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Trump’s COVID case could be entering a crucial stage

Early in the morning on October 2, President Donald Trump tweeted that he had tested positive for COVID-19. Only 33 days away from a highly contentious election, the diagnosis plunged the nation into uncertainty. Doctors, scientists and pundits quickly began speculating on what will happen to the president, and the White House has been both tight-lipped and prone to giving conflicting information about the VIP patient.

But in general, the course of this disease is no longer a complete black box to medicine. Trump will be at a fork in the road during the latter half of this week, say infections disease and critical care physicians who spoke with Scientific American. He could be heading for a bad stretch in a prolonged illness or he could be on an upward swing to recovery. Doctors sadly have the experience of treating more than 36 million COVID-19 patients worldwide and more than 7.5 million in the U.S. Using this clinical history, many now divide the disease into several stages, each with distinct symptoms and treatments. Based on when he first reported symptoms, Trump appears to be at the end of one phase and the verge of the next. Here is the sequence that physicians usually see and how it applies to the president.

Exposure and incubation

A COVID-19 infection begins when the SARS-CoV-2 virus enters cells in the body and begins to replicate. This period of time, after infection but before symptoms start, is called the incubation period—and it occurs between two and 14 days after contracting the virus. While people may not know they are sick, they often become contagious two or three days before symptoms begin.

Viral replication

Symptoms start by the fifth day after infection for most people, and they include fever, cough, sore throat, fatigue, aches, pains, gastrointestinal issues, and loss of smell or taste. Taison Bell, a pulmonary and critical care physician at the University of Virginia, says that when symptoms arise, this change signals a person is at “peak infectivity,” which means they are shedding lots of virus particles into the air, putting nearby people at risk.

This timing has big implications for the president and those around him, Bell says: “The most famous person in the world right now has COVID-19, and one could assume, based on the time line, that he could have been infectious during the presidential debate.” The televised argument with challenger Joe Biden took place last Tuesday, and Trump began showing symptoms on the following Thursday. “He is still infectious now and was when he took his joyride,” says Bell, referring to short trip Trump took in a car with Secret Service agents on Sunday. The vehicle traveled around and just outside the Walter Reed National Military Medical Center, where he was being treated.

At this early stage of the disease, most people do not receive aggressive treatment, but Trump was given two experimental drugs: the antiviral medication remdesivir and an infusion of monoclonal antibodies. He also received an established

Unemployed Stage Actors to Face New Health Insurance Hurdle

Facing enormous financial strain because of the shutdown of the theater industry, the health insurance fund that covers thousands of stage actors is making it more difficult for them to qualify for coverage.

Currently, professional actors and stage managers have to work 11 weeks to qualify for six months of coverage. But starting Jan. 1, they will have to work 16 weeks to qualify for a similar level of coverage.

Nonprofit and commercial theater producers contribute to the health fund when they employ unionized actors and stage managers, but because theaters have been closed since March, those contributions — which make up 88 percent of the fund’s revenue — have largely ceased.

“The fact that we have no contributed income is something no one could have foreseen,” said Christopher Brockmeyer, a Broadway League executive who co-chairs the fund’s board of trustees, which is evenly divided between representatives of the Actors’ Equity union and producers. “We really put together the only viable option to cover as many people as possible with meaningful benefits under these totally unprecedented circumstances.”

Brockmeyer and his co-chair, Madeleine Fallon, said the fund, which currently provides insurance coverage for about 6,700 Equity members, is facing its biggest financial challenge since the height of the AIDS crisis. At that time, the challenge was high expenses for the fund; this time, it is low revenues.

“Everybody is out of work, everybody is panicked, everybody has lost income and can’t make their art, and on top of that their health fund is in crisis,” said Fallon, who leads the union bloc on the board. “It’s been an emotionally difficult journey, but we hope our members will understand that we did find the plan that gives us our best chance to rebuild.”

Under the new system, those who work at least 12 weeks can qualify for lower-tiered plans with higher co-payments and more restrictions.

Actors’ Equity, which appoints half of the fund’s trustees, but is otherwise an independent organization, opposes the changes.

“We all understand that there is no escaping the devastating loss of months of employer contributions nationwide, and no alternative aside from making adjustments to the plan,” the union’s president, Kate Shindle, said in a statement. “But I believe that the fund had both the obligation and the financial reserves to take the time to make better choices.”

Shindle said the union had asked its members on the fund’s board of trustees not to support the changes until they conducted a study about the potential impact on union members of color, on pregnant union members, and on union members who live outside New York, Chicago and Los Angeles.

A similar battle is unfolding in the film and television industry. Members of SAG-AFTRA, a union representing actors in those media, have loudly objected to changes in their health plan.

Stage actors are accustomed to working to earn health care benefits — some take jobs for the express purpose of getting weeks that will help qualify them for insurance. But many