Former Gov. Chris Christie has spent five days in the hospital being treated for the coronavirus with little word on how he’s doing.
Christie is one of several people who spent time with President Donald Trump’s inner circle who tested positive for COVID-19 over the last week. The former New Jersey governor was admitted into Morristown Medical Center on Saturday as a precaution because of his history with asthma.
At the time, Christie said he had mild symptoms. Since then, he and his doctors have been publicly silent about his treatment and condition. A source with knowledge of the governor’s case said only that he is in good spirits and is getting good care.
It’s unclear if Christie, 58, is still in the hospital because his condition has gotten worse or if he’s being held as a precaution. In addition to asthma, Christie has weight issues, two conditions that may put him at higher risk for complications from the virus. He also is the former governor.
“Obviously, VIPs get VIP treatment,” said Lewis Nelson, an emergency physician and chair of emergency medicine at the Rutgers New Jersey Medical School in Newark.
Nelson hasn’t treated Christie and doesn’t know the details of his case. But he said being a VIP can be a blessing and a curse in a hospital. A high-profile patient can get top notch care and speedy access to doctors and drugs other patients might not get, as President Donald Trump did during his hospitalization for COVID-19.
But they can also be held in the hospital longer than necessary.
“They do tend to get over-managed and over-tested,” Nelson said.
Christie is likely receiving some of the same treatments as other coronavirus patients who were ill enough to have to be admitted to a hospital. Here’s what a COVID-19 patient might experience in the hospital, according to Nelson and Anne K. Sutherland, a pulmonologist who runs the intensive care unit at University Hospital in Newark:
Evaluation: Though Christie tweeted “I checked myself into Morristown Medical Center,” most people don’t get to just show up at the hospital when they test positive for COVID-19 and get a room like it’s a hotel, doctors said.
Coronavirus patients would likely be examined by a doctor who would check for fever, breathing difficulties and a low blood oxygen level, Nelson said. If the blood oxygen reading is 94% or below, the patient would likely be given oxygen and admitted to the hospital because that may be a sign they are headed for a crisis.
Patients with high risk factors, including being overweight, having diabetes or asthma, a heart condition or a chronic health condition, would be more likely to be hospitalized, Nelson said.
Access to drugs: While in the early days of the virus doctors were unsure what, if any, drugs to use to treat COVID-19, most hospitalized patients are now given remdesivir, an antiviral. The drug was first developed to treat Ebola but has become a go-to drug for hospitalized coronavirus patients in recent months.
There is not definitive proof remdesivir works, but there is also no proof it does any harm, Nelson said. So, many doctors are using it to treat COVID-19 patients, especially those who are older, overweight or have other high-risk factors.
“We tend to use remdesivir fairly liberally in these people,” Nelson said.
Patients may also be treated with anti-inflamatory drugs and steroids, like the dexamethasone steroid Trump was given in the hospital. Again, doctors say there are no studies proving they work. But doctors have found them effective in many patients.
In New Jersey hospitals, some COVID-19 patients may also be asked to participate in one of several clinical trials testing the effectiveness of other new drugs and treatments.
It remains unclear whether many treatments, including the Regeneron monoclonal antibody cocktail Trump was given, are working. But many doctors and patients are willing to experiment, Nelson said.
“We don’t know the best answer. That’s the problem,” Nelson said.
Asthma concerns: Asthma is considered one of the conditions that might raise a patient’s risk for having a severe case of COVID-19. But asthma sufferers, like Christie, probably would not receive any special drugs or monitoring.
“They would not be treated any differently,” said Sutherland, a pulmonologist and associate professor at the Rutgers New Jersey Medical School.
The preliminary data has shown that having asthma doesn’t increase the severity of the coronavirus or increase a patient’s risk of death, Sutherland said. But more extensive studies are needed. For now, doctors keep a close eye on asthma patients.
An isolated room, with the possibility of visitors: New Jersey hospitals no longer have the crush of COVID-19 patients that did in the early months of the pandemic. These days, patients will likely have their own rooms in an isolated part of the hospital in units reserved for coronavirus patients, the doctors said.
“We’re able to sequester people,” Nelson said.
Patients who are not on ventilators are usually able to eat meals, if they feel well enough, and walk around their rooms. They are not usually permitted to walk the halls or go to other areas of the hospital.
Hospitals have lifted their bans on visitors to COVID-19 patients, so some patients are able to see their families from a safe distance.
Constant monitoring: Coronavirus patients will be hooked up to multiple monitors and have a steady stream of nurses and doctors checking on them, Sutherland said.
They will likely have a pulse oximeter checking their oxygen levels continuously and a heart monitor to check for cardiac complications. They will have their blood pressure monitored every one to four hours, along with their respirator rate.
Doctors will also be monitor patients and give them preventative drugs for blot clots in the legs and lungs, a dangerous complication found in some COVID-19 patients, Sutherland said.
Those with breathing difficulties might need supplemental oxygen or a high-flow nasal oxygen machine, a devise that looks similar to a sleep mask used by people with sleep apnea, Sutherland said. As a last resort, patients will be put on a ventilator to keep them breathing if the virus attacks their lungs.
Watching the timeline: Patients who are able to breathe on their own should not expect a long stay in hospital unless they have other complications, the doctors said.
“If you’re not on a ventilator … you are usually going to be gone from the hospital in a few days,” Nelson said.
Doctors who have treated many coronavirus patients say they’ve spotted a pattern in people who develop severe cases. The turning point for many is between five and eight days after they get sick.
“That’s when they would take a turn for the worse,” Sutherland said.
Most people who make it past the 10-day mark without severe symptoms don’t get any sicker, she added. But every case is different and there are no guarantees.
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Kelly Heyboer may be reached at [email protected].
