U.S. 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 — an outing that disregarded precautions meant to contain the virus that has killed more than 209,000 Americans.
Meanwhile, White House Press Secretary Kayleigh McEnany late Monday morning became the latest person in Trump’s orbit to reveal a positive test. McEnany said that after days of negative tests, she tested positive and will go into quarantine, though it wasn’t clear where that would be or how it would affect the handling of the administration’s communications to reporters.
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 had 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 was improving and he could be discharged as early as Monday to continue the remainder of his treatment at the White House.
Trump “is ready to get back to a normal work schedule” and was optimistic about a Monday release, White House chief of staff Mark Meadows told Fox News. He said a determination would be made by his medical team.
Less than one month before election day, Trump was eager to project strength despite his illness. The still-infectious president surprised supporters who had gathered outside the hospital, riding past them Sunday 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 fuelled confusion about Trump’s health. 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.
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In a short video released by the White House on Sunday, Trump insisted he understood the gravity of the moment. But his actions a short time later, by leaving the hospital and sitting inside the SUV with others, suggested otherwise.
Vice-President Mike Pence and his wife Karen tested negative again, the White House said on Monday. Pence is scheduled to debate his Democratic counterpart in the only vice-presidential debate on Wednesday in Salt Lake City, Utah.
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.
Biden also said he was willing to debate Trump in the previously scheduled Miami meeting of the candidates on Oct. 15, provided it was safe to do so.
Blood oxygen concerns reported, belatedly
The president, meanwhile, still faces questions about his health.
His doctors sidestepped questions on Sunday about exactly when Trump’s blood oxygen dropped — episodes they neglected to mention in multiple statements the day before — or whether lung scans showed any damage.
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It was not clear 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 had expressed concern about the lackadaisical attitude toward masks and physical 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 per cent. White House physician Sean Conley said the president had a “high fever” and a blood oxygen level below 94 per cent on Friday and during “another episode” on Saturday.
He was evasive about the timing of Trump’s oxygen drops. 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 per cent — 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.”
Trump’s treatment with 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 antiviral 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.
The National Institutes of Health COVID-19 treatment guidelines recommend against using dexamethasone in patients who do not require supplemental 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.