Donald Trump. (EFE Agency)
The special treatment Donald Trump received that gave him access to an experimental medicine to combat COVID-19 raises questions about the quality of medical services the common American receives and the public's right to know their health, according to experts in medical and ethical issues.
The Regeneron Pharmaceuticals Inc. laboratory revealed on Tuesday how unusual it is for someone to receive the medicine that was given to the president without having completed the rigorous studies . The medicine, which generates antibodies that help the immune system fight the coronavirus, is believed to hold great promise.
Trump also received the antiviral remdesivir and the steroid dexamethasone, but it's impossible to know if either of those drugs worked.
“He deserves special treatment in light of his position , “ said George Annas, who runs a Boston University center on health law and ethics. “What you have to see is whether the treatment was good . “
These drugs have not been tested in moderately serious illnesses and they have not been used in combination either. The use of the steroid seems to go against the usual guidelines based on what doctors say about the severity of their infection.
“The public is getting mixed messages about his status and that is a problem,” Annas said, adding that public opinion has a right to know everything that may affect Trump's ability to perform his duties.
How did you get the medicine?
Trump's doctors asked for the Regeneron under the rules that dictate his “compassionate employment”, which allow a patient in danger of death to receive experimental drugs if they cannot be enrolled in a study of that medicine and there are no good alternatives. If you had signed up for a study, you would have risked being in a randomly selected group that will not necessarily receive the drug.
Compassionate requests are decided on a case-by-case basis and must be approved by both the pharmaceutical company and the Food and Drug Administration (FDA). An FDA spokeswoman declined to comment on the issue and to say whether others had asked to use the drug.
How special is this medicine?
Fewer than 10 applications have been accepted for its experimental use, according to Regeneron spokeswoman Alexandra Bowie. There is not much stock and the priority is to use it in ongoing studies. It is authorized for emergency use “only in rare and exceptional circumstances , “ Bowie wrote in an email.
He added that the laboratory contacted the campaign of Trump's Democratic rival in the November 3 elections, Joe Biden, to inform him how to request the medicine if the need arises, although without giving guarantees that the request would be accepted.
Alison Bateman-House, an ethics expert at New York University Langone Health, says that makes her uneasy.
“It goes out of line and creates the feeling that the use of an unapproved product is being promoted” in violation of FDA regulations, Bateman-House said. “Call us and we will avoid queuing you,” he added.
As for Trump, “it is not clear to me that this was an emergency,” said Steve Joffe, chief of the ethical medicine unit at the University of Pennsylvania.
“I think it is not right for the privileged, the president, to receive special treatment that is not available to the rest of us,” he said. “There is so much injustice in our health system, so many people who do not have access to the most basic …”, that the favoritism seen in the case of Trump is “a symptom of a much bigger problem.”
How bad is Trump?
Trump's doctor has avoided giving details of his condition in view of privacy regulations. He says the symptoms are “mild” and he was given oxygen twice, but he has no trouble breathing. The steroid given to him is recommended only to hospitalized patients who need oxygen. Studies indicate that it can be harmful if given to patients who are not very ill.
“They give us quite confusing information. There are aspects of the story that don't seem to fit, ”Joffe said.
“The White House,” he added, “has an obligation to provide the population with a clear picture of the health of the commander-in-chief during a health crisis” even if it withholds specific details, perhaps at the request of the president.
The Trump people “have not fulfilled their moral responsibility to the American people” to be honest and frank in reporting their health, Bateman-House said . “A person gives up much of their privacy when he is president.”
Some resent the possibility that Trump received special treatment after ignoring recommendations about what to do to contain the spread of the virus, refusing to wear chinstraps and take other measures.
“You have an obligation to play by the rules and set a good example,” said Bateman-House. “We have doubts on both fronts.”