Presidential Health

 

In the last week since Trump was released from Walter Reed, there have been speculations about the effects COVID-19 may have had on his mental health. Part of the speculation has been because his doctor was caught lying to the press and the number of lies Trump and his administration routinely tells. All of the lies naturally have a lot of people questioning the truth about Trump’s health. The problem with someone lying in almost everything they say makes it hard to believe them even when they may be telling the truth. Think of the fable, “The Boy Who Cried Wolf.” Of course, Trump is not the first president to lie about his health, and he is unlikely to be the last.

 

The most significant issue is that we are only now beginning to understand the long-term effects of COVID-19. COVID-19 has been compared to the 1918 Spanish flu epidemic since it began spreading around the world. Luckily, medicine has progressed considerably since 1918, and it is unlikely to cause the number of worldwide deaths that the Spanish flu caused. Five hundred million people were infected with the Spanish flu, which was one-third of the world’s population at the time. Estimates of deaths range from 17 million to 50 million to as high as 100 million. Hopefully, an effective vaccine will be found before too long, and millions of lives will be saved.

 

Just as with Trump contracting COVID-19, the president of the United States also caught the Spanish flu in 1919 while at the Paris Peace Conference. Several members of the American delegation got influenza, and, like COVID-19, influenza can be transmitted before symptoms appear. Some of my readers may know this, but the United States’ involvement in the First World War is my academic specialty. So, I am very familiar with Woodrow Wilson and the Paris Peace Conference, which was an integral part of my master’s thesis. However, I am embarrassed to say that I had not previously known that Wilson contracted the Spanish flu. I knew he had a stroke while trying to convince Americans to support the United States joining the League of Nations, but there is much more to the story.

 

On Thursday, April 3, 1919, Wilson suddenly fell ill. White House physician Cary Grayson noted he was seized by “violent paroxysms of coughing, which were so severe and frequent that it interfered with his breathing,” followed by such other symptoms as high fever. Grayson tried to keep the illness secret, but word leaked out that Wilson was sick, and Grayson lied, insisting Wilson simply had a bad cold. Afraid of another leak, Grayson wrote a note to be hand-delivered to Wilson’s chief of staff, which said, “That night was one of the worst through which I have ever passed. I was able to control the spasms of coughing, but his condition looked very serious.”

 

Like the 1918 flu virus, COVID-19 impacts virtually every organ in the body, including the brain. Most problematic are cardiovascular and neurological impacts. For COVID-19, cardiovascular complications, including stroke, are so common that some experts consider this and not the lung, the primary problem. And according to a study in Annals of Neurology, 25 percent of patients have some neurological dysfunction, and 7 percent have “impaired consciousness.” Another study in Clinical Neurology and Neurosurgery found 36.4 percent of patients to have neurological symptoms. In 1918, it was much the same. The single most comprehensive study of the 1918 pandemic concluded, “The effect of the influenza virus on the nervous system is hardly second to its effect on the respiratory tract. … From the delirium accompanying many acute attacks to the psychoses that develop as ‘post-influenzal’ manifestations, there is no doubt that the neuropsychiatric effects of influenza are profound.”

 

For Wilson and the world, the effects were indeed profound. He became paranoid, convinced he was being spied on. Herbert Hoover, who was at the time, was in charge of the American food relief efforts for the devastated Europe, believed Wilson’s mind lost “resiliency” and its ability to reason clearly “in coming to conclusions.” Others made similar comments. Nonetheless, after five days in bed and too ill to go out, Wilson insisted on rejoining the peace negotiations. British and French Prime Ministers David Lloyd George and Georges Clemenceau — whose nickname was “the tiger” — came to his room. They, too, found a different man. Lloyd George commented on Wilson’s “nervous and spiritual breakdown in the middle of the Conference.”

 

Nothing in Wilson’s prior history suggests he would compromise on any principle. Before his illness, he had insisted upon “peace without victory,” his Fourteen Points, and supporting self-determination around the world. But over the next few days, he gave way on almost every point to Clemenceau and agreed to a peace deal that punished Germany and preserved other nations’ imperial ambitions. Historians agree that the treaty contributed significantly to the rise of Adolf Hitler and the start of World War II. A few months later, Wilson’s influenza attack very likely contributed to his debilitating stroke while campaigning across the country to get the support of the American people for the Versailles Treaty.

 

Today, the case mortality for a 65 to 74-year-old man — Trump is 74 — is 3.1 percent and somewhat higher for those who required oxygen, as Trump did, so the odds of recovery are strongly in his favor, especially given his immediate treatment with remdesivir and experimental monoclonal antibodies, and now dexamethasone (treatments most Americans do not have access to). But recovery may leave him not only fatigued for an extended time but also with an increased chance of stroke or neurological impacts. Since being released from the hospital, Trump’s judgment has been more in question than ever. Trump could just be desperate because he is behind in the polls, and thus he has increased his efforts to give credence to his base’s wild conspiracy theories. His recent appearances on Fox News and Rush Limbaugh show him seemingly more unhinged than ever. Whatever is going on with the president’s health may take years, if ever, for us to find out the extent of his COVID-19 infection and its effects. Only time will tell, but one thing is for sure, we cannot allow him to get reelected.