From getting a helicopter ride to a military hospital with a specialized suite to receiving experimental drugs made available to fewer than 10 people, Donald Trump’s experience with Covid-19 has been very different from that of your average 74-year-old American with a serious illness.
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The president ignored these disparities after returning to the hospital on Monday night and in a video from the White House Trump said of Covid-19: “Don’t be afraid of it.”
Here’s a look at how different the experience of catching Covid-19 is for the most powerful 74-year-old in the US compared with most of his fellow citizens:
First, there is the simple step of realizing someone has the illness.
Trump had access to regular testing, something most, if not all, 74-year-olds do not.
As a white male, Trump was less likely to test positive for the virus. Though testing rates are similar across racial and ethnic groups, Hispanic patients were more than two and a half times more likely to have a positive result and Black and Asian patients were nearly twice as likely to test positive compared with white patients, according to Kaiser Family Foundation (KFF).
This suggests people of color face increased barriers to testing which delay their ability to get a diagnosis until their condition is more serious.
People who test positive for Covid are usually told to monitor their symptoms at home, no matter what their age.
Trump was able to take a helicopter to a military hospital once he tested positive. And at his home, the White House, the president will be receiving an outstanding level of care from a team of well-equipped, dedicated medical staff.
He will have access to an at-home clinic with exam rooms and hospital equipment, including supplies to perform emergency lifesaving procedures. In an emergency, he can also turn to his fleet of helicopters to get him to the hospital in a few minutes.
The president has access to the best specialists, the best medical care and really any medical countermeasure that he would ever want
Dr Krutika Kuppalli
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Dr Krutika Kuppalli, an infectious disease physician at the Medical University of South Carolina, said: “The president has access to the best specialists, the best medical care and really any medical countermeasure that he would ever want. That is not the medical care most people have in the United States, or in the world.”
If a 74-year-old is admitted to the hospital, they could, like the president, have access to the antiviral drug remdesivir.
But unless they enroll in a clinical trial, they can’t access the experimental antibody treatment Trump is receiving. Regeneron Pharmaceuticals, which makes the antibody cocktail, said it had been made available to fewer than 10 people outside of a clinical trial.
After Trump’s oxygen levels fell, he also received a steroid usually reserved for people in more severe stages of the illness. Trump’s doctors have not clarified if he was given the steroid, dexamethasone, because his illness was more severe than they have described or for a different reason.
Trump is the only person in the world known to be taking that combination of medication treatments. And typically, people are not discharged from the hospital while taking an injectable, experimental drug. “The fact that he’s able to do that shows how different his care is compared to other people,” Kuppalli said.
The president does not have to worry about the cost of his healthcare, even after paying $750 in taxes in 2017, because free health coverage is a perk of being the president.
The other 74-year-olds are mostly looking to the government health insurance for adults 65 and older, Medicare, to cover their costs. Those who aren’t covered by it either have employer-sponsored health insurance or are not eligible for it because they aren’t citizens or permanent residents.
After being admitted to the hospital, if a 74-year-old patient has basic Medicare, they would be subject first to the $1,408 deductible, the cost they have to pay before insurance kicks in. Most Medicare beneficiaries have additional coverage which reduces these costs, but 6.1 million people just have the basic package.
If someone with the basic package must stay in the hospital longer than the president, for more than 60 days, they must also pay $352 for each additional day in the hospital.
It is not entirely free for people with Medicare supplements. Add-ons to the program can cost older adults up to $461 in monthly premiums and what is covered depends on what supplement they have.
Like Trump, most 74-year-olds would not need to worry about the cost of treatments such as supplemental oxygen. Much of the other care he is receiving, however, would not be covered for most older adults.
Tricia Neuman, executive director of KFF’s program on Medicare policy, said it would be highly unusual for Medicare to cover an air ambulance, experimental drugs like the Regeneron antibody cocktail or remdesivir if it was being administered at home (it should be covered in the hospital).
Medicare patients would, unlike the president, have to pay for the over-the-counter drugs he is taking including vitamin D, zinc, melatonin and aspirin.
Despite the unique level of care Trump has access to, at the end of the day, he is still a 74-year-old man, which puts him at high risk of suffering severe respiratory problems because of his Covid-19 infection.
People between 65 and 74 are also 90 times more likely to die from Covid-19 than people between 18 and 29, according to the Centers for Disease Control and Prevention.
The rates are worse for Black and Hispanic patients. Across age group and sociodemographic factors, they have twice as high a death rate as white patients, according to KFF.
Kuppalli said the president’s existing health vulnerabilities, along with his decision to withhold information about his symptoms, raise questions about his fitness for office.
Kuppalli said: “This is somebody who could really have many challenges in the next few years as president, and his ability to execute his functions as president as result of the long-term symptoms of the disease.”