PHILADELPHIA - When President Donald Trump talks about his bout with coronavirus - and urges Americans to not let the pandemic that has killed more than 210,000 "dominate their lives" - Jesus Ortiz can hardly bring himself to listen.
Ortiz, 58, was diagnosed in May with COVID-19, and his experience couldn't have been more different from the president's.
Back then, at the height of the pandemic's first wave in the Philadelphia region, testing backlogs meant Ortiz, an apartment building maintenance supervisor from Warminster, had to wait a week for his test results. As he waited, he grew sicker, struggling to breathe. It took two trips to an emergency room before he was admitted to a COVID-19 ward, he said.
Alone in the hospital, with no visitors allowed, Ortiz remembers asking a doctor if he could be treated with blood plasma from other COVID-19 patients, a therapy he had read about. He was told that it was in such short supply that it had to be conserved for the sickest patients, and bad as he felt, that didn't yet include Ortiz.
Eventually, Ortiz did get both plasma and remdesivir - the antiviral medication that the president received right away during his stay at Walter Reed National Military Medical Center earlier this month. After more than a week in the hospital, Ortiz went home, 30 pounds lighter and still relying on supplemental oxygen.
Seeing the president speak about how easy his care and recovery were has stung Ortiz, who felt entirely alone as he grew sicker and demanded scarce treatments.
When the president tells Americans not to worry about the virus, "he makes it into a joke, as far as I'm concerned," Ortiz said. "This is a life-threatening thing, for sure."
Ortiz isn't alone in his anger: Doctors, patients, and their advocates from around the region say Trump's cavalier attitude toward the virus is clearly a dangerous message to precaution-weary Americans. But what's more, his experience speaks to the vast social, racial, and economic inequities in American health care.
"Most catastrophes - natural disasters and pandemics - often open everyone's eyes to the inequities that are there, that are easy to overlook," said Claiborne Childs, a hospitalist at Penn Presbyterian Medical Center. "These disparities have been here for as long as we've been alive."
Two of the drugs that Trump was prescribed at Walter Reed - remdesivir and the steroid dexamethasone - are, generally speaking, available by prescription.
But he also received an experimental antibody treatment made by Regeneron, which is still in clinical studies and out of reach for all but a few.
In Philadelphia, Temple University is running one of the trials needed to prove safety and effectiveness, but participants do not know whether they receive the drug or not. The drug is also available for "compassionate use" cases - patients in serious or life-threatening condition who aren't involved in the clinical study.
"What is extraordinary is the structure of care around him," said Anne Sutherland, a pulmonary and critical care physician and the director of the medical intensive care unit at Rutgers University Hospital in Newark. "Normal people do not get a helicopter to the hospital, normal people do not have 20 doctors for one patient. He makes it seem so easy. But the level of support, and the level to which he has people around him, allowing him to go back to work, is just not available to basically anybody else."
The dire need for support services is clear to community healthcare workers in Philadelphia who help patients navigate healthcare systems.
Mary White, of the Penn Center for Community Health Workers, said that these days, her first interaction with a patient is often reassuring them that they can get tested for the coronavirus even if they don't have insurance. Many of her clients lost their jobs and insurance during pandemic-induced layoffs.
"They're like, 'Where do I go? I've been laid off from my job. Is it free? How am I going to pay for it?' " she said. "These are things that they might not have been concerned with before."
Her patients often don't even have a place to quarantine - many of the families White works with in West Philly don't have enough room in their homes to effectively separate family members, she said.
Other patients will call with concerns about child care, about elderly relatives they care for, and about the risks to their own lives. People of color, especially Black people, contract the virus and die from it at disproportionate rates, national and local data have shown.
"Of course, when it was announced the president had it, he could get to the hospital right away, he got tested right away," White said. "For everyday people, it's hard enough just to find out where to go."
Another challenge: Many patients in Philadelphia are wary or even afraid of going to the hospital for care, said Tony Reed, the executive vice president and chief medical officer at Temple University Hospital.
That's partly because they fear contracting the virus - but also due to lingering distrust of the medical system as a whole, especially among communities of color.
"The minority population in America have been conditioned to not inherently or implicitly trust the U.S. healthcare system, and I'll take ownership of that for past generations," he said. "It's our fault."
And even after the virus has run its course, residents of the poorest big city in the country still face an uphill battle. At Temple's Community Care Transitions program, licensed clinical social worker Ebonee Miller-Williams screens recovering COVID patients for financial hardships including paying for housing and food, and connects them with services that can help. Those needs have increased during the pandemic, she said.
"I don't think that most of (our patients) anticipated the needs they would have following COVID," she said.
Like many recovered patients, Ortiz still feels the lingering effects of his bout with COVID-19 and urges people not to think Trump's experience has much to do with the reality of their lives.
Trump "was the most guarded human being on the planet - they're going to do everything possible to get everything he needs. But every person deserves the right to live, to be treated the best they can, for them all to make it home to their families. It just shows you how unfair things really are," he said.
"To see someone taking (the virus) so lightly, like it's no big deal, knowing that hundreds of thousands of people lost their lives - that's a huge deal."
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