After a briefing on Sunday at Walter Reed Medical Center, where President Donald Trump is being treated, several crucial questions about the president’s health remain unanswered by his medical team, led by his personal physician, Navy Commander Dr. Sean Conley
WHAT DID WE LEARN ABOUT TRUMP’S HEALTH ON SUNDAY?
President Trump’s oxygen levels have dropped twice since his diagnosis but never below 90 per cent, Dr. Sean Conley said on Sunday, also admitting for the first time the president received supplemental oxygen. A normal oxygen reading is between 95 and 100 per cent.
Conley said the president received supplemental oxygen for about an hour on Friday at the White House and the drop – along with a ‘high’ fever – is part of what prompted the decision for Trump to go to Walter Reed. He could not say if the president received supplemental oxygen on Saturday. ‘I would have to check with the nursing staff. If he did, it was very limited,’ Conley said. Conley, on Saturday, evaded questions on whether the president received extra oxygen.
Additionally, Dr. Brian Garibaldi, a specialist in pulmonary critical care on the president’s medical team who practices at John Hopkins, said Trump received a second dose of the experimental drug remdesivir along with a first dose of dexamethasone, a steroid, on Saturday. He noted the president isn’t showing any side effects ‘that we can tell.’
Dexamethasone has been shown to help patients who are severely ill with COVID but it’s not typically used in mild cases. In could be harmful early on as it could dampen the body’s own immune response. On September 2, the World Health Organization recommended the steroid only be given to patients with ‘severe and critical Covid-19.’
TO WHAT EXTENT HAS TRUMP BEEN GIVEN SUPPLEMENTAL OXYGEN AND WHEN?
Dr. Conley revealed publicly for the first time Sunday that ‘over the course of his illness the president has experienced two episodes of transient drops in his oxygen saturation.’ A drop in the body’s ability to transport oxygen through the blood is one of the dangerous complications associated with COVID-19. Physicians like to see the number above 95 per cent.
As a response, the team decided to initiate use of Dexamethasone, a steroid and anti-inflammatory. Trump’s first dose of the drug, added to his numerous other medications, came Saturday. The president’s oxygen level was in the ‘high 90s’ Thursday night and Friday morning, Conley said.
But later Friday morning, the oxygen saturation level was ‘transiently dipping below 94 per cent,’ Conley said. At that point, Conley recommended ‘we try some supplemental oxygen, see how he’d respond. He was fairly adamant that he didn’t need it. He was not short of breath. He was tired, had the fever and that was about it. And after about a minute, on only two liters, his saturation levels were back over 95 per cent,’ he said.
‘He stayed on that for about an hour, maybe, and it was off and gone,’ said Conley. When questioned, Conley said that on Saturday ‘there was another episode’ where the level dropped down ‘about 93 per cent. He doesn’t ever feel short of breath. We watched it, and it returned back up.’
Asked point-blank if Trump was put on oxygen for a second time Saturday, Conley dodged.
‘I’d have to check with the nursing staff,’ said Conley, who is overseeing Trump’s care. ‘I don’t think that – if he did, it was very, very limited. But he’s not on oxygen. And the only oxygen that I ordered that we provided was that Friday morning, initially.’
Asked when the second incident occurred, he said it was ‘over the course of the day – yesterday morning.’ His comments, vague and sometimes contradictory as they were, went far beyond what he was willing to say Saturday, when he refused to answer whether Trump had ever been on oxygen during his still-early bout with COVID-19.
On Saturday, when pressed, he said: ‘He’s not on oxygen right now.’ Asked if Trump had received any, he said then: ‘He’s not needed any, this morning, today at all. That’s right.’ Then he said that ‘right now, all indicators are that that he’ll remain off of oxygen going forward.’
Pressed yet again on whether Trump had ever been on oxygen, Conley said: ‘He, right now he is not on oxygen.’
‘I understand, I know you keep saying right now, but should we read into the fact that he had been previously?’ a reporter continued.
‘Yesterday and today he was not on oxygen,’ said Conley.
That statement is contradicted by his Sunday statement that the president was put on oxygen Friday morning.
HOW CAN DOCTORS PLAN TRUMP’S RELEASE WHEN HE IS ON A STEROID USED FOR VENTILATOR PATIENTS IN ICU AND REMDESEVIR, WHICH IS SUPPOSED TO BE TAKEN IN HOSPITAL ONLY?
Garibaldi said the president ‘continues to look and feel as well as he does today, our hope is to plan for a discharge as early as tomorrow.’ But what hasn’t been clarified is how the president will continue his treatment of drugs that are usually only given in hospital settings. President Trump received a second dose of remdesvir, an antiviral drug given temporary FDA approval to treat severe cases of COVID, on Sunday, according to his medical team. The drug, which is injected in the arm, is only supposed to be given in a hospital setting. A typical course of it lasts five days. Additionally, the president’s doctors said he received a first dose of dexamethasone, a steroid that has been found to significantly reduce the risk of death among patients who are on a ventilator.
DO WE KNOW THE FULL TRUTH ABOUT TRUMP’S HEALTH?
Among the questions not answered at the briefing about the president’s health: how low did his blood oxygen levels go, does he show signs of pneumonia, does he have heart and lung damage, and is he in a negative pressure room. Additionally, Conley said the president’s temperature was ‘high’ but did not say how high it went. When asked about President Trump’s oxygen levels, Conley said: ‘It was below 94%. It wasn’t the low 80s or anything.’ He was asked about any damage to the president’s heart or lungs, which can happen to COVID patients, but only said it was being tracked. ‘There’s some expected findings but nothing of any major clinical concern,’ Conley said. He declined to answer several specific questions on the president’s health and about his treatment, including whether Trump was in a negative pressure room, which can help combat the spread of COVID. ‘I’m not going to get into the specifics of his care,’ Conley said. The White House still hasn’t answered when the president last tested negative for COVID.
HAVE DOCTORS TOLD THE TRUTH ALL ALONG?
Conley was asked why he and White House Chief of Staff Mark Meadows gave different pictures of the president’s health on Saturday with Conley painting a positive picture and Meadows saying the president went through a ‘very concerning’ period. ‘I was trying to reflect the upbeat attitude of the team, that the president, that his course of illness has had,’ Conley said. He added that he ‘didn’t want to give any information that might steer the course of illness in another direction. And in doing so, came off like we’re trying to hide something, which wasn’t necessarily true.’ Dr. Conley grinned on Saturday as he repeatedly said Trump as ‘not on oxygen now.’ Pressed repeatedly about the president ever having had it he said: ‘Thursday, no oxygen, none at this moment, and yesterday with the team, while we were all here, he was not on oxygen.’ About an hour later the New York Times and Associated Press reported Trump was given oxygen at the White House residence. There has been no official denial or confirmation but Dr. Conley had left that possibility open. Why he would not confirm it is unknown.
HAS THE PRESIDENT OR ANYONE ELSE ORDERED DOCTORS NOT TO BE FULLY TRANSPARENT?
This is simply unknown. Dr. Conley has never spoken to reporters before Saturday, and read initially from a prepared statement on both Saturday and Sunday. He has had lengthy time with the president and as a patient, the president has veto over any aspect of revealing his medical information, such as when and how he was diagnosed, his use of oxygen and his maximum temperature. Also present at Walter Reed is Mark Meadows, the White House chief of staff. He does not formally control Dr. Conley who is in the military chain of command, but is a member of the Cabinet and would be seen as having authority to act on the president’s behalf to control the release of information.
WHAT TEMPERATURE DID THE PRESIDENT’S FEVER SPIKE AT?
This simple question was not answered. On Sunday, Dr. Conley said Trump had a ‘high’ fever but did not say what it was. It is a crucial clinical indication but all Dr. Conley would say on Saturday is that he had been fever-free for 24 hours – since Friday morning. A Vanity Fair report said it reaches 103F on Friday early in the morning.
DOES THE PRESIDENT HAVE HEART OR LUNG DAMAGE?
Dr. Conley was asked about heart and lung damage, which can happen to COVID patients, but said it was being tracked. ‘There’s some expected findings but nothing of any major clinical concern,’ Conley said. On Saturday, he said: ‘We’re following all of that. We do daily ultrasounds. We do daily lab work. The team is tracking all of that.’ But that does not say if there is any damage to his lungs.’ He simply ignored a question about Trump’s heart.
DO WE KNOW EVERY DRUG OR TREATMENT HE HAS TAKEN?
The White House in two statements has detailed drugs Trump has been given. On Friday’s afternoon it said he was given the experimental Regeneron antibody ‘cocktail’ as well as zinc, Vitamin D and the histamine-blocker famotidine. Then late on Friday night a statement from Dr. Conley said he had been given the antiviral Remdesvir and, on Sunday, doctors said Trump received a second dose. Additionally, Dr. Brian Garibaldi said Trump received a first dose of dexamethasone, a steroid, on Saturday. Trump previously took hydroxychloroquine in late May and early June despite its use at the time being at best questionable and at worst risky. In June Dr. Conley said Trump takes three daily drugs: 40mg of Rosuvastatin, a statin; 1mg of finasteride, the hair-loss drug generally marketed as Propecia; and 81mg of aspirin.
DO WE KNOW ALL THE PRESIDENT’S UNDERYING CONDITIONS?
We do not know if we do. The last medical report in June said he was clinically obsess but had health cholesterol, resting heart rate and blood pressure., normal kidney, liver and thyroid function, normal blood count and normal Vitamin V12 and Vitamin D levels. But the White House has never explained fully his mystery trip to Walter Reed in November 2019 when Mike Pence was told to be on ‘standby’ to assume the powers of the presidency. Since then Trump’s struggle to walk down a ramp at West Point and his strange drinking of water with two hands has been the subject of widespread speculation about cognitive issues. He has denied having ‘a series of mini-strokes’ in an angry tweet but his physician has never fully addressed the visit or his cognitive state.
WHO IS TREATING THE PRESIDENT?
His treatment is being led by Dr. Sean Conley, who introduced other Walter Reed staff – including pulmonary specialists – and Dr. Brian Garibaldi who has been brought in from Johns Hopkins in Baltimore. But the White House has not answered questions on the names of his full team. It has also not said if he or Dr. Conley have consulted other doctors on the coronavirus task force including Dr. Tony Fauci and Dr. Deborah Birx, both renowned specialists. And it has not said if he has consulted Dr. Scott Atlas the controversial member of the taskforce who has spoken in favour of ‘herd immunity’ and minimized the importance of masks, and been called an ‘outlier’ who gives ‘bad information’ by Dr. Fauci. Also unaddressed is whether Dr. Conley has reached out to Admiral Ronny Jackson, Trump’s last White House doctor. He quit after his nomination to run Veterans Affairs was withdrawn and an investigation opened into whether he was drunk on the job and gave out prescription drugs to staffers, earning the nickname ‘Candyman.’ He had previously claimed the president could ‘live to 200.’ On Friday he tweeted that the president was ‘asymptomatic’ which quickly became plainly untrue. He is running for Congress as a Republican and it is unclear if he retains a medical registration.
WHEN PRECISELY WAS HE DIAGNOSED WITH COVID-19?
We still do not know. We now have had three different versions of when Trump was diagnosed from the White House, ranging from Wednesday morning to Friday at 1am. The White House has also not said what ‘diagnosed’ means – it could mean spotting clinical symptoms or testing positive.
The White House first announced Donald Trump’s positive test result – and that of the first lady – at 1am EST on Friday morning. But Dr. Sean Conley said on Saturday morning just before midday that the president was ‘ 72 hours into the diagnosis.’ That would mean he was diagnosed with COVID on Wednesday and as early as Wednesday morning – after he returned from the presidential debate with joe Biden and before he took part in a White House South lawn event then flew to Minnesota for an indoors fundraiser and outdoors rally. Dr. Conley then offered a different version saying that on Thursday afternoon ‘we repeated testing’ and Trump was given a PCR test – the most accurate kind because he ‘gave a kind of clinical indication.’ He did not say if that was before or after he flew to New Jersey for an indoors fundraiser. Trump himself told Sean Hannity shortly after 9pm that night that he was waiting for a test. After Conley spoke a White House source said ‘on background’: ‘The doctor meant it’s day 3, not yet 72hrs. Diagnosis made Thursday night.’ Then in another turn, White House press secretary Kayleigh McEnany issued a written statement from Conley saying he ‘incorrectly used the term ‘seventy two hours’ instead of ‘day three’ and ‘forty eight hours’ instead of ‘day two.’ He added that the first diagnosis was on ‘Thursday evening.’
WHEN PRECISELY WERE SYMPTOMS FIRST DETECTED AND WHEN PRECISELY WAS HE TESTED?
Again we do not know. There is no clarity over when Trump was last tested before his positive result. Dr. Conley repeated the White House claim that he is tested ‘frequently’ but did not say what that meant. They have never said if he was routinely given the less accurate Abbott Labs 15 minute test or the advanced OCR test.
When he arrived at Tuesday’s presidential debate Trump was too late to be tested by the Cleveland Clinic. Moderator Chris Wallace said there was an ‘honor system’ for the candidates; Trump’s team told the Debate Commission he was negative. That night he was said to have fallen asleep on Air Force One home from the presidential debate, in contrast to normally watching television and tweeting. But it is unknown if this was seen as a possible symptom at the time.
Dr. Conley initially said Trump was diagnosed ’72 hours’ before the Saturday statement which would mean Wednesday morning.
Trump then went to Minnesota on Wednesday for a fundraiser and a rally, where he spoke for 45 minutes, far less than his usual performances of more than an hour. It is unknown if this was treated as a symptom. Hope Hicks’ positive result came on Thursday morning but nobody has said if Trump was tested as soon as it was given or if it was until late Thursday afternoon that he was given a full nasal swab.
DID HE GO TO ANY EVENTS WHEN DOCTORS SUSPECTED HE WAS UNWELL OR HAD BEEN DIAGNOSED WITH CLINICAL SYMPTOMS OF COVID?
The White House doctors and series of statements offer no insight into when Trump first felt unwell; when anyone suspected he was unwell; when he was first tested; and if a doctor had seen clinical signs of COVID before he was nasally swabbed. That means that Trump could have gone to any or all of a Minnesota fundraiser and rally; a White House South Lawn event; and a New Jersey fundraiser with doctors suspecting he had COVID or even having tested him for it.