HEALTH CARE BRIEFING: Trump Doctor Sows Confusion on Vitals
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Donald Trump’s physician admitted to giving a misleading statement about the president receiving oxygen, the latest in a series of contradictory and confusing accounts about Trump’s coronavirus infection.
White House physician Sean Conley told reporters yesterday that Trump had received supplemental oxygen on Friday, after saying the previous day that the president hadn’t been treated with oxygen on Friday. He said he gave the misleading information initially to “reflect the upbeat attitude” of Trump and his doctors.
Yesterday’s briefing also included a series of inconsistent or misleading responses that appeared intended to serve Trump’s desire to reassure Americans, but instead left the country with an incomplete snapshot of his health. Even as their statements left doubt about the president’s condition, the doctors yesterday insisted that Trump is doing well and could be discharged as soon as today.
They also announced he was on a new drug, while remaining evasive about whether he received supplemental oxygen on Saturday and declining to detail any damage to his lungs.
The White House has withheld information about Trump’s illness from the beginning. On Friday, Chief of Staff Mark Meadows and Press Secretary Kayleigh McEnany said throughout the day that Trump had only mild symptoms. The White House and Trump’s medical staff have since acknowledged that he had what Conley called a “high fever,” that his oxygen levels were dipping below 94%, and that he was given oxygen for about an hour, before eventually being hospitalized.
On Saturday, Conley gave his first press briefing, and avoided several direct questions. At one point, pressed on whether Trump was receiving oxygen, he said that “yesterday and today, he was not on oxygen,” referring to Friday and Saturday. He has since said that was incorrect.
“I was trying to reflect the upbeat attitude that the team, the president, that his course of illness had had,” Conley said yesterday. “I didn’t want to give any information that might steer the course of illness in another direction, and in doing so it came off that we were trying to hide something, which wasn’t necessarily true.” He added: “The fact of the matter is he’s doing really well.”
Broadly, White House officials have repeatedly described Trump’s health as improving even while doctors were administering a rising number of drugs. He received Regeneron’s therapeutic on Friday, and later that night began a treatment course of Gilead Science’s remdesivir. Remdesivir is given intravenously.
Trump’s doctors said Saturday that Trump “likely” would stay at Walter Reed National Military Medical Center for all five days of that treatment if he needed the full dose. Yesterday, they changed course and said he could get the final doses at the White House, emphasizing that Trump was improving.
Conley then announced that Trump had been given dexamethasone, his third therapeutic treatment in as many days. Dexamethasone is used to calm an overly active inflammatory response to the infection, one that typically doesn’t start until the virus has been present for some time. Trump receiving it at this stage is a sign that doctors may think the illness is progressing quicker than expected, or that he’d actually contracted it earlier.
The decision to give Trump dexamethasone suggests that his physicians were worried that he might be about to suddenly deteriorate, said two doctors not involved in his care. Covid-19 is a two-phase infection, and the most life-threatening symptoms often come not from the virus itself, but when the immune system spirals out of control in the second stage of the disease.
Conley was also evasive about the results of X-rays and CT scans of Trump’s lungs. “There’s some expected findings but nothing of major clinical concern,” Conley said, appearing to acknowledge that Trump has suffered lung damage to some extent. Asked about Trump’s lung function, Conley said Trump is “maxing” out lung capacity tests. “He’s doing great.” Read more from Josh Wingrove and Robert Langreth.
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- All told, hundreds of people — some masked, many not — came into contact with Trump in the week leading up to his positive Covid test, according to interviews with witnesses and a review of White House schedules, news accounts and photographs. Most famously, the Rose Garden event to announce Amy Coney Barrett as a Supreme Court nominee attracted 150 people — at least eight of whom have since tested positive for the illness. Between it and Friday, when Trump was helicoptered to Walter Reed National Military Medical Center, he headlined a string of risky events, many indoors, that have sent people scrambling to get tested. Read more from Jennifer A Dlouhy, Ari Natter and Misyrlena Egkolfopoulou.
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Speaker Nancy Pelosi (D-Calif.) said Friday that negotiations with the White House will press ahead and Trump’s Covid-19 diagnosis might change the tenor of the talks by underscoring the seriousness of the pandemic. Senate Majority Leader Mitch McConnell (R-Ky.) said Friday that the talks have “speeded up in the last few days,” though he didn’t make a prediction about the eventual outcome. Read more from Tony Czuczka.
- McConnell Saturday also said the fast-track schedule for confirming Trump’s Supreme Court nominee Amy Coney Barrett won’t be affected by Covid-19 diagnoses of the president and three Republican senators, despite rising concern about a wider spread of the virus in the government. McConnell said he plans to seek a two-week recess of the full Senate for all but brief pro-forma sessions, and confirmation hearings will continue. He is likely to get bipartisan consent for the plan today, according to a Senate aide.
- Senate Minority Leader Chuck Schumer (D-N.Y.) said holding the hearings would endanger senators and staff, and he dismissed virtual hearings as insufficient for a lifetime appointment that he said could cast deciding votes on ending abortion rights, protections for pre-existing health conditions and more. Schumer also said McConnell has blocked a coronavirus testing plan for all senators and staff at the Capitol. Read more from Steven T. Dennis.
Regeneron Virus Drug Thrust to Center Stage: Regeneron Pharmaceuticals has found itself in the spotlight after Trump was treated with its experimental antibody treatment, just days after the unveiling of promising preliminary trial results. Monoclonal antibodies are seen as one of the most promising possible treatments for Covid-19, and Regeneron is one of the front-runners in testing them. They have the potential to be used both as a treatment and as a quick-acting prophylactic drug. Robert Langreth and Michelle Fay Cortez have more.
GOP War on Covid Orders Grinds On: Republicans’ efforts to roll back Covid-fighting measures have been steaming ahead for months, and little could halt their momentum Friday even as Trump became one of over 30,000 Americans hospitalized with Covid-19. In Michigan, the state Supreme Court invalidated dozens of Governor Gretchen Whitmer’s pandemic executive orders. In Wisconsin, Republican legislators filed a brief in support of an effort to block a mask requirement amid one of America’s most dire outbreaks. Still, rank-and-file Republicans and officials spoke more tentatively about measures to curb the pandemic than they had in the months before, Jonathan Levin, Richard Chess and Vincent Del Giudice report.
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Schumer also said the Trumps’ infections mean the White House should “immediately conduct a contact tracing regime” that follows CDC guidelines. Schumer also urged “thorough testing and isolation for those who were exposed to infection risk.” House Minority Leader Kevin McCarthy (R-Calif.) similarly called for a regular testing regime, Alex Ruoff reports: “There are so many bodies coming in and out of there.”
The Office of the Attending Physician later released an update stating it tests members of Congress experiencing symptoms of Covid or are concerned that they’ve come into contact with the virus. The overall test positivity rate under the OAP’s testing program has been less than 1%, the office said.
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Free Vaccines Seen as Path to Ease Restrictions: Free Covid-19 vaccinations promised by Trump’s administration may more rapidly ease punishing shelter-at-home and social distancing requirements, but only if the country can commit significant funds for the effort, according to group of scientists and academics advising the government. The National Academies of Sciences, Engineering, and Medicine offered the government the recommendation in a final report Friday to develop guidelines on the fairest way to distribute vaccines. Read more from Jeannie Baumann.
Medicare Tops 1 Million Covid-19 Patients: Traditional Medicare spent $4.4 billion in 2020 to hospitalize over 178,000 beneficiaries with Covid-19, federal data show. Over 1 million Medicare beneficiaries have contracted the disease that continues to hit hardest among the elderly, minorities, and patients with kidney failure, new Medicare Covid data-19 show. Read more from Tony Pugh.
Covid ‘Long Haulers’ Ask Who Pays: Millions of people will live with coronavirus’s effects long after the pandemic subsides. Even mild cases have caused lung, heart and kidney damage in otherwise healthy people. It’s unclear what their future health-care needs will be, or how much their care will cost. As with HIV and opioid addiction crisis, the scope and newness of the pandemic presents many new questions about what treatments insurers will cover. Patients have to go through lengthy appeals processes with their insurance companies when a claim is denied, so disputes have yet to reach the courts.
The Affordable Care Act prohibits most health plans from refusing to cover people or hiking their costs if they have a pre-existing condition. But those safeguards could be wiped out if the Supreme Court strikes down or guts the ACA.
Even if Obamacare remains, insurance plans that fall under the law’s purview can decide what treatments are medically necessary and which doctors they’re willing to pay for. Read more from Lydia Wheeler.
Covid-19 Falling Harder on Rural U.S.: The pandemic is slamming rural America harder than ever before, with new daily cases reported in Montana and South Dakota hitting records, putting the focus on small towns with typically limited hospital resources. On a per-capita basis, the most rural counties have never had it so bad relative to the most urban, government data show. Based on a rolling seven-day average, there are around 19.5 daily cases per 100,000 residents in America’s most rural counties. Read more from Jonathan Levin.
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What Else to Know
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Racial Health Gaps Seen as Wake-Up Call: The NIH will pour more work into eliminating health disparities that caused Black Americans and other minorities to suffer worse outcomes during the pandemic, the agency’s director said. “We all have to recognize that COVID-19 has shown a bright light into the tragedy of health in equities and health disparities in the U.S,” Francis S. Collins, director of the National Institutes of Health, said Friday. Read more from Jeannie Baumann.
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