In this handout provided by The White House, President Donald J. Trump works in his conference room at Walter Reed National Military Medical Center after testing positive for COVID-19 on October 3, 2020 in Bethesda, Maryland. President Trump’s medical team says the President’s oxygen levels dropped and he took a steroid treatment of dexamethasone. (Photo by Joyce N. Boghosian/The White House via Getty Images)WASHINGTON — President Donald Trump sought to dispel any perception of weakness Sunday with a surprise and seemingly risky outing from his hospital bed to greet supporters even as his doctors once again rewrote the official narrative of his illness by acknowledging two alarming episodes they had previously not disclosed. The doctors said that Trump’s blood oxygen level dropped twice in the two days after he was diagnosed with the coronavirus, requiring medical intervention, and that he had been put on steroids, suggesting his condition might be more serious than initially described. But they insisted that his situation had improved enough since then that he could be released from the hospital as early as Monday. The acknowledgment of the episodes raised new questions about the credibility of the information provided about the commander in chief of a superpower as he is hospitalized with a disease that has killed more than 209,000 people in the United States. With the president determined not to concede weakness and facing an election in just 30 days, officials acknowledged providing rosy assessments to satisfy their prickly patient. Determined to reassert himself on the political stage on his third day in the hospital, Trump made an unannounced exit from Walter Reed National Military Medical Center in the early evening, climbing into his armored Chevrolet Suburban to ride past supporters holding Trump flags gathered outside the building. Wearing a suit jacket and face mask but no tie, Trump waved at the crowd through a closed window as his motorcade slowly cruised by before returning him to the hospital. “It’s been a very interesting journey,” Trump said in a one-minute video posted on Twitter, looking stronger and sounding more energetic than he had the last couple of days. “I learned a lot about COVID. I learned it by really going to school. This is the real school. This isn’t the let’s-read-the-books school. And I get it. And I understand it. And it’s a very interesting thing and I’m going to be letting you know about it.” Trump’s camera-friendly, morale-boosting “surprise visit,” however, may have masked the reality of his condition, and his seeming energy may have reflected the fact that he was given the steroid dexamethasone, according to medical experts. Dexamethasone has been shown to help patients who are severely ill with COVID-19, but it is typically not used in mild or moderate cases of the disease. Moreover, some medical experts said Trump’s trip out of the hospital was reckless, unnecessarily putting both hospital staff members and Secret Service agents at risk for a stunt. Others questioned the president’s statement in his video that he had met soldiers while at Walter Reed. “Every single person in the vehicle during that completely unnecessary Presidential ‘drive-by’ just now has to be quarantined for 14 days,” Dr. James Phillips, an attending physician at Walter Reed, wrote on Twitter. “They might get sick. They may die. For political theater. Commanded by Trump to put their lives at risk for theater. This is insanity.” In a telephone interview Sunday night, Phillips also said the trip raised the alarming question of whether the president was directing his doctors. “At what point does the physician-patient relationship end, and does the commander in chief and subordinate relationship begin, and were those doctors ordered to allow this to happen?” he said, noting that it violated standards of care and would not be an option open to any other patient. “When I first saw this, I thought, maybe he was being transported to another hospital.” Judd Deere, a White House spokesperson, said precautions were taken in organizing the excursion. “The movement was cleared by the medical team as safe to do,” he said. But the criticism threatened to reinforce views of Trump’s handling of the pandemic as a whole, which has been widely criticized and remains his biggest political vulnerability. Even as the White House released new details about the president’s condition Sunday, it continued to withhold others, including when Trump had his last negative test for the coronavirus and his first positive one. Two administration officials speaking on condition of anonymity acknowledged that he had an undisclosed positive result from a rapid test Thursday evening after returning from a fundraiser at his golf club in Bedminster, New Jersey. But he did not reveal it when he subsequently called into Sean Hannity’s Fox News show and, in a raspy voice, said he was still waiting for results. Only after the television show did the results of another, more sophisticated PCR test come back confirming the positive reading, according to the officials, an account previously reported by The Wall Street Journal. It was that later test result that Trump announced on Twitter around 1 a.m. Friday. Speaking with reporters Sunday without wearing a mask, Kayleigh McEnany, the White House press secretary, would not specifically confirm the earlier test but said that “the first positive test he received was after he returned from Bedminster.” Each passing day brings new information about those early hours of the illness that contradicts the version of events originally put out by the White House. Dr. Sean Conley, the White House physician, acknowledged on Sunday that Trump had a high fever and saw his oxygen drop Friday morning, confirming reports by The New York Times and other news outlets. That episode helped prompt the decision to transfer Trump to the hospital later in the day, a move initially described by the White House as simply a precautionary measure. Conley also disclosed for the first time another episode of falling blood oxygen level Saturday. Trump was put on supplemental oxygen during the Friday spell over the president’s strenuous objections, Conley confirmed. “He was fairly adamant that he didn’t need it,” he said. The doctor said he was not sure if the president was given oxygen Saturday, but if so, it was “very, very limited.” The steroids were administered afterward. Conley had refused repeatedly during his televised briefing Saturday to say whether the president had received supplemental oxygen and provided such a relentlessly upbeat assessment that Mark Meadows, the White House chief of staff, afterward felt compelled to tell reporters off camera that the president’s situation had been more serious. During his briefing Sunday, Conley acknowledged that he had provided a rosy version of events to please his notoriously sensitive patient. “I didn’t want to give any information that might steer the course of illness in another direction, and in doing so, you know, it came off that we were trying to hide something, which wasn’t necessarily true,” he said. Alyssa Farah, a White House communications adviser, conceded that Conley had been speaking to an audience of one during his Saturday briefing. “When you’re treating a patient, you want to project confidence, you want to lift their spirits, and that was the intent,” she said. She said that Meadows was trying “to be as transparent as we can” be by amending the report later. Conley and other doctors were nonetheless optimistic Sunday that Trump was doing better and could be sent back to convalesce at the White House perhaps on Monday. “If he continues to look and feel as well as he does today, our hope is to plan for a discharge as early as tomorrow to the White House, where he can continue his treatment course,” said Dr. Brian Garibaldi, another physician treating the president. In addition to the steroids, Trump has received an experimental antibody cocktail and is in the midst of a five-day course of remdesivir, an antiviral drug. The White House has a medical unit capable of responding to a president’s health troubles but not with the sophisticated equipment available at Walter Reed. Trump, who historically hates hospitals and anything related to illness, has been hankering to get released, according to two people close to him, and some aides expressed fear that he would pressure Conley into releasing him by claiming to feel better than he actually does. But advisers were also troubled by the doctors’ prediction that they might release him Monday because if they do not, it would signal that the president is not doing as well as indicated. They also worried that a premature return could lead to a second trip to the hospital if his condition worsened.
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