump has been in isolation at the White House today and will be hospitalized after announcing early this morning that he and First Lady Melania Trump have tested positive for the coronavirus.

The president made the announcement on Twitter shortly before 1am, hours after it was reported that one of his closest White House aides, Hope Hicks, had tested positive. Hicks had been with the president on Air Force One on Wednesday for a trip to a campaign rally in Minnesota.

Later in the morning, White House Chief of Staff Mark Meadows told reporters that President Trump and the First Lady are in good spirits, but that the president does have mild symptoms.

"The doctors continue to monitor both his health and the health of the First Lady," Meadows said.

This afternoon, White House Press Secretary Kayleigh McEnany tweeted a memo from President Trump's personal physician that said the president had received a single 8-gram dose of Regeneron's polyclonal antibody cocktail as a precautionary measure. And in a late-breaking development, media sources said President Trump is leaving the White House for Walter Reed Hospital.

Concerns about contacts

The news about the president's diagnosis has prompted concerns about his busy schedule over the past week, and the number of people he's been in contact with.

Among the events President Trump attended over the past 7 days was a Sep 26 Rose Garden ceremony to announce the nomination of Amy Coney Barrett to the Supreme Court, where many in attendance were not wearing masks. Two attendees of that event, Sen Mike Lee (R-Utah) and University of Notre Dame president Fr. John Jenkins, both tested positive today.

On Wednesday, the president attended a fundraiser in Shorewood, Minnesota, and later held a rally in Duluth. Three Minnesota Republican congressmen flew on Air Force One to and from that rally, and all three are getting tested, according to the Minneapolis Star Tribune. The Minnesota Department of Health also issued a warning that there is a potential risk that transmission occurred at the Duluth rally and other events associated with the president's visit.

"Anyone who attended events associated with the President's visit and who now has symptoms should get tested right away," the department said in a statement. "People should consider getting tested even if they do not have symptoms because some people may not develop or recognize symptoms and people can spread the virus even without displaying symptoms."

On Tuesday, President Trump participated in the first presidential debate of the 2020 election. Neither the president, Democratic presidential nominee Joe Biden, nor moderator Chris Wallace wore masks during the 90-minute debate, but all were more than six feet apart. Biden and his wife both tested negative today.

Fox News reported that New Jersey Gov Phil Murphy is urging everyone who attended the president's fundraiser at the Trump National Golf Club on Thursday to get tested for the coronavirus.

Brown University School of Health Dean Ashish Jha, MD, said on Twitter that everyone who's been near the president since Saturday should be identified and tested.

"I'd go back, test everyone near [the] President from at least Saturday on to see if we can identify [the] source," Jha tweeted. He also said that anyone near the president since Tuesday should quarantine.

Vice President Mike Pence and second lady Karen Pence have both tested negative. But Pence's physician released a memo saying the vice president does not need to quarantine because he's not a close contact of the president, according to The Hill.

President's age puts him at higher risk

Although President Trump is experiencing only mild symptoms at this point, his age (74) puts him at a higher risk of severe illness. According to the Centers for Disease Control and Prevention (CDC), Americans between the ages of 65 and 74 years have the third highest COVID-19 hospitalization rate, with 198.7 hospitalizations per 100,000 population. Eight out of 10 COVID-19 deaths have been in people 65 years old and older.

"The president's in a high-risk group simply by virtue of his age," former Food and Drug Administration (FDA) commissioner Scott Gottlieb, MD, told CNBC. "He's also reported to be overweight."

According to the results of his most recent annual physical exam, President Trump's body mass index is above the clinical threshold for obesity. The CDC says having obesity increases your risk of severe illness from COVID-19.

Studies have also identified being an older man as an increased risk factor for COVID-19 death.

Gottlieb noted that research out of the United Kingdom estimates that the risk of death for COVID-19 patients age 74 and under is 3.4%. Despite these risk factors, Gottlieb said there's every reason to expect President Trump will do well and recover.

In an opinion piece for Fox News, former CDC director Tom Frieden, MD, said that 85% to 90% of those who are infected in their 70s will have no, mild, or minor illness, and Frieden called the president's infection a "sobering reminder" that COVID-19 is an ongoing threat to our country.

"His infection shows that, sadly, COVID is real, still with us, and can happen to anyone," Frieden wrote. "No one is safe – not even heads of state – until everyone is safe."

Vaccine allocation

In other COVID-19-related news, the National Academies of Science, Engineering and Medicine today released its recommendations for equitable distribution of a COVID-19 vaccine once one is approved by the FDA.

The document lays out four allocation phases, with high-risk health workers and first responders receiving the vaccine in phase 1a—the "jumpstart phase,"—and people of all ages with comorbid and underlying conditions that put them at significantly higher risk, along with older adults in congregate care settings, getting immunized in phase 1b. NASEM estimates phase 1a includes about 15 million people.

Phase 2 includes of K-12 teachers and staff, childcare workers, critical workers in high-risk settings, and people in homeless shelters and prisons. Phase 3 consists of young adults and children, along with workers in industries that are important to society but not included in the first two phases. Phase 4 includes everyone who didn't receive the vaccine in the previous phases.

NASEM also recommends that for each population, vaccine access should be prioritized for areas identified as vulnerable, particularly Black, Latino, and Native American communities, which have all been hit hard by the coronavirus pandemic.

A COVID-19 vaccine was among the topics of discussion today at a hearing of the Select Subcommittee on the Coronavirus Crisis, where Department of Health And Human Services Secretary Alex Azar sought to assure lawmakers that the vaccine approval process will be grounded in science.

"I will be confident that my family and I should take the vaccine, and you should be confident that you and your family should take it too, because any vaccine will have met FDA standards, as judged by FDA career scientists," Azar said.

The United States now has 7,312,444 confirmed COVID-19 cases, with 208,403 deaths, according to the Johns Hopkins COVID-19 dashboard.

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