Older, overweight and male: Trump's COVID risk factors make him vulnerable

Older, overweight and male: Trump's COVID risk factors make him vulnerable

LONDON/FRANKFURT - US President Donald Trump's gender, age and weight are all factors that make him more vulnerable to developing severe COVID-19, and give him a notional risk of around 4 percent of dying from it, health experts said on Friday.

The probability is hard to assess precisely, however, since factors such as overall fitness and activity levels, pre-existing conditions and recent medical research can all make a significant difference.

A working paper by the US National Bureau of Economic Research published in July put an infected but otherwise healthy 70- to 79-year-old's risk of dying from COVID-19 at 4.6 percent, regardless of gender.

David Spiegelhalter, a professor of risk and an expert in statistics at Britain's Cambridge University, cited a COVID-19 survival calculator that put the mortality rate for an otherwise healthy 74-year-old white man with COVID-19 during the peak of the pandemic in Britain earlier this year at 3 percent to 4 percent.

That risk would now "presumably be somewhat less", he said, as doctors have gained experience in treating the disease.

Michael Head, a global health professor at Britain's Southampton University, said that "the president's profile would classify him as vulnerable."

Information provided by a White House physician in June puts the 74-year-old president in the obese category, which triples his risk of needing hospital treatment, according to data from the US Centers for Disease Control and Prevention (CDC) released in August.

David Strain, also at the University of Exeter medical school, said that, assuming Trump contracted the virus recently, he is likely to have few symptoms over the next four to five days.

"The classic respiratory symptoms would occur midway through next week," Strain said.

"His physicians will be aware of the risk that a crash, similar to that ... Prime Minister (Boris Johnson) experienced at around day 10, may occur," Strain said.

"Should this occur at his age, he would need to be hospitalized and we would be concerned for his survival."

WALKING AND GOLF

Even for otherwise healthy 65- to 74-year-olds infected with coronavirus, the mortality risk is 90 times higher than for those aged 18-29, according to the CDC data.

Julian Tang, an expert in respiratory sciences at Leicester University, said that, apart from age and obesity, "other existing medical conditions like diabetes, hypertension, other chronic heart and lung disease can lead to serious COVID-19 disease".

But Naveed Sattar, a professor of metabolic medicine at the University of Glasgow, noted that Trump has no reported chronic conditions and is reasonably active - he plays golf frequently and appears to walk briskly - which may offset some of the risks.

The CDC data also do not take into account the state-of-the-art care that the president is likely to receive, although medical experts warned Trump's doctors not to be tempted to treat him differently from any similar patient.

"I would advise them: Do not deviate from your standard protocol - because that's when mistakes happen and you're starting to experiment," said Bharat Pankhania, senior clinical lecturer at Britain's University of Exeter Medical School.

"This is not a time or place to experiment, just because he happens to be the president."

A number of possible COVID-19 treatment approaches are currently being tested in late-stage trials, including manufactured antibodies designed to stop the coronavirus from invading cells.

Pankhania said the standard protocol for Trump's doctors would be to "monitor, and act if required".

"The usual thing that we need to act on, if required, is oxygen," he said. "And if a patient needs oxygen support, there may also be some benefit from giving the steroid dexamethasone."

The generic anti-inflammatory drug and Gilead's anti-viral remdesivir are the only drug therapies approved for treating hospitalised COVID-19 patients.

-reuters-

Trump economic stimulus against coronavirus off to slow start

WASHINGTON — President Donald Trump's push for economic stimulus measures to combat market turmoil caused by the growing coronavirus crisis got a slow start Tuesday after talks with skeptical lawmakers.

The outbreak has prompted US airlines to cancel flights, the Federal Reserve to make its first emergency rate cut in 12 years and the stock exchange to experience its worst session since 2008, though some of that ground was gained back in Tuesday's trading.

This spells trouble for the US economy but also threatens Trump's reelection campaign, which is based heavily on his touting of booming stock prices and low unemployment.

Trump promised to announce "major" economic measures on Tuesday and he made a rare trip to Capitol Hill for talks with his Republican party lawmakers.

The biggest item on his wish list is a cut in payroll taxes. But even allies in Congress and reportedly some aides in the White House are skeptical, questioning the cost.

By day's end there was a notable lack of detail about Trump's entire relief plan, especially how the tax cut would be funded.

"Let us put the proposal out in concrete details," Trump's economic adviser Larry Kudlow told a news conference, asking for more time when pushed to explain.

Trump says he wants to help hourly employees and small businesses, which could be hurt most by the need to take time off for quarantine or treatment in case of coronavirus infections. 

Measures are also being proposed to include aid for workers in the gig economy who worry about calling in sick.

The administration earlier in the day unveiled steps to help airlines and the cruise industry and agreements by insurance companies to waive copay charges for people seeking tests for the virus.

Given the emphasis on quarantine to keep people from spreading COVID-19, paid sick leave is seen as particularly important, yet is not guaranteed in the US.

"The vast majority of low wage workers have zero paid sick hours," said Arthur Wheaton, a professor at Cornell University who specializes in labor.

"The most vulnerable or precarious workers in the country have the least protections or security in case of sickness or emergencies," he added, arguing that workers in the gig economy -- drivers for delivery companies or ride-sharing services -- are even worse off.

Fight for $15, an organization representing McDonald's workers, called on the fast food giant to provide paid sick leave to workers whose immediate relatives show symptoms of potential infection and to keep paying workers even if they end up quarantined or if the outbreak requires a restaurant to shut.

LAYOFFS 

With few employees and sensitive to drops in demand, small businesses are also seen as vulnerable.

"Business cycles usually hit small retail establishments and restaurants... relatively lightly compared to heavy industries. This one, I think, is going to be the reverse," Alan Blinder, a former Fed vice chair.

Amanda Ballantyne, national director of The Main Street Alliance, which works with small businesses, said employers are asking for expanded unemployment benefits or other forms of direct support.

"There's a feeling of unpredictability and anxiety. Some businesses have already started contemplating temporary layoffs," she said, adding "there's a real need for some kind of stimulus money and emergency support."

Fears for the wider US economy are real: in a report last week, the Fed said the virus has already disrupted travel and access to goods for US industry, and businesses are fearful it may get worse.

Investors expect the Fed to cut the benchmark borrowing rate again at the March 17-18 policy meeting to stem the economic uncertainty.

Trump's talk of a tax cut has meanwhile been condemned by the Democratic opposition and also by some economists.

"A payroll tax cut is the politically most expedient way to shovel money to those who need it least," tweeted Justin Wolfers, an economics professor at the University of Michigan.

Agence France-Presse