TRUMP RECEIVING POWERFUL LUNG DRUG, DOCTORS DISCLOSE
As questions mount about extent of his illness, president takes drive-by for supporters
President Donald Trump, hospitalized with COVID-19, received supplemental oxygen on Saturday — a previously undisclosed episode — and is being treated with a powerful steroid amid indications that his lungs may have suffered some damage, the White House physician said Sunday.
As questions continued about the severity of his illness and its progression, Trump late Sunday afternoon staged a motorcade drive-by outside Walter Reed National Military Medical Center and could be seen through the window of his massive black SUV, masked and waving to supporters who gathered outside.
The brief trip drew sharp criticism from medical experts who said Trump had endangered the Secret Service agents in the vehicle with him.
Earlier, at a briefing in front of the hospital, doctors treating Trump continued to be upbeat about his condition.
One of his physicians said the president could be discharged as soon as today, but another conceded they had not been fully forthcoming in their initial medical briefing Saturday.
Trump’s hospitalization, the most serious known medical episode involving the country’s chief executive since President Ronald Reagan was shot in 1981, has roiled the presidential race a month before the Nov. 3 election.
Former Vice President Joe Biden’s campaign announced Sunday evening that he had tested negative for the virus that has killed nearly 210,000 Americans. Biden had a similarly negative test Friday.
At Sunday’s briefing, the White House physician, Dr. Sean P. Conley, provided several significant new pieces of information about the 74year-old president, saying that he had experienced a “high fever” Friday morning and had received supplemental oxygen for about an hour before being transported to the military hospital in Bethesda, Md., later that day.
He disclosed that Trump’s oxygen level had fallen again on Saturday to the point that supplemental oxygen was again required, and that scans of his lungs showed some indications of damage, although he insisted they were not of “major clinical concern.”
Significantly, Conley said the president had been given dexamethasone, a steroid. Doctors prescribe that drug for COVID-19 patients to combat lung damage caused by inf lammation, which is one of the major ways the disease can kill patients. Experts had said previously that a decision to put Trump on the drug would be a major development.
Conley had not answered a question Saturday about whether Trump had been given any steroid and had also evaded repeated questions about supplemental oxygen. On Sunday, he acknowledged that he had omitted some information at the earlier briefing, saying he was “trying to ref lect the upbeat attitude” of Trump and his aides.
“It came off that we were trying to hide something,” he said, adding that had not been their intent. He continued to withhold some information, however, declining to say how low Trump’s oxygen level had dropped, for example. On Friday it fell “below 94 percent” but hadn’t hit “the low 80s,” he said.
The disclosure that Trump is receiving dexamethasone is a clear signal that his illness is a serious one, said Dr. Ashish Jha, dean of the Brown University School of Public Health.
In an interview Saturday, Jha said he would watch for use of dexamethasone, which would be a “very clear signal that he has a more severe disease.”
In mild cases, he said, “we actually think it does more harm than good.”
On Sunday, Jha repeated that assessment, noting that it was unclear whether Trump could suffer longterm damage to his lungs. Some patients have breathing trouble even after their initial recovery, he noted.
Although doctors have only released incomplete information, Jha said it appears Trump has a moderate case of COVID-19.
“I don’t think he’s out of the woods yet. He could get worse,” Jha said. “And I think he needs very close monitoring.”
Like other steroids, dexamethasone can have significant side effects that could have an impact on Trump’s ability to work. Those can include irritability, mood swings and trouble sleeping, according to medical experts.
The National Institutes of Health recommends use of the drug for COVID-19 patients who need supplemental oxygen, but cautions against it in mild cases.
Despite the disclosure of more serious symptoms, the medical team said Trump was doing well on Sunday.
Another member of the medical team, Dr. Brian Garibaldi of Johns Hopkins University, said Trump was “up and around” and feeling well.
“Our hope is that we could plan for a discharge as early as tomorrow,” he said.
At the same time, however, the doctors said that Trump was only midway through a five-day course of remdesivir, an antiviral drug that medical experts have said would be more difficult to provide outside a hospital setting.
Trump released a video on Twitter shortly before his brief trip outside the hospital in which he implied that his bout of illness was already behind him.
“I learned a lot about COVID — I learned it by really going to school,” Trump, clad in an open-collared white shirt and a suit jacket, said in the video. “This is the real school, this isn’t the ‘Let’s read a book’ school. And I get it.”
But his foray drew an outpouring of criticism. Dr. James Phillips, a professor of emergency medicine at George Washington University Medical School and an attending physician at Walter Reed, who is not treating the president, called it “insanity.”
Phillips noted on Twitter that Trump’s armored limousine is designed to be sealed from outside air, concentrating any viral particles that might have passed through Trump’s mask.
Everyone in the vehicle should now face a 14-day quarantine, he wrote.
“They might get sick. They may die. For political theater.”