What are the President's COVID Odds?

Please, no politics. Science only.

As a physician I have been concerned how president Trump’s recent contracting of Covid has been presented as a “mild” case. When you hear the word “mild,” it leads you to believe that it’s not a big deal, that recovery is assured, and all will be well. I’m around the president’s age (without many risk factors), and if my doctor told me that I had a “mild” case of Covid, I would still be very worried and I’d want some estimate of the odds of death. I understand no one has a crystal ball when it comes to outcomes.

There is an indisputable fact. The president of the United States has tested positive and been hospitalized for Covid. He now enters into a cohort of individuals for whom there are some data that can provide a risk estimate of death or disability. We know that Covid is not a harmless disease, especially in a man of Trump’s age and health profile.

At a recent socially-distanced, mask-wearing evening with some medical colleagues, we pondered how likely is the possibility of the president dying? I participated in that conversation then, just as we are now. Healthcare practitioners should have an honest space to discuss this issue among ourselves, so we are better able to discuss it outside the medical community.

This was our back of the envelope estimate of the chances of Mr. Trump dying. I’d welcome your estimate and rationale.

According to CDC data, about 37% of the hospitalizations involve people over the age of 65. https://gis.cdc.gov/grasp/covidnet/COVID19_5.html

The national death rate for people 65-84 years ranges from 3% to 11%. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm

In addition to age, morbidity and mortality are negatively influenced by health status and risk factors such as obesity, hypertension, race, chronic disease, diet, and stress. While only a few people on the planet know his current status, we do know that the president has several meaningful risk factors.

Morbidity and mortality are also significantly decreased by the quality of medical care. The United States has made progress in the treatment of Covid disease. We’ve been amassing data on what works and what doesn’t. Rest assured, the president will get the best medical care in the world. In addition to evidenced-based treatments in practice, such as the use of dexamethasone, he will have access to not yet FDA approved anti-viral therapies that show high promise.

Our best guess is that the president has about a 3% or slightly greater chance of death. This does not take into account disability via lung, brain, or heart damage from the virus.

Your non-political thoughts????