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You Can’t Learn Much From One COVID-19 Patient — Even When That Patient Is President Trump

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Oct. 8 marked a major milestone in what we know about the efficacy of remdesivir, the experimental antiviral medication that was the first therapy drug to be issued an emergency use authorization for COVID-19 in the United States. On that day, the results of a major medical trial — double-blind, placebo-controlled and involving more than 1,000 patients — were finally published in the New England Journal of Medicine. The study found that the drug really does seem to shorten the number of days it takes to recover from COVID-19, and it even had fewer serious side effects than the placebo control. However, researchers also showed the drug was not exactly a game-changer. It didn’t significantly reduce mortality, for example. Overall, though, the study was good news.

One day earlier, a 74-year-old COVID-19 patient who took remdesivir returned to work in his regular office. That bit was probably good personal news for one man, but if you want to know how well remdesivir works — and what it means for you, if you were to get the coronavirus — the former matters a lot more than the latter. Even if that man is the leader of the free world.

He may have taken a combination of experimental drugs, but President Trump’s hospital stay was not an experiment. We have learned nothing about COVID-19 or its treatments by watching what happened to him. That’s true whether you’re tempted to look at his experience for proof that COVID-19 isn’t that big of a deal, or if you’re hunting Twitter for evidence that the drugs he took are having an outsized impact on his mental state.

From the moment the president inhaled particles of virus, his illness carried not just a physical risk to himself, but also a moral hazard to a country desperate for solid answers about an infectious disease that has been resolutely hard to pin down for over seven months. COVID-19 has presented us with one liminal space after another. It’s been nearly impossible to neatly chart the probable course of the pandemic, prevent the virus’s spread and even count the number of Americans who have died without a pile of asterisks and qualifications. So when the president of the United States became one of the infected, it seemed like there was, at the least, an opportunity to offer a little bit of clarity — to pin one thing down in the public conversation over the coronavirus and get everybody on the same page about the seriousness of the disease and its risks.

But that didn’t happen.

Understanding one person’s case was never going to help us understand the disease as a whole, but we can barely even do that. The White House’s lack of transparency about what exactly has happened — and when — has left the country unable to agree on what really happened. It’s still unclear when the president first tested positive. There appears to have been no contact tracing and reporting of the president’s contacts who may have contracted the virus; if there’s been any, it’s been left to the media and private citizens. It’s difficult to untangle how sick he actually was from rosy public statements — that his doctor admitted were deliberately spun to be positive and upbeat.

Trump is not the first president to be cagey about his physical health. (Although, one would think there is a little more reason to be transparent when the disease in question is contagious. President Kennedy wasn’t spreading Addison’s Disease around the Rose Garden.) In this case, though, the lack of clarity from the White House has tangled up with the lack of clarity about the virus itself. If you were confused about whether the president tested negative before his first post-hospitalization rally, wait until you find out that’s not really the right question to ask.

Partly, though, the problem with expecting Trump’s illness to clarify the murky waters of COVID-19 is expecting any one person’s illness to cut through the muck. That is just not how science works. As the CEO of Regeneron — the manufacturer of the experimental antibodies Trump also took — put it on Face the Nation last weekend: “The president’s case is a case of one, and that’s what we call a case report, and it is evidence of what’s happening, but it’s kind of the weakest evidence that you can get.”

That evidence is weak because medical science doesn’t work the same way as our system of government — you can’t just pick individuals to represent the biology of society as a whole. Our bodies are all a little bit different. Our circumstances are all a little bit different. If a patient takes a drug and recovers, how do you tell whether the medicine actually works, or you just tried it on someone who would have recovered anyway? How do you tell whether the medicine is safe, or the patient is just more tolerant of its effects than the average person?

The answer is that you run the test again and again, on more and more people. And you make sure that some of them are told they got the drug even though they really didn’t, so we can also distinguish between the benefits of the medication and the power of our own bodies under suggestion. That’s how science weeds out the outliers and comes to know, as best it can, whether a medicine truly works. It’s not perfect, but it’s better than the alternative. This research isn’t about a strong leader, it’s about the community.

But the president of the United States is kind of the ultimate outlier. Even among older white men, he is not typical. He is far wealthier. He has access to much better health care. He has handlers and on-call physicians and a literal hospital suite made just for him. And this particular president is probably not even all that representative — in temperament, habits and life history — of even your average older white male president. If he were, he might not have contracted the virus at all. What happens to him is never going to tell us what a run-in with COVID-19 is likely to look like. What happens to him is never going to tell us whether a medicine worked. What happens to him is never going to tell us about the side effects of remdesivir, the Regeneron antibody cocktail or dexamethasone.

And all that is especially true when we’re talking about a virus that can tear through a family with seemingly random abandon — killing some, hospitalizing others and barely registering as an illness with others.

No politician can be our figurehead here. Demagoguery doesn’t work for the study of infectious disease.

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Follow live: Kershaw, Glasnow face off in Game 1 of World Series

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7th Kiermaier singled to right, Wendle scored, Brosseau to second. 3 8 7th Brosseau singled to right, Margot scored, Wendle to third. 2 8 6th Muncy doubled to deep right center, Turner scored. 1 8 6th Betts homered to right (349 feet). 1 7 5th Hernández singled to left, Smith scored, Taylor to second. 1 6 5th Taylor singled to left center, Muncy scored, Smith to second. 1 5 5th Smith singled to center, Seager scored, Muncy to third. 1 4 5th Muncy grounded into fielder’s choice to first, Betts scored, Seager third. 1 3 5th Kiermaier homered to right (382 feet). 1 2 4th Bellinger homered to right center (378 feet), Muncy scored. 0 2

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Lomachenko recovering from shoulder surgery

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Recently dethroned lightweight champion Vasiliy Lomachenko underwent right shoulder surgery Monday, according to his manager, Egis Klimas.

Lomachenko previously had surgery on his right shoulder in May 2018. Klimas said this surgery was a result of both a pre-existing ailment and an injury suffered during the second round of Saturday night’s decision loss to Teofimo Lopez.

Lomachenko was very cautious in the first half of the contest, when Lopez built a significant lead on the scorecards. His late-rounds rally fell short, and Lomachenko lost his WBC, WBO and WBA titles.

He was examined Monday by Dr. Neal ElAttrache (who also oversaw his operation in 2018) and was told he would need surgery that day.

Lomachenko should be able to resume training by mid-January, according to Klimas.

“When he arrived to the States to prepare for the fight, he said in the Ukraine he felt the sharp pain in his right shoulder,” said Klimas, who noted that an MRI didnt reveal any significant injury to the shoulder. “We took him right away to Dr. ElAttrache to examine him.”

At six weeks out from the fight, Lomachenko was given an injection and alerted both the Voluntary Anti-Doping Association and the Nevada State Athletic Commission.

“We lost one week of training. We lost one week of sparring because the doctor forbid him to do much for a week after the injection,” Klimas said.

Klimas added that a few weeks later the pain flared up again during a sparring session. At that juncture, Lomachenko was given another injection and his father and trainer, Anatoly, “wanted out of the fight,” said Klimas.

Vasiliy Lomachenko said he would not pull out of the fight and made it clear to his team that if he dropped out, he would retire.

While news of the injury came out quickly after Saturday’s loss, Klimas insisted: “We didn’t want to look like we were looking for excuses or something.”

When Lomachenko heals up, Klimas says he wants a chance to get back the belts.

“If it’s possible, we would like to have the rematch,” Klimas said. “If they are so tough … are they willing to come back and do that?”

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Tiger considers playing in Houston before Masters

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THOUSAND OAKS, Calif. — Tiger Woods is defending his Zozo Championship title this week with an eye on the Masters in three weeks.

And the run-up to what usually is the first major championship of the year is strange to say the least, he said.

So odd, in fact, that Woods said he is considering adding another tournament before the Masters, the Houston Open.

What?

“I think my plan is just to play and practice,” he said at Sherwood Country Club, where the relocated Zozo Championship begins Thursday. “I don’t know if I’m going to play Houston or not. I’m not playing next week, and we’ll see how this week goes and make a decision from there.”

It would have been a good bet to figure that this week’s tournament would be the only one before the Masters, simply because Woods has never played the week before the Masters in any year since playing his first as a pro at Augusta National in 1997.

Asked how he would try to replicate his run-up to the Masters, Woods said: “You can’t.”

“It’s not normally this time of year,” he said. “It’s not normally played this way, the configuration of events. We’re not in a Florida swing. This is all different. This whole year’s been different for all of us.

“The fact that the Masters will be held in November, it’s unprecedented, never been done before. I can’t simulate the normal ramp-up that I normally have, and I don’t think anyone else can either. It will be different for all of us.”

Woods is making only his sixth start on the PGA Tour since the resumption of play following a 13-week pandemic shutdown. His best finish is a tie for 37th at the PGA Championship in August. He has slipped from 13th to 28th in the world.

His last start was a month ago at the U.S. Open, where he missed the cut and struggled again with back stiffness.

Woods played nine holes at Sherwood on Tuesday and looked good, something that can be said of many of his practice rounds. What he brings to the course when it counts is what ultimately matters; so far this year, he’s never had a reasonable chance of contending going into the weekend.

He has played only seven times in 2020, his best finish a tie for ninth at the Farmers Insurance Open in January.

“My game’s definitely better than it was at the U.S. Open,” he said. “I feel a little bit more prepared, a little bit better, and hopefully that translates into playing the golf course.”

His Zozo victory in Japan seems ages ago. Woods went there with low expectations after taking a nine-week break following arthroscopic knee surgery. And after a slow start, he shot consecutive 64s to open the tournament and posted a three-shot win over Hideki Matsuyama.

It was his 82nd victory on the PGA Tour, tying the mark of Sam Snead.

As a past Masters champion, Woods is an honorary member of Augusta National, meaning he can play the course whenever he wants. He has done so numerous times in preparation for the Masters, but said he’s done so only once in November back in the fall of 2001 after the club made numerous changes to the layout.

He recalled cool, difficult conditions. “It can be awfully difficult and long and much different than what we play in April,” he said.

Woods said he has not been back to Augusta National since his stirring 2019 victory, his fifth Masters title. Everything about it this time will be different, from no spectators to different colors and to perhaps a more strenuous golf course.

Another huge difference would be Woods playing the week prior.

“The whole idea is to be ready in a few weeks and whether or not that’s playing one more event, whether that’s Houston or just playing here at Zozo, just making sure that I’m ready for Augusta,” Woods said.

Woods does have a strong history at Sherwood Country Club, which he played 12 times when it hosted his World Challenge charity event that has since moved to the Bahamas. Woods won that tournament five times and was runner-up on five other occasions.

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