President Trump aims for Monday release from hospital

In this image from video, President Donald Trump waves as he drives past supporters gathered outside Walter Reed National Military Medical Center in Bethesda, Md., Sunday, Oct. 4, 2020. Trump was admitted to the hospital after contracting COVID-19. (AP Photo/Carlos Vargas)

BETHESDA, Md. — 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 to salute cheering supporters by motorcade.

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.

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Less than one month until Election Day, Trump was eager to project strength despite his illness. The 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.

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.

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.

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.”

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.”

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.