What is ‘VIP syndrome’? Trump’s COVID-19 diagnosis underscores challenge of treating famous patients

October 5, 2020, 9:37 AM UTC

The team of medical professionals treating U.S. President Donald Trump for COVID-19 are providing him with “all the standard of care and beyond,” Trump’s personal physician, Sean Conley, said on Saturday.

The medical team in charge of Trump’s care have prescribed the President an experimental antibody cocktail, an antiviral drug, and a steroid usually administered to patients with severe cases of COVID-19. The comprehensive nature of Trump’s treatments and the conflicting reports about his health have led medical experts to raise concerns about a new risk: “VIP syndrome.”

“VIP syndrome,” coined in 1964 by Walter Weintraub, a doctor at the University of Maryland School of Medicine, describes a phenomenon in which the medical treatment of a famous, powerful, or influential patient—a very important person, or VIP—faces challenges caused by the person’s fame, power, or influence.

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Doctors might make decisions they wouldn’t normally make because they are more willing to accede to the famous person’s demands or are more concerned than usual that the VIP avoids feeling pain or recovers quickly.

“[VIP syndrome] often pressures the health care team to bend the rules by which they usually practice medicine,” according to a 2011 paper in the Cleveland Clinic Journal of Medicine.

Complications can arise when doctors embark on medical treatments that diverge from the standard course of care that may turn out to be detrimental to the patient’s health.

“A VIP draws special attention based on his or her status in society and level of importance as perceived by the health care professional providing treatment,” according to a 2007 article in the peer-reviewed medical journal Intensive Care Medicine. “The special handling of the VIP patient…induces the potential for inappropriate and ineffective care.”

To be clear, there is no firm evidence that VIP syndrome is a factor in the President’s care, but experts have offered it as a possible explanation for the mixed messages from Trump’s medical team.

Thomas McGinn, physician-in-chief at Northwell Health in New York, told the New York Times that the range of drugs prescribed to Trump “raises the question: Is he sicker than we’re hearing, or are they being overly aggressive because he is the President, in a way that could be potentially harmful?”

Trump announced his diagnosis early Friday. By the end of the day, he had been airlifted to Walter Reed National Military Medical Center and had received an unauthorized, experimental antibody treatment developed by U.S. biotech firm Regeneron that’s been issued to patients 10 or fewer times.

Conley, Trump’s physician, said at the Saturday press briefing that Trump had started advanced therapies “a little bit earlier than most of the patients we know and follow.”

In addition to the antibody treatment, Trump is on a course of remdesivir, an antiviral drug with emergency use authorization from the U.S. Food and Drug Administration. Trump’s doctors also gave him dexamethasone, a steroid given only to people with severe cases of COVID-19.

Conley also said on Saturday that Trump was “up and active” and his cholesterol and blood pressure levels were “great.” In response, one reporter asked why the medical team had decided to transfer Trump to Walter Reed. “Because he’s the President of the United States,” Conley said.

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