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ER Physician on President Trump's COVID-19 diagnosis: ‘I’ve never heard of another patient getting this combination of treatments'

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Dr. Darria Long, ER Physician and Clinical Assistant Professor at University of Tennessee School of Medicine, joins Yahoo Finance’s Zack Guzman to discuss Trump’s COVID-19 prognosis

Video Transcript

ZACK GUZMAN: Meantime, a focus on how the president continues to do as he stays in the hospital here. We were expecting potentially as early as today, he could be discharged. Doctors there saying that it could be tomorrow, could be today. His chief of staff, Mark Meadows, delivering the update on the condition saying that the president's progress has been, quote, "unbelievable" in his fight against the coronavirus.

Of course, we're still seeing cases rise, though a bit lower than what we had seen in the past. Questions looming about what this could mean for renewed efforts here to keep things controlled as we see hotspots pop up, especially here in New York City in select neighborhoods. New measures potentially coming down on the lockdown front.

And here to discuss all of that with us is our next guest. Dr. Darria Long is an ER physician and clinical assistant professor at the University of Tennessee school of medicine. Dr. Long, it's good to be chatting with you again. I just want to start on the topic we had here.

With President Trump, we're learning more about the remedies being used to help him in his battle with coronavirus-- of course, as I said, on day four here. But we're learning that he's receiving quite a few therapies. The one that's moving the market today is Regeneron's antibody cocktail used to treat COVID-19-- that, along with Gilead Sciences' Remdesivir as well as a steroid here as well, a generic steroid. So talk to me about what you see in how he's being treated and what it might indicate, since there have been questions about how his progress truly looks right now.

DARRIA LONG: Yeah, hi, Zack, good to see you. And you're right. We're kind of extrapolating based on what the president is receiving because we're not getting full data. I'll tell you, I've never heard of any other patients getting that exact combination of medications. So we kind of have to assume that it's one of two things. Either the president truly is moderately to critically ill-- and it could be moderately ill-- or this is a case of VIP syndrome, which is when you have a patient who tends to dictate a little bit more of their medical care. Right now, we don't have enough data to decide which of those it is. But it is concerning for either way.

ZACK GUZMAN: Yeah, I mean, it's concerning because you have him operating, as you said, kind of as the most important COVID-19 patient here that we've seen and have been covering here in the US. And we've seen that play out before in other countries where their leaders have tested positive for COVID-19. But when you talk about that risk, in terms of looking at it as a VIP, what are those when you're throwing everything at the board when so little is known about how some of these remedies interact with each other?

DARRIA LONG: Yes, we see this in the hospital every once in a while, Zack, and it's not a good idea because you want to be led by the medicine and what the evidence shows. We don't want to be led by somebody dictating some care or some kind of experimental things that we think will work unless you truly-- unless his medical team truly thinks he's in that much risk, which is a possibility. But again, we just don't know from it.

ZACK GUZMAN: Yeah, and again, there's still a lot of unknowns, whether it's President Trump dealing with this or anybody else, and that's to be certain here.

DARRIA LONG: Right. When we talk about what's to come though in a lot of other areas experiencing upticks in cases, we saw that across the pond in the UK as well as in France here-- with bars, again, we're learning that they could be shut down in Paris. That's the plan.

And here in New York, we're seeing, again, upticks in certain zip codes here causing Mayor Bill de Blasio to shut down activity in certain zip codes where we're seeing things peak. The return to lockdown, though, seems to be one of those questions that, if it's starting in localities, could spread to states. I'd be curious to get your take on why that might prove effective or not when we think about trying to control the spread when so many cases are already out there.

DARRIA LONG: Yeah, I mean, so let's, again, look at why they're having to shut things down. New York has had-- had this big peak and then seemed to get things under control, but there are specific areas that seem to have a much higher positivity rate. So if the average in New York City right now is around 1.5%, you have these pockets where it's anywhere from 3% to 8% positivity rates.

But Zack, what you've got to note, it's not because there's something special going on with the virus or anything else because largely, it's felt that in these pockets, people aren't masking and they're not doing distancing. It's a behavior-driven issue. So my goal is-- if by doing lockdowns, if, potentially, they can drive behavior-- that would be important, and then we can get those positivity rates back down.

The difficulty of doing just targeted lockdowns is that people from one community could go to another community to go to the store or something else. So that always creates a little bit of vulnerability. But if we can change behavior back to what people were doing, which was more strict-- doing distancing, wearing those masks, not just assuming you have some herd immunity-- we could potentially get those positivity rates back down. This isn't rocket science at this point. It's strictly behavior.

ZACK GUZMAN: Yeah, the tricky part is that, I mean, there's a lot of other things to discuss within that realm around masks. I mean, I, myself, was on the subway yesterday. Everyone's supposed to be wearing masks. There was a woman who plugged her nose, and I saw some stuff come out. Subway came through. All that flew around the station. It was not great.

DARRIA LONG: Oh, oh no.

ZACK GUZMAN: When we're talking about it, it's not just that, I mean, when we think about public transport being an issue here, but also school seems to be the topic du jour when we think about what's going on in hotspots, specifically in New York City, the new announcement that Governor Cuomo said he wants to shut down schools in certain zip codes here. And that's one that really-- I mean, even the CDC was warning about risks, but it wasn't entirely clear when we were thinking about a return to school. So what do you think about that being a piece of the puzzle here when we think about what's going on with this uptick in cases?

DARRIA LONG: Yeah, so actually, I'm working with a number of schools, Zack, to help them create their protocols for back to school safely. And in our region, a number of them have been back for 30 plus days, which is good. And again, no claims of victory. This is always a work in progress, and this virus humbles all of us.

But we have some lessons for that, and that is that your community prevalence matters. We've got to get that down. And potentially, school closures can drive people's behavior because they want their kids back in school.

Secondly, it depends what you're doing in those schools because all of us, no matter what our communities are in terms of positivity rate, we have to assume that COVID's going to kind of walk in through the door. So what are the schools doing, in terms of stopping the transmission from that one child, to rapidly identify them, and to stop transmission to other children? So it's kind of a two-part process. You have to do it in your community, and you have to do it in your school.

ZACK GUZMAN: Yeah, and on that point--

DARRIA LONG: You can be successful, as we have seen in many situations.

ZACK GUZMAN: Well, I guess that would be the question, too, because even when you think about the White House and their strategy here, relying on testing to kind of make sure that the president was safe or that this wouldn't be happening, we've seen false test results in testing. And obviously, I think a lot of people out there might be saying, look, if you in the White House can't figure this out, if they're testing and trying to figure out who has it and who doesn't, gets it wrong, we see this explosion in cases within that camp, what hope is there for people with less resources out there in schools, public schools around the country to do this well? If they can't do it, why should we expect anyone else to? And I guess that's a fair question on the testing front.

DARRIA LONG: Yeah, I would say it's two things. One is we have no idea what the White House is doing in terms of testing. People keep asking me on social media-- people ask me often questions, and one of them is when was the president's last negative test. We don't know. The White House is not sharing that. So we cannot really draw any lessons from the White House in terms of how they are handling the coronavirus crisis and how the rest of us in the real world should. I wish we could. We can't.

When we look at other schools and the schools that I'm working with, they've been doing a lot of testing. And it's amazing. You do identify children and staff who are totally asymptomatic. Now, most testing is still really unaffordable for most schools, so it's very interesting that we're now looking at pooled testing and other ways that you can do testing much less expensively. That way, you can do pool testing. You can know in your community.

And a negative test is not a passport to go out and party and do everything. It's really that a positive test just helps you much more rapidly get a handle on where your cases are so you can tamp down transmission and keep everybody else in school as safely as possible.