Terry H. Schwadron
The news about a temporary, emergency use of recycled antibody plasma as a coronavirus treatment was so important that Donald Trump needed a Sunday night announcement last week.
In the succeeding days, medical experts came out of the woodwork to underscore that this is not the breakthrough treatment that Trump was indicating. It works in some patients who are already ill with the virus, and in those instances, it seems to lessen the most serious impact of disease and keep hospitalized patients alive.
But as with his endorsement of hydroxychloroquine, Trump was reaching for something that say that we can regard the pandemic as over, because a new treatment is on hand. Use of plasma is neither a preventive nor a treatment that will eliminate the threats from pandemic.
Even Dr. Stephen Hahn, the head of the FDA, felt compelled to back track his support for the move — and dismissed the Trump-appointed departmental PR spokeswoman, saying he had overstated effectiveness in his original remarks.
So, too, with maneuvering to tell the Centers for Disease Control to cut back on testing of asymptomatic but exposed people, an announced policy that had to be walked back. Then there were disclosures that promised payments for uninsured patients were not going through as had been announced. And an anti-flu vaccine rally in Boston where speakers encouraged all to remove masks to breathe free shows that introduction of an eventual vaccine is going to run into acceptance troubles.
Coping With Reality
All this remains in the air because the handling (or not) pandemic clearly has emerged as a touchpoint for the elections, and in the magical imagery of the Republican National Convention last week, the story of government misstep and failure leading to nearly 180,000 deaths since February was recast as a hero story for Donald Trump.
In the re-telling, Trump is the only one in America to see the beneficial effects of stopping air traffic from China (he wasn’t), the only one to marshal federal resources to help the states (if their governors thanked him publicly), hospitals, doctors and nurses, the single source of protective gear for emergency medical workers (not).
We’re skipping over that Trump did not fully stop flights from China, that Joe Biden, as charged, didn’t call that specific move xenophobic, that Trump had eliminated the White House office dealing with pandemics, that he had not restocked federal shelves with needed equipment, that he eschewed the obvious public health needs for masking, physical distancing and testing-contact tracing required, that he has failed to this day to organize a coordinated national set of policies that are aimed at knocking down disease over a preferred path to reopen the economy.
His narration makes for better TV, he believes, and a better shot at reelection.
Are we serious about stopping disease –or providing hurricane aid, or unemployment stimulus or racially tinged violence — or are we content with slogans?
This election, this debate about American values, may hang on whether we act or just mutter out loud.
Indeed, the example of Trump’s grab at the use of antibody plasma transfusion is a move that makes it look as if he is leading, when it isn’t.
A New York Times interview with Mayo Clinic doctors involved in the study of plasma said whatever positive results were based on a small subgroup of hospitalized patients who under 80 years old, not on ventilators and received plasma known to contain high levels of virus-fighting antibodies within three days of diagnosis.
Trump’s bullying of the FDA has resulted in the most temporary approval for the experimental use of the transfusions. In actuality, medical experts see this as damping down full clinical trials on the effectiveness of plasma treatments because no one will volunteer for trials now in which they might get a placebo. In the end, it will impact only a relatively small swath of the millions testing positive for coronavirus.
The whole presentation of the information about plasma comes across as a flailing effort in a storm. And the narration of the Trump presidency in time of pandemic at the convention lands somewhere between sad and disappointing.
As always with the Trump administration, even when there is good intent and policy involved, there are issues about effectiveness because there is no infrastructure to carry through the idea to reality.
And as the convention uses a pretend narration for pandemic, it also is projecting images of a nation under fire over protest of racial injustice, of a bloated and unneeded set of regulation for the environment, an over-weaning reliance on Science over Business, a booming economy about to be ditched by raving socialists and the like.
In the re-telling, the only thing between Life as It Should Be and Complete Disaster is Donald Trump.
Appealing as it may be to those already sworn to salute the Trump flag, these are arguments that are wholly ineffective to the rest of us, even to the point of insulting.
It is clear that we cannot have a fully operating economy without a more systematic approach to pandemic, just as it is clear that we cannot just hope away through denial the inexorable, measurable effects of climate change or just wish away the threat of nuclear weapons in the hands of Iranians and North Koreans.
The point of these conventions is to persuade, right?
But this Republican National Convention seemed misguided in that belief. It features Trump himself, rather than a team much broader than his own family and advisors. It recasts past events as Trump victories even when there was no victory at hand. Other than in its use of utter fear of Democrats as monsters, as a political case, there is no attempt to reach out to recruit me, say, as a supporter.
A president is someone we hire to do a job on our behalf, not someone to worship. That job requirement would start with an ability to look at and accurately assess the nature of the problems we face.
Let’s Make American Problem-Solving Great Again.