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Trump, moving to show strength, aims for Monday release

President Donald Trump was hoping for a Monday discharge from the military hospital where he is being treated for COVID-19.

Posted: Oct 5, 2020 9:03 AM

BETHESDA, Md. (AP) — President Donald Trump was hoping for a Monday discharge from the military hospital where he is being treated for COVID-19, a day after he briefly ventured out while contagious to salute cheering supporters by motorcade in a move that disregarded precautions meant to contain the deadly virus that has killed more than 209,000 Americans.

White House officials said Trump was anxious to be released after three nights at Walter Reed National Military Medical Center, where doctors revealed on Sunday that his blood oxygen level dropped suddenly twice in recent days and that they gave him a steroid typically only recommended for the very sick. Still, the doctors said Trump’s health is improving and volunteered that he could be discharged as early as Monday to continue the remainder of his treatment at the White House.

“This is an important day as the president continues to improve and is ready to get back to a normal work schedule,” White House chief of staff Mark Meadows told Fox News on Monday. He said the determination on whether Trump would leave the hospital won’t be made until later in the day after the president is evaluated by his medical team, but that Trump was “optimistic” he could be released Monday.

Less than one month until Election Day, Trump was eager to project strength despite his illness. The still-infectious president surprised supporters who had gathered outside the hospital, driving by in a black SUV with the windows rolled up. Secret Service agents inside the vehicle could be seen in masks and other protective gear.

The move capped a weekend of contradictions that fueled confusion about Trump’s health, which has imperiled the leadership of the U.S. government and upended the final stages of the presidential campaign. While Trump’s physician offered a rosy prognosis on his condition, his briefings lacked basic information, including the findings of lung scans, or were quickly muddled by more serious assessments of the president's health by other officials.

In a short video released by the White House on Sunday, Trump insisted he understood the gravity of the moment. But his actions moments later, by leaving the hospital and sitting inside the SUV with others, suggested otherwise.

“This is insanity,” Dr. James P. Phillips, an attending physician at Walter Reed who is a critic of Trump and his handling of the pandemic. “Every single person in the vehicle during that completely unnecessary presidential ‘drive-by’ just now has to be quarantined for 14 days. They might get sick. They may die.”

White House spokesman Judd Deere said Trump’s trip outside the hospital “was cleared by the medical team as safe to do.” He added that precautions were taken, including using personal protective equipment, to protect Trump as well as White House officials and Secret Service agents.

Joe Biden’s campaign, meanwhile, said the Democratic presidential nominee again tested negative for coronavirus Sunday. The results come five days after Biden spent more than 90 minutes on the debate stage with Trump. Biden, who has taken a far more cautious approach to in-person events, had two negative tests on Friday.

For his part, Trump still faces questions about his health.

His doctors sidestepped questions on Sunday about exactly when Trump’s blood oxygen dropped — an episode they neglected to mention in multiple statements the day before — or whether lung scans showed any damage.

It was the second straight day of obfuscation from a White House already suffering from a credibility crisis. And it raised more doubts about whether the doctors treating the president were sharing accurate, timely information with the American public about the severity of his condition.

Pressed about conflicting information he and the White House released on Saturday, Navy Cmdr. Dr. Sean Conley acknowledged that he had tried to present a sunnier description of the president’s condition.

“I was trying to reflect the upbeat attitude that the team, the president, that his course of illness has had. Didn’t want to give any information that might steer the course of illness in another direction,” Conley said. “And in doing so, you know, it came off that we were trying to hide something, which wasn’t necessarily true. The fact of the matter is that he’s doing really well.”

Medical experts said Conley’s revelations were hard to square with his positive assessment and talk of a discharge.

“There’s a little bit of a disconnect,” said Dr. Steven Shapiro, chief medical and scientific officer at the University of Pittsburgh Medical Center.

It was not clear for how long Trump's recovery would continue at the White House once he is discharged.

According to CDC guidelines, “In general, transport and movement of a patient with suspected or confirmed SARS-CoV-2 infection outside of their room should be limited to medically essential purposes.”

Even before Trump's motorcade outing on Sunday, some Secret Service agents have expressed concern about the lackadaisical attitude toward masks and social distancing inside the White House, but there isn’t much they can do, according to agents and officials who spoke to The Associated Press. This close to the election, thousands of agents are engaged on protective duty so they can be subbed out quickly should someone test positive.

The disclosures about Trump's oxygen levels and steroid treatment suggested the president is enduring more than a mild case of COVID-19.

Blood oxygen saturation is a key health marker for COVID-19 patients. A normal reading is between 95 and 100. Conley said the president had a “high fever” and a blood oxygen level below 94% on Friday and during “another episode” on Saturday.

He was evasive about the timing of Trump oxygen drops. (“It was over the course of the day, yeah, yesterday morning,” he said) and asked whether Trump’s level had dropped below 90%, into concerning territory. (“We don’t have any recordings here on that.”) But he revealed that Trump was given a dose of the steroid dexamethasone in response.

At the time of the briefing, Trump’s blood oxygen level was 98% — within normal rage, Trump’s medical team said.

Signs of pneumonia or other lung damage could be detected in scans before a patient feels short of breath, but the president’s doctors declined to say what those scans have revealed.

“There’s some expected findings, but nothing of any major clinical concern,” Conley said. He declined to outline those “expected findings.”

Asked about Conley’s lack of transparency, White House aide Alyssa Farah suggested the doctors were speaking as much to the president as to the American public, “when you’re treating a patient, you want to project confidence, you want to lift their spirits, and that was the intent.”

In all, nearly 7.4 million people have been infected in the United States, and few have access to the kind of around-the-clock attention and experimental treatments as Trump.

Trump’s treatment with the steroid dexamethasone is in addition to the single dose he was given Friday of an experimental drug from Regeneron Pharmaceuticals Inc. that supplies antibodies to help the immune system fight the virus. Trump on Friday also began a five-day course of remdesivir, a Gilead Sciences drug currently used for moderately and severely ill patients. The drugs work in different ways — the antibodies help the immune system rid the body of virus, and remdesivir curbs the virus’ ability to multiply.

Garibaldi, a specialist in pulmonary critical care, said the president was not showing any side effects of the drugs “that we can tell.”

The National Institutes of Health COVID-19 treatment guidelines recommend against using dexamethasone in patients who do not require oxygen. It has only been proven to help in more serious cases. Among the concerns with earlier use is that steroids tamp down certain immune cells, hindering the body’s own ability to fight off infection.

Trump is 74 years old and clinically obese, putting him at higher risk of serious complications. First lady Melania Trump has remained at the White House as she recovers from her own bout with the virus.

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 276500

Reported Deaths: 3321
CountyCasesDeaths
Hennepin590031089
Ramsey24988472
Anoka19724213
Dakota19215176
Washington12538106
Stearns1226689
Scott753854
St. Louis740897
Wright663436
Olmsted610130
Sherburne512539
Clay445155
Carver409712
Blue Earth373511
Rice361431
Kandiyohi348215
Crow Wing316130
Nobles296028
Chisago28398
Otter Tail266615
Benton261940
Winona246128
Mower236722
Polk228621
Douglas219829
Morrison211621
Lyon193711
McLeod18879
Beltrami184615
Goodhue177626
Becker17559
Itasca168924
Steele16756
Todd165312
Isanti165015
Carlton153610
Nicollet146523
Freeborn13935
Mille Lacs132830
Le Sueur13219
Waseca129710
Cass12018
Pine11926
Brown117510
Meeker10797
Roseau9923
Martin98220
Hubbard97022
Wabasha9121
Dodge7850
Redwood78018
Watonwan7754
Chippewa7697
Sibley7094
Renville70818
Cottonwood7060
Wadena7006
Aitkin68923
Pipestone67018
Rock6439
Houston6152
Fillmore6050
Yellow Medicine56611
Pennington5356
Kanabec52911
Murray5283
Swift4976
Pope4820
Faribault4750
Stevens4442
Clearwater4356
Marshall4277
Jackson4091
Lake3584
Unassigned34356
Koochiching3325
Wilkin3275
Lac qui Parle3203
Lincoln3141
Norman3096
Big Stone2771
Mahnomen2494
Grant2346
Red Lake1903
Kittson1856
Traverse1330
Lake of the Woods871
Cook580

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 213603

Reported Deaths: 2193
CountyCasesDeaths
Polk31707324
Linn13442161
Scott1040375
Black Hawk10393127
Woodbury9932114
Johnson911635
Dubuque879290
Story647619
Dallas602856
Pottawattamie585166
Sioux351925
Webster335930
Marshall332942
Cerro Gordo326541
Clinton307737
Buena Vista291114
Muscatine270366
Des Moines270116
Plymouth259537
Warren258510
Wapello242871
Jones222212
Jasper206639
Marion194418
Carroll190920
Lee190315
Bremer182612
Henry17087
Crawford170615
Benton160315
Tama146340
Jackson13758
Delaware136221
Washington131313
Boone128811
Dickinson127510
Mahaska121327
Wright11625
Buchanan11009
Page10834
Hardin107510
Clay10624
Clayton10234
Harrison102328
Hamilton10157
Cedar101413
Calhoun10047
Mills9886
Fayette9768
Floyd96914
Lyon9668
Kossuth9464
Poweshiek93712
Butler9134
Winneshiek90310
Iowa88011
Winnebago87523
Louisa81316
Hancock8067
Grundy79710
Chickasaw7893
Sac7817
Cherokee7624
Cass75419
Appanoose7426
Shelby7265
Allamakee72411
Mitchell7184
Union7096
Guthrie70815
Emmet70623
Franklin68419
Humboldt6645
Madison6474
Jefferson6351
Palo Alto6064
Unassigned5950
Keokuk5397
Pocahontas5192
Howard5069
Greene4980
Osceola4941
Clarke4614
Davis4405
Ida43910
Montgomery43210
Taylor4312
Monroe42912
Adair4157
Monona3932
Fremont3463
Van Buren3364
Worth3360
Lucas3076
Decatur3000
Wayne2876
Audubon2831
Ringgold1892
Adams1551
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