User:PatriceMO1/COVID-19 case of Donald Trump

Source: Wikipedia, the free encyclopedia.

At 12:54 a.m. EDT on October 2, United States president Donald Trump announced via Twitter that both he and the First Lady Melania Trump had tested positive for the SARS-CoV-2 virus that night.[1][2] The president was hospitalized for three days. The First Lady, along with their son who also tested positive, isolated at the White House where they eventually recovered.

Source of infection

Exactly whom Trump caught covid from remains unknown. At least a dozen people present at a September 26 event at the White House in which Trump formally announced Amy Coney Barrett as his choice of nomination for the u.S. Supreme Court later tested positive. These include Hope Hicks, Mike Lee, Thom Tillis, and Kellyanne Conway[3]

Hospitalization

Airlift to Walter Reed and experimental treatments, October 2

Donald Trump Twitter
@realDonaldTrump

Tonight, @FLOTUS and I tested positive for COVID-19. We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!

October 2, 2020[4]

The afternoon of the same day, the White House announced that Trump would be hospitalized at Walter Reed National Military Medical Center in Bethesda, Maryland "for the next few days" "out of an abundance of caution", on the recommendation of the medical team headed by Sean Conley, a doctor of osteopathy who had been the Physician to the President since 2018. Because he was a Navy commander, Conley was oblighed to follow the orders of his commander-in-chief.[5] Trump, who was wearing a mask, was briefly filmed walking unassisted from the White House to the Marine One helicopter outside to transport him to Walter Reed.[6] According to White House Chief of Staff Mark Meadows, Trump was hospitalized because he "had a fever and his blood oxygen level had dropped rapidly".[7] The Associated Press reported that "a person familiar with Trump's condition confirmed that Trump was given oxygen at the White House" in the morning before arriving at Walter Reed, although Trump's doctors refused to say whether he had ever been given supplemental oxygen.[8]

Trump had Walter Reed personnel sign non-disclosure agreements in 2019 before they could be involved in treating him. Two doctors refused to sign the NDAs and were not allowed to have any involvement in his care. Medical personnel are already prohibited by the Health Insurance Portability and Accountability Act (HIPAA) from releasing personal health information without consent. Medical ethics professor Arthur Caplan called the NDAs redundant.[9]

Experimental treatments, October 2

On Friday afternoon, physicians revealed Trump had been given an experimental course of monoclonal antibodies from drug maker Regeneron Pharmaceuticals,[10] which further confirmed that Trump had received an "8 gram dose of REGN-COV2".[11] The drug was immediately provided in response to a "compassionate use" request from the medical team.[12] That night, Trump received his first infusion of remdesivir, an antiviral drug that disrupts virus replication. Remdesivir has not been approved by the Food and Drug Administration, but has been used as an emergency treatment for hospitalized COVID-19 patients.[13] The extremely aggressive combination was described as "uncharted territory"; Trump is believed to be the first individual to ever undergo both treatments simultaneously.[14]

Steroid treatment, October 3

'Dr. Sean Conley, Physician to the President, Provides an Update on President Trump' – video courtesy of the White House.

At an 11 a.m. press conference on October 3, Conley stated that Trump was not currently on oxygen, that he had not had a fever for the past 24 hours, and that he was "doing very well".[15][16][17] Conley described Trump as being "just 72 hours into the diagnosis now", raising questions among journalists about when the diagnosis had actually been made, since it had been publicly announced only 36 hours previously. A 72-hour timeline would suggest that Trump actually knew he had the infection on September 30, but proceeded with his plans for a public rally that evening and a fundraiser on October 1.[18] Conley later clarified that he had meant "day three" instead of "72 hours", referring to the then-current time of Saturday morning compared to the diagnosis time of Thursday night (about 36 hours). Doctors also revealed that he had exhibited symptoms on October 1, including a "mild cough, and some nasal congestion and fatigue".[19] When Conley was asked if Trump was on steroids, Conley ended the briefing.[20][21]

Trump in the Walter Reed conference room, October 3. There were some reports of speculation that the photo was "staged".[22]

Minutes after the press conference, an anonymous source — later identified as Meadows[23] — contradicted the assessment from the doctors, saying "The president's vitals over the last 24 hours were very concerning and the next 48 hours will be critical in terms of his care", adding "We're still not on a clear path yet to a full recovery."[24][25] Shortly thereafter, Meadows stated on the record the president was "doing very well".[26] That night, Conley warned that Trump was "not yet out of the woods" with regard to his condition.[27] The White House released two photos which showed Trump working at the hospital, according to their captions; strangely, the president was signing documents that appeared to be blank.[22]

Motorcade excursion, October 4

Sean Conley's press update on President Trump, October 4 – video courtesy of the White House

In an October 4 press conference, Trump's medical team claimed that he was "doing really well" after his oxygen level dipped the day before and after he was given the steroid dexamethasone, which works by reducing inflammation in the lungs,[28] but can have significant mental health side effects, including psychosis, delirium and mania.[29][30][improper synthesis?] Asked if CT scans showed pneumonia or lung damage, Conley said, "There's some expected findings, but nothing of any major clinical concern." He declined to say what was found.[31] When asked why he was reluctant to disclose that Trump had been given oxygen during the October 3 briefing, Conley stated that he did not want to "give any information that might steer the course of illness in another direction" and "it came off that we're trying to hide something, which wasn't necessarily true."[32] White House Director of Strategic Communications Alyssa Farah later stated that it was "a common medical practice that you want to convey confidence, and you want to raise the spirits of the person you're treating," while also asserting that Meadows' anonymous statement to reporters was intended to "give you guys more information just to try to be as transparent as we can," effectively conceding Conley was addressing the president on television, rather than the public.[33][34] The president was reported to be angry about Meadows' off-the-record assessment.[35]

Trump greets supporters from inside an SUV on October 4.

Later in the day, Trump briefly departed the hospital in order to ride past a gathering of supporters at the medical center, waving from the back seat of an SUV, before returning.[36] Medical experts stated that the outing endangered the Secret Service agents accompanying Trump inside the vehicle due to his infection.[37][38] James Phillips, doctor of emergency medicine at George Washington University and an attending physician at Walter Reed, called the drive-by "insanity" for "political theater" and wrote that Trump had endangered the Secret Service agents in the presidential SUV by potentially exposing them to COVID-19.[39][40]

Within the Secret Service, some agents expressed outrage or frustration with Trump's behavior.[37][41][42] One anonymous agent told journalists, "He's not even pretending to care now."[41] Joseph Petro, a former veteran Secret Service agent and senior official, wrote in a Washington Post op-ed that Trump's behavior was part of a longstanding pattern of endangering others; he also criticized Secret Service management for an "inexcusable lack of concern" for the health of agents and their families.[43]

Return to White House, October 5

Sean Conley's press update on President Trump on October 5 – video courtesy of the White House

At 2:37 p.m. EDT on October 5, Trump tweeted that he would be discharged from the hospital at 6:30 p.m. that day.[44] However, doctors said in an afternoon news briefing that Trump continued to be treated with dexamethasone and remdesivir.[45] The prospect of Trump's early release astonished infectious disease experts, who noted that Trump planned to be discharged in a period when COVID-19 patients are particularly vulnerable (7–10 days after symptoms first appear) to unpredictable and rapid declines in condition.[46] Outside physicians stated that the depiction of Trump's illness as relatively mild was inconsistent with the aggressive treatment he was receiving.[46] Trump's medical team made cryptic remarks about his status and declined to say whether Trump's CT scans contained indications of pneumonia or lung damage.[46] Trump made phone calls in which he shared the idea of him leaving the hospital feigning frailty, but would then rip open his dress shirt to reveal a Superman T-shirt underneath, as reported by The New York Times.[47]

After reportedly pressuring his doctors to release him,[48] he was discharged and arrived at the White House shortly before 7 p.m. He stood for a photo op at the South Portico balcony, where he removed his mask despite being potentially contagious.[49][50] Having climbed two flights of stairs to the balcony, Trump appeared to breathe heavily as he steadied himself. He then gave a salute before walking inside.[45][48] He later went back outside with a camera crew to reshoot his entrance.[51] Within an hour of his arrival he released a video showing Marine One's flight and landing and his saluting pose. The video included a message saying, "We're going back to work. We're going to be out front. As your leader, I had to do that. I knew there's danger to it, but I had to do it. I stood out front. I led. Nobody that's a leader would not do what I did. And I know there's a risk, there's a danger, but that's OK. And now I'm better and maybe I'm immune, I don't know. But don't let it dominate your lives."[52] The message was widely criticized. The New York Times commented, "Trump's statement was meant to cast his illness as an act of courage rather than the predictable outcome of recklessness."[53] He also echoed a message he had earlier tweeted: "Don't be afraid of Covid. Don't let it dominate your life" – a message which reportedly angered many survivors of the virus or people who had lost loved ones to the disease.[54] The New York Times tabulated that Trump's tests, treatments, airlifts, and hospital stay, if given to an average American, would have cost more than $100,000. The helicopter rides alone would have cost $40,000 after insurance.[55]

Return to the West Wing, October 6–7

On October 6 and 7, Trump made no public appearances and had an empty public schedule, although he made more than 50 Twitter posts.[56] In the tweets, Trump compared SARS-CoV-2 to the flu and falsely claimed that the flu had higher death rates: "Are we going to close down our Country (because of the flu)? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!"[57] Many doctors expressed alarm at the notion that the public should "learn to live with" the pandemic. Twitter tagged the post with a "misleading and potentially harmful information" flag, and Facebook removed a similar post by Trump.[58] Four hours after the tweet, and after it was flagged by Twitter's staff, Trump tweeted "REPEAL SECTION 230", an attack against Section 230 of the Communications Decency Act, which protects online platforms from litigation surrounding the content their users post.[59]

Trump's behavior on October 6 caused some White House staffers to wonder if he was being influenced by the cocktail of drugs he had been taking. Aides said that Trump still sometimes sounded as if he was trying to catch his breath;[60] Trump continued to receive remdesivir treatment inside the White House and conducted business without wearing a mask.[61] Dr. Conley said in a memo that Trump has "no symptoms" and is doing "extremely well."[62]

On October 7, Trump insisted on conducting business in the Oval Office, although he was supposed to be quarantined in the residential portion of the White House and rooms had been set up there where he could work. He reportedly entered the Oval Office through an outdoor entrance so as not to encounter staff. Only two aides – Mark Meadows and Dan Scavino – spent time with him there, fully dressed in personal protective equipment.[63][64]

Return to public events, October 8–12

Trump speaking to a crowd in the White House grounds on October 10, 2020

Trump suggested that he could have gotten COVID-19 from family members of fallen soldiers who were at the September 27 reception for Gold Star Families. He said on a Fox Business interview on October 8 that the family members "come within an inch of my face" and that "They want to hug me, and they want to kiss me."[65] Trump did not wear a mask during the event. The White House later clarified that "based on contact tracing, the data we have, we don't think it arose from that event" while defending holding such events indoors with few or no masks.[66] Trump also said in the interview that he remains on dexamethasone.[67]

Dr. Conley issued a memo that day saying that Trump's condition was stable and he was "devoid of symptoms". He added that "Saturday (October 10) will be day 10 since Thursday's diagnosis, and based on the trajectory of advanced diagnostics the team has been conducting, I fully anticipate the president's safe return to public engagements at that time."[68] Ten to 20 days is the CDC's recommendation for how long people should isolate themselves after having COVID-19.[69] In an interview that night, Trump said he would like to hold a rally in Florida on October 10 and one in Pennsylvania on the 11th.[69]

On October 10, Trump held his first public event since being diagnosed with the virus, speaking briefly from the South Lawn portico to hundreds of guests.[70] Conley said on October 12 that Trump tested negative on "consecutive days" using rapid antigen tests and that the results of a PCR test, along with CDC guidelines for mild to moderate cases, indicate that he is not infectious.[71][72] The CDC says it "does not recommend using antigen tests to make decisions about discontinuing isolation" and that negative tests should be confirmed with a PCR test.[73] Later that day, Trump held his first rally since being diagnosed, in Sanford, Florida.[74] The Wall Street Journal, The Washington Post, and other news outlets did not send reporters to travel with Trump, citing concerns over basic precautions.[75]

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