President Trump getting Regeneron treatment is 'wrong and unethical': Dr. Ezekiel Emanuel
Dr. Ezekiel Emanuel, UPenn Vice Provost for Global Initiatives, former White House Health Policy Advisor and author of “Which Country Has the Best Healthcare in the World”, attended the final round to discuss President Trump's promotion of Regeneron treatment for COVID-19, how his government handled the virus and how he was thinking about reopening states for meals and indoor activities.
SEANA SMITH: President Trump's doctor says he's feeling much better and can safely return to public events this Saturday, 10 days after we learned of his symptoms. But the president is said to be planning a personal event at the White House on Saturday.
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For a little more, we want Dr. Include Zeke Emanuel. He is the UPenn Vice Provost on Global Initiatives and a former White House health policy advisor. Dr. Emanuel, it's great to have you back at Yahoo Finance.
We know we don't have a complete picture of all the details about President Trump's health and exactly where it is right now. But I'm curious, from your point of view, from what we know, at this point do you have any public health concerns that President Trump is either returning to campaign or hosting a personal event at the White House tomorrow?
EZEKIEL EMANUEL: Well, I always have concerns because the President has repeatedly flaunted public health measures. And when he wants to return to public meetings with people - and 10 days is the CDC recommended schedule. But the question is, are we actually going to stick to public health policies?
He'd better wear a mask. There is better social distancing. And those interactions should be outside. And he shouldn't scream or raise his voice, sneeze, cough and the other things that give you poor satiety and a lot of potential virus when he still has viruses around.
When these things are in place, these will be important control points. I am concerned that the president is planning large rallies with many people. And those rallies in the past have not been with social distancing, not with face masks. And that is extremely worrying.
Rick Newman: Hey, Dr. Zeke. Can you give us your thoughts on how much information the public should appropriately have about the president's health, especially if he was so scared? Should we know everything, or could there be reasons that if he has a persistent problem, you wouldn't want to send it around the world, to the leaders of China and Russia, etc.?
EZEKIEL EMANUEL: Well, I think we should know everything. And I think the American public has a right to everything. You know, under previous presidents, we have certainly had very full health disclosures since President Reagan. And I think that should be the standard.
This president never adhered to that standard of health and did not comply with that standard in relation to taxes. And both pose serious national security risks. And we need to know what is happening. Let's remember, no matter what happens on November 3rd, the minimum time this president has in office is the next three and a half months.
And the world is a very dangerous place, isn't it? We have China and the South China Sea and trade talks. We have North Korea. We have a conflict between Azerbaijan and Armenia. There are many, many hot spots, not to mention Iran.
We need to know that this president is actually doing well. We need to know that all the factors that affect his health, energy level and ability to concentrate. And, you know, that flip-flop we've just seen on a stimulus for the past few days, we pull the stimulus.
Airlines, $ 1.8 trillion stimulus is what we have in mind. Oh no we need more You know? This does not create trust in someone he will get to be good at assessing critical questions that might arise.
AKIKO FUJITA: Doctor, I wonder if you can talk to this political report coming out talking about how the Pfizer CEO is wooing some of his critics and those who have raised concerns about the vaccine timing. Pfizer, of course, has said that they could possibly know by the end of the month if their vaccine is actually effective.
And you have been highlighted in this article as someone who said there shouldn't be FDA approval until after the election. I'm curious what you think of Pfizer's efforts, and whether you would actually feel comfortable, if at least you meet with the company, you know what your concerns are at this point, if it actually does exist - one of those drugs the makers want announce yourself before the election and get approval.
EZEKIEL EMANUEL: Well, I actually had a call today with the CEO of Pfizer. And so I discussed the situation with him. So that we understand each other. You could get a signal of effectiveness. However, they do not have a sufficient safety signal to get approval from the FDA for an emergency.
And I think you know we need both factors for an effective vaccine. An effective vaccine that isn't safe isn't a vaccine you can use in healthy people. And so it seems to me that before Pfizer goes to the FDA, you must have both of these factors.
And as I understand it, you won't have both factors until two weeks, maybe three weeks, after the election. They know that having just one effective vaccine is not enough and shouldn't be the foundation of anything. Public disclosure, or certainly an emergency permit, must have both effectiveness and safety. One alone has no value.
JEN ROGERS: Are you encouraged by the treatment the President has received and how good he appears to be that the treatments are actually working? Did we learn anything from the fact that he received all of these treatments and is apparently fine?
EZEKIEL EMANUEL: No. You can't learn anything from a case. We in medicine call it selection bias, right? You are treating someone and choosing them based on a factor.
And again, given that we know so little about the President's condition, when the last negative test is and when he actually received the first test that turned out to be positive, what his actual condition was when they drew - know You, now we know they drew labs looking for antibodies on Thursday. That suggests they knew he was COVID positive before Thursday.
And when did you know? What symptoms did he show? Why did they pull the antibody levels? As we understand, the antibody levels were low. This is actually not a good sign. And that was the reason I got the Regeneron Antibody Cocktail.
If he's not unique at getting the Regeneron cocktail, then remdesivir, then dexamethasone, he's certainly in a very small group. And it is very difficult to draw a conclusion on that basis. That's why we research. That is why we actually include patients. We do randomized studies.
I think it is wrong and unethical that he did not receive the Regeneron in a randomized study. If he was going to get Regeneron, it should have been like anyone else in a clinical trial.
SEANA SMITH: Well, Dr. Emanuel, I want to ask you about this Regeneron treatment because President Trump touted it as safe, like he said. That will be widespread.
What is the truth in this claim? I mean, just in terms of the fact that if this is approved and we get this and it goes into the next phase is that something - is this a drug that would be generally available? What's the timeline for that?
EZEKIEL EMANUEL: Well, everything in that statement is wrong. It is not a cure. I even think the company said it wasn't a cure. It is supposed to be given to people, and again to people with low antibody responses to the virus. And it seems to shorten the duration of the symptoms. This is not a cure. I don't think it has been tested and rated as a cure at all.
Second, we need to understand monoclonally - and this drug can be very, very good. We have to understand that monoclonal antibodies - there isn't enough capacity to produce them. There will be a limited amount available. It certainly won't be - we don't have enough monoclonal antibodies, and we can't even make enough monoclonal antibodies for the 40, 43,000 Americans who contract this virus every day.
The idea that there will be a crowd, we couldn't handle the number of people in about 25 days. We have a million people. We cannot produce a million treatments every 25 days. That's for the United States, not to mention the world. This shouldn't be touted that way. Plus, it won't be a very cheap treatment.
RICK NEWMAN: Hey, Dr. Ezekiel, I want to know if there is anything there can be done about this public health problem where there are people who seem ready to go to Trump rallies and other events like this that know - or they should anyway knowledge. Some of us know that we are at a higher risk for COVID.
I have some friends in the medical industry who say if people do this they should sign a waiver and say, well, I'll go to it, but I sign my right to health care and therefore put health professionals at higher risk out than they need to be. I mean, I realize that this is a very difficult problem when the President himself breaks these guidelines. But can anyone do something about it?
EZEKIEL EMANUEL: Yes, the President could do something about it. I mean, he could clearly do something. And he could say Joe Biden has the right model here. Joe Biden has a model in which he wears a mask. He only collects where there are people - with a small number of people, where people are distributed, where each individual actually wears masks.
The President has deliberately and repeatedly refused to adhere to these guidelines. You know, the only way we can really get this pandemic under control is if we actually stick to these public health measures.
By the way, this will also be the case if we are given a vaccine, especially if the vaccine is only 60% or 70% effective. Because we still have to follow many of these guidelines until we have vaccinated enough people. And that will take many, many months.
Let me just say that Italy was in the same boat as the United States for a few weeks ahead of us in March and April. And then they deliberately banned and people really let themselves be held nationwide. And they brought their new infection rate very, very low. It's been a little creaky since August, but nowhere near our infection rate.
It is not that Italy has a specific drug or vaccine or other preparation that we do not have. You have one thing and we have the same thing: good, effective public health policies that are largely implemented under social pressure for people to abide by them and punished for when people fail hold on to them. We could do the same.
The President has repeatedly disregarded these public health measures and made fun of those who abide by them. That's why he got COVID. And you know we need a leader who does not see that they can be cured and anyone can be cured, but that it is a very deadly disease. About 1,000 people, Americans, die from it every day, and something we can do to reduce that rate.
SEANA SMITH: Doctor, if you look at the numbers for the past week, an average of more than 44,000 Americans have been diagnosed with COVID every day over the past week. What will that number look like in the winter months if the national response to it changes, if the Trump administration's response to it doesn't change?
EZEKIEL EMANUEL: Yes, it's scary. It will go up. It's hard to believe it won't go up. You know the four ways this thing - to increase the risk of transmission - are closed rooms, indoors, large crowds over a long period of time with screaming, coughing, sneezing, singing. If you spend long periods of time with groups indoors, the risk of transmission increases.
And when winter comes, people go in. In this way, if they actually go in with new groups, we will increase the frequency of transmission and the number of cases. This is what every public health person, including myself, has been concerned about for the next few months and the rise in cases, and with it the rise in hospital stays and mortality.
SEANA SMITH: And Doctor, assuming the number of cases is increasing, we already have areas in the northeast and in Boston and in New York City. Certain districts are reversing course.
They are tightening restrictions on businesses, schools and outdoor areas due to the increase we are seeing in the number of cases. Do you think we should consider further shutdowns at this point? Or when should we possibly reintroduce this?
EZEKIEL EMANUEL: Well, again the problem is that we have to try to reduce the number of people, so no more than 20. That seems to be the key number for super spreading events. We need to reduce indoor activities, such as indoor weddings or indoor funerals, indoor dining and indoor bars. These are dangerous events for the spread.
And I guess you don't want to close everything. And I think that closing down outdoor activities where we can actually humans spread out is probably not a good idea. You have to give people options, but the options have to be safe. So if people want to be outside, they have to be two meters away. You must wear face masks.
I think we want to encourage this type of activity, not discourage it. But doing indoor activities is negative. So I'll tell you again One of the things I do is we like to eat outside with other people. We have a table where you can be a meter apart. We have heaters. We have blankets.
You know we're planning this for as long as possible. But these are the things that we have to take on. Eating indoors with other people - not a good idea.
SEANA SMITH: All right, Dr. Ezekiel Emanuel, it's always great to have you on this show. We look forward to welcoming you back to Yahoo Finance soon. Thank you for taking the time to join us this afternoon.
EZEKIEL EMANUEL: Take care. I wish you a nice weekend and please stay safe.
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