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An ACTUAL Mini-Primer on President Trump's Medication Regimen. And Some Additional, Uhhh, Thoughts.

I have been asked why I have not written about COVID recently, and my answer was two-fold.

First, I am visiting my family for the first time since COVID started, and I wanted to focus on enjoying my time with them.

Second, to be completely frank, there has not been a ton of breaking/surprising developments I thought were worthy enough to warrant an entire post on their own, though I will include some brief points below.

But first…

Enter: President Trump and his not-smartness.

As always, I want to make this clear this is NOT a political debate - I personally do not care if you are a Democrat or Republican.

I only mention Trump is an idiot because that is what he is - an idiot. And though there are idiots on both sides of the aisle, this one just happens to be the POTUS.

His recklessness deserves to be called out at every opportunity. He has a YUUUUUGE amount of influence with his supporters. And his non-scientific approach to the pandemic has led to a huge number of deaths or people suffering as a result.

And where he himself may be a victim.

Listen - I do not take joy in anyone suffering. But NONE of us should be surprised this happened to him as he belongs in a high-risk category.

But he brought it upon himself because if he wanted, the White House should be the safest building IN THE ENTIRE WORLD if he wanted it to be. But he never took this pandemic seriously.

He still held a fundraiser even though he knew Hope Hicks was infected - who by the way was one of the few Trump supporters who actually WORE a mask but was made fun of for it by others. And he is the one who decided to hold what easily could end up being a super-spreader event just to announce his pick Judge Barrett for the SCOTUS vacancy left by the Notorious RBG 😇❤, as many attendees of the event did not wear masks nor abide by social distancing guidelines, 7 of which are now testing positive for the virus, NONE of whom wore a mask and interacted in close proximity to many 🤦🏽‍♂️.

And now Chris Christie is positive, who aided Trump in debate prep. And I am sure more names will be added in the coming days.

Okay, now that the idiocy of the entire situation has been addressed to some degree, I thought it would be worthwhile going through in more detail what exactly the President is receiving as treatment and why. Many may not understand each drugs role in fighting COVID-19, so thought I would help shed some light on this all 🙂.

His treatment thus far is as follows: an infusion of Regeneron’s polyclonal antibody "cocktail", zinc, Vitamin D, famotidine, melatonin, and aspirin. And most recently, Remdesivir. That is all we know so far.

But wait...


Why? Probably, well, BECAUSE THERE IS NO EVIDENCE IT WORKS. And it can have untoward side effects.

So if it is the miracle cure Trump claimed, how come his doctor is not prescribing it to him? If it is apparently good ood enough for you, why is it not good enough for him? 

Because he is FULL OF SHIT, that is why.

Moving on.

Let us break his regiment down, one by one:

Regeneron’s polyclonal antibody cocktail - REGN-COV2:

REGN-COV2 is taken as a one-time infusion. It is a mixture of antibodies taken from two possible sources:

  1. Genetically-modified mice, termed VelocImmune mice, whose immune systems have been altered to mimic that of a human-being. These mice have then been exposed to SARS-CoV-2, producing hundreds of different types of antibodies towards the virus itself.

  2. Antibodies isolated from humans themselves who have recovered from COVID-19. 

From this antibody pool, the top two (or possibly more) antibodies are then selected for the “cocktail” treatment based on the antibodies potency and binding ability to the spike protein - the viruses receptor binding site (RBS) - plus additional desirable factors (not exactly sure what this specifically refers to) to allow targeting of different parts of the spike protein so it could theoretically protect against future variants of the virus itself.

In the most recent trial involving 275 patients who received this cocktail - the majority of which were considered high-risk groups, including a high-enrollment of minorities - showed a decrease in viral load and more rapid resolution of symptoms in those patients who were not hospitalized, though the strongest responses occurred in those who had not yet mounted their own immune defense against the virus. The results of this trial LOOKS promising, BUT the safety and efficacy of the treatment cannot as of yet be determined based on such a small trial.

Hence why it has not yet been FDA-approved and can only be accessed in two ways:

  1. Enrolling in an experimental trial, though you run the risk of obtaining placebo instead

  2. Applying under a “compassionate use” waiver, which is what Trump’s physicians did because, well, he is the POTUS.

By the way, this would not swing in the favor for any of us normal, everyday people.

Zinc and Vitamin D both show evidence of supporting and/or modifying the immune system's response to infection.

Zinc: There is evidence Zinc offers possible protection against infection via anti-inflammatory effects that may be protective. Researchers in Spain found that patients with lower zinc levels CORRELATED with higher degrees of inflammation/inflammatory markers and poorer outcomes, including death.

HOWEVER, correlation does NOT imply causation, so it is not possible to determine if this association indeed exists, at least with current studies available. But there is no harm in taking zinc as many people do so for the common cold anyway, and if it helps, great.

Vitamin D: there is more and more research coming out supporting Vitamin D as a protective measure, not only against COVID-19, but other respiratory viruses in general.

It is known Vitamin D helps regulate innate and adaptive immune responses that could reduce viral load and limit the cytokine storm response. It is also known to down regulate ACE2, which has also been implicated in COVID-19.

Studies are showing an association of increased Vitamin D levels with decreased risk for adverse clinical outcomes including death, decrease levels of inflammatory markers, and increase levels of lymphocytes to help fight infection.

Vitamin D deficiency is prevalent worldwide, but worst during the winter months at higher latitudes, due to people staying indoors, bundling up and less skin exposure, and lower UVB exposure by the sun to allow sufficient production of self-made Vitamin D.

And interestingly enough, those with darker skin tend to be the most Vitamin D deficient since increased melanin in the skin limits UVB absorption, further limiting production of Vitamin D. In addition, the older we get, the less efficient our bodies become in producing Vitamin D.

This could be a not-insignificant component of why Black, Hispanic, and elderly communities are disproportionately impacted by the virus compared to other communities.

Famotidine: It is typically used as an H2-receptor blocker to suppress stomach acid production, ie to prevent heartburn. However, computational models identified famotidine as a drug that could potentially inhibit a protease (a protein-cleaving enzyme) which is essential for viral replication. However, this has not played out in reality:

In addition, a meta-analysis of 5 studies - none high quality - showed it may decrease mortality from COVID-19. Though again, the research is FAR from definitive:

Melatonin: it is a hormone which helps regulate our sleep cycles. There is some evidence it may have anti-inflammatory effects and limit lung and neurologic injury, and improved sleep may also help improve immune system function.

But again, the evidence is still very weak for its role in protecting against COVID.

Aspirin: it is well-known at this point being infected with COVID-19 can lead to increased risk of clotting, so this likely is simply being given as a prophylactic against it.

Remdesivir: This drug had been touted for months as a possible "miracle" drug.

But it has not be proven to be so at all.

It has not been shown to reduce disease severity or mortality, and an early trial was aborted due to significant side effects. Thr decreased days to resolution of symptoms was NOT clinically significant. And finally, the evidence shows it is most effective prior to or at time of innoculation - which essentially is impossible to predict.

Hence why we need to allow SCIENCE to do its thing. Slow your roll, people.

Overall, I think taking Zinc (recommended dose 15-30 mg per day) and Vitamin D (recommended dose varies from 1000-5000U per day) is easy and safe to do, and many people take both without consulting a physician anyway. But if you are considering taking anything else I spoke about, please consult with your primary care provider first ❤.

And no, you will not be getting REGN-COV2 or Remdesivir so do not ask 🤣.

Alright, that is enough nerdiness for now. Time to rot my brain watching college football 🏈🍻😇🤣.

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