Donald Trump will continue taking a cocktail of drugs to combat COVID-19 while he fights the virus from the comfort of the White House, rather than the Walter Reed hospital.
The president received oxygen on Friday in the White House, and medics will be ready in case he needs it again.
He also, on Friday, begun a course of remdesivir – an antiviral drug administered intravenously, which was first developed as a treatment for Ebola.
He had his fourth dose on Monday night at Walter Reed, and will have his fifth and final dose at the White House.
The 77-year-old will also continue to take the steroid dexamethasone – a relatively common and inexpensive anti-inflammatory drug which increases energy, well-being and reduces pain. It was unclear how long he would continue taking the steroid: it is normally prescribed for ten days, because after two weeks effects such as paranoia and anger can begin to creep in.
On Friday he also took a one-off eight gram dose of regeneron, a lab-made antibody designed to fight the virus.
In addition, the president takes zinc, vitamin D, famotidine, melatonin and aspirin, his doctors say.
It is not clear if any of these are deliberately for COVID-19, and whether he was continuing to take them in addition to his other drugs.
Zinc is a mineral that does have a role in the immune system, but there is no evidence that such supplements improve people’s ability to fight the virus.
Vitamin D is known as the sunshine vitamin as it is made in the skin in response to sunlight. It also has a role in a healthy immune system, but again there is no evidence that taking supplements helps against Covid 19.
Famotidine decreases stomach acid production and is used for people with stomach ulcers or reflux, and there is some suggestion it may help with COVID treatment.
Melatonin is a hormone the body makes in the evening while people sleep; it is sometimes given as a treatment for insomnia.
Aspirin is a pain killer and blood thinner that is used to reduce the risk of blood clots. His doctors failed to clarify whether he was taking blood thinners; there were some suggestions he was not, because his brother Robert, who died in August, had been taking them and died of a brain bleed.
Doctors on Monday said that while Trump was not ‘out of the woods’, they were satisfied he could go home.
They refused to share details of his health, like when he last tested negative, citing medical privacy laws as reasons not to share information like the results of a lung scan.
The president’s kidney and liver function are both good, they said. His temperature on Monday was 98.1F.
The doctors defended their treatment of him and of the decision to discharge him, saying he has some of the best care in the world at the White House.
‘Every day a patient stays in the hospital unnecessarily is a risk to themselves. There’s nothing being done here that can’t be done safely at home,’ said Dr Sean Conley, presidential physician.
‘We all remain cautiously optimistic and on guard, because we’re in a bit of uncharted territory when it comes to a patient that received the therapies he has so early in the course.’
On Monday night Trump walked out of Walter Reed, took Marine One back to the White House – and took off his mask almost immediately.
He saluted, waved, and then started filming a video on the balcony of the South Portico, returning to an executive mansion where multiple aides and household staff also have the virus, and from where he promises he will soon leave to hit the campaign trail.
Removing his mask was a jarring end to three days of drama which saw him medevaced to Walter Reed on Marine One on Friday, revealed to have been on oxygen repeatedly, and treated with drugs not available to ordinary Americans.
Two staffers were visible behind him: official photographer Andrea Hanks filmed his arrival back to the executive mansion with a videographer standing by for a campaign video.
Less than half an hour later the video emerged: a slow-motion, cinematic production showing an apparently vital commander-in-chief’s return, with only the site of Marines in masks giving away the fact that Trump was so ill that he was given oxygen and steroids normally reserved for people on ventilators.
Also waiting his arrival was trade adviser Peter Navarro, 71, who stood at the entrance.
Navarro is himself at elevated risk thanks to his age but he has been an advocate of hydroxychloroquine in the past.
Having gone inside, Trump went back out to the balcony almost immediately, apparently to reshoot the video – extending the exposure of his aides to the virus.
His move was on the day that the CDC officially warned that the coronavirus is spread through the air.
Trump returns to a White House which has been devastated by the virus since he left. Inside the residence is the sick First Lady; upstairs in the housekeeping department two staff have tested positive.
In the West Wing, the Press Secretary Kayleigh McEnany and two of her aides have tested positive – after she tested negative for days and spent the time briefing reporters without a mask – along with others members of his inner circle.
His bodyman Nick Luna, one of the few staff who moves between the East and West Wings is positive; his attorney general Bill Barr, 70, is self-isolating after going to the unveiling of Amy Coney Barrett as the Supreme Court nominee on the previous Saturday and funding himself at a super spreader event.
Chris Christie, who was there and prepared Trump for his debate, is in the hospital after testing positive. Three Republican senators, two clerics – a Catholic priest and an evangelical pastor – and his former aide Kellyanne Conway are all positive after the same event.
Outside his polls have plunged again, his rival Biden hit the campaign trail in Florida, where Republicans are fighting a rearguard action against a tide of Democratic cash.
Before he left Walter Reed Trump tweeted ‘do not let it dominate your life’ after receiving the combination of experimental treatments.
The U.S. death toll stood at 210,013 and earlier in the day Dr Anthony Fauci warned that the country was ‘not in a good place.’
On Monday evening his campaign released a parody video of the president dodging what appeared to be the coronavirus before scoring a touchdown.
In the clip, which is a parody of a San Francisco 49ers game highlight, shows Trump’s face on the body of rookie wide receiver, Brandon Aiyuk.
The video shows Trump hurdling a defender that appeared to be the coronavirus.
Trump is then seen making a touchdown before being tackled by another player.
The real moment occurred during an NFL game between the 49ers and the Philadelphia Eagles on Sunday night.
The Eagles – the virus – won 25-20.
Trump had walked out of the hospital at 6:40pm.
Before he departed, aides set up lights outside the hospital doors to set the scene for the president’s big moment, giving Trump the dramatic, ‘made-for-TV’ moments he loves.
Trump turned his exit from the hospital into a show of strength, walking out the door and pumping his fist and giving a thumbs up sign as he walked to an SUV saying: ‘Thank you everybody.’
But he was asked by a waiting reporter: ‘How many of your staff are sick? Are you a super spreader?’
He wore a surgical mask.
He was followed by Mark Meadows, the White House chief of staff, Dan Scavino, his director of social media, and Dr Sean Conley, his osteopath White House physician.
All three of the aides were wearing face shields and what appeared to be N-95 masks. They were followed by Secret Service agents, also in more PPE than Trump.
Marine One lifted off at 6:45pm, and landed at 6:55pm on the South Lawn of the White House.
Marine One’s crew will have to isolate for 14 days, and the helicopter will have to be deep cleaned.
On arrival at the White House, his walk up the stairs was no doubt a show of fitness.
But his flagrant disregard of medical guidelines with his removal of his face mask will add to the criticism he’s faced about how he’s managed his diagnosis.
Trump, 74, was admitted to Walter Reed on Friday amid reports he had trouble breathing and had a fever.
He has received care from the best doctors in the country, and has been driven around in an SUV to wave at fans who lined up outside to greet him – a move that outraged critics who said he put Secret Service agents’ lives at risk for a political stunt.
‘Will be back on the Campaign Trail soon!!!’ he tweeted on Monday evening, shortly before departing.
‘The Fake News only shows the Fake Polls.’
Crowds of supporters held a vigil outside the hospital, and were rewarded with the drive-by.
People wore ‘Make America Great Again’ paraphernalia, waved campaign signs and hoisted Americans flags.
One woman waved a ‘we [heart] u Mr. Trump sign’ while another man waved a ‘We [heart] Trump’ sign.
Dr Conley cited patient confidentiality laws during the press conference when asked about Trump’s lungs.
He did however say that his liver and kidney function were good and that Trump did not put any pressure on doctors to release him, despite earlier reports that he was ‘done’ with staying in hospital and was ‘demanding’ to be discharged on Sunday.
‘The president has been a phenomenal patient during his stay here,’ said Dr Conley.
‘He has been working hand in glove. Today it got the point, he’s holding court, going over all the specifics, the testing, what the future is.
‘We’ve been back and forth on what’s safe or reasonable.
‘He has never once pushed us to do anything that was not sage and reasonable.’
The doctor said that Trump was ‘a little dehydrated on Friday’ but he was able to recover from that.
‘Everything looks great. There is no evidence of live virus present that he could transfer to others,’ he said.
‘We’re checking him more routinely than waiting 10 days. We will know as soon as possible – then we’ll look at him clinically. How are you feeling? How are you doing?’
Fourteen people in Trump’s inner-circle have now tested positive with the deadly virus that has claimed more than 210,000 American lives.
He has been desperate to get back to the White House since Sunday and, according to aides, fears that staying in hospital any longer will make him look weak.
It comes amid claims that the President knew he had tested positive with the virus on Thursday night but kept it secret during an interview on Fox.
White House Chief of Staff Mark Meadows on Monday insisted to Fox News that Trump was in good health and made ‘good progress’.
He also defended Trump’s outing on Sunday, as have other allies including former campaign manager Corey Lewandowski and Rudy Giuliani.
Meadows said: ‘He is ready to get back to a normal working schedule.’
In a flurry of tweets starting at 6.30am on Monday, Trump boasted about the stock markets, promised to deliver more tax cuts and listed ‘pro life’, ‘space force’, ‘religious liberty’ and ‘law and order’ as among reasons why he should win again.
Over the weekend, Trump released several video addresses where he promised to be in good health despite his diagnosis, and the White House shared photographs of him working at the hospital.
He claims to have been meeting some of the wounded veterans who are also being treated in the hospital.
On Sunday night, he made a surprise appearance outside the hospital to thank fans who had turned out with signs, flags and banners wishing him a speedy recovery.
Trump said he was touched by the outpouring of support and wanted to show his appreciation.
But doctors – including one from Walter Reed – say it was irresponsible of him to get into the presidential SUV with Secret Service agents and risk infecting them.
Dr James Phillips, a Walter Reed attending doctor, condemned the president’s Sunday afternoon drive, which violated Centers for Disease Control (CDC) guidelines.
Meadows dismissed the criticism on Monday morning in an interview with Fox.
‘The president expressed appreciation to some of the people outside Walter Reed yesterday. Even that was getting criticism.
‘How do we think that he got here? We came in Marine One. The agent who’s been with him… we took additional precautions with PPE.
‘A number of folks are just trying to make a big deal of that when indeed, I know that myself and some of the Secret Service detail are right there with him trying to make sure he’s protected each and every day and that he returns to the White House as expeditiously as possible.’
Corey Lewandowski, his former campaign manager, also defended the outing.
He told Today that the agents involved volunteered to drive him and came under no duress.
‘The president wanted to thank all the supporters. The detail leader and the driver both volunteered for that assignment.
‘They were not required to do that.
‘They volunteered. There was a piece of plexiglass between the two agents and the president.
‘The president wanted to show his supporters how much he appreciated them and show that you can still continue to function with COVID-19. He’s a leader. He wants to lead. This was the president out thanking his supporters for supporting him.’
In an interview with Good Morning America on Monday morning, Dr. Phillips doubled down on his claims that it was irresponsible.
‘I don’t know what the benefits of this political stunt were, but I do know what the risks were.
‘My concern is that perhaps the Secret Service agents were inside don’t know the full risk of what they were up against.
‘So far as the military and Johns Hopkins physicians who are taking care of this patient, they’re excellent.
‘But they are also under undue pressure and a lot of influence outside of that normal physician-patient relationship.
‘Influence weighs heavy and when we’re dealing with a highly unusual environment like what we’re in right now, the question is – and I’d love to hear the answer from some military physician folks – where does that line between that physician patient relationship come into contact with the commanding officer and subordinate relationship?’
Phillips, chief of disaster medicine at George Washington University’s Emergency Medicine division, and a Covid-19 consultant specializing on how to reopen safely, said that the design of the presidential vehicle, specifically modified to protect the passengers from attacks, made the drive even more dangerous.
‘That Presidential SUV is not only bulletproof, but hermetically sealed against chemical attack,’ he continued.
‘The risk of COVID19 transmission inside is as high as it gets outside of medical procedures. The irresponsibility is astounding. My thoughts are with the Secret Service forced to play.
‘Every single person in the vehicle during that completely unnecessary Presidential ‘drive-by’ just now has to be quarantined for 14 days,’ Phillips pointed out.
‘They might get sick. They may die. For political theater. Commanded by Trump to put their lives at risk for theater. This is insanity.’
The CDC website explicitly states that COVID patients should stay at home except to get medical care.
In their section advising healthcare workers, the CDC states: ‘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.’
Doctors said the president’s treatment with dexamethasone – a steroid used for patients who require extra oxygen – is the clearest sign yet that Trump may have a severe case of COVID-19.
Other doctors also took issue with Trump’s medical team’s rosy picture of his health.
‘People can be doing OK, but it can get rocky very quickly,’ said Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security.
The experts told the Washington Post that Trump’s medical team has withheld key information about his condition, and that he was on a ‘kitchen sink’ regimen of monoclonal antibodies, the anti-viral remdesivir, and steroids.
‘For someone sick enough to have required remdesivir and dexamethasone, I can’t think of a situation in which a patient would be OK to leave on day three, even with the White House’s medical capacity,’ Robert Wachter, chairman of the University of California at San Francisco’s department of medicine, told the paper.
A second doctor, Jonathan Reiner, professor of medicine and surgery at George Washington University, echoed Dr Phillips’ condemnation.
‘By taking a joy ride outside Walter Reed the president is placing his Secret Service detail at grave risk,’ he said.
‘In the hospital when we go into close contact with a COVID patient we dress in full PPE: Gown, gloves, N95, eye protection, hat. This is the height of irresponsibility.’
And Dr Craig Spencer, an ER doctor who survived Ebola and is currently director of global health in emergency medicine at Columbia University, was shocked at the president’s ‘joyride’.
‘Moments after stating ‘I learned a lot about COVID’, the President takes a joyride in an enclosed space with presumably #COVID19 negative people, all while on experimental medications,’ he said.
NBC News’ Peter Alexander said on Sunday night that he had asked why Melania Trump was not visiting her husband, and was told it was because she did not want anyone else to become infected.
‘Reminder: A White House official, on Saturday, told me the First Lady would not be visiting Trump at Walter Reed because ‘she has COVID and that would expose the agents who would drive her there,” he tweeted.
A crowd Trump’s supporters gathered outside the Bethesda, Maryland, hospital – and many were not wearing face masks.
Questions the president’s doctors haven’t yet answered about his condition:
Which drugs is taking?
Trump has taken his taken his fourth dose of the experimental drug Remdesivir. He is also taking desxamethasone, a steroid used to reduce inflammation in the lungs.
His doctors revealed after he was hospitalized that Trump is taking an experimental antibody cocktail produced by biotechnology company Regeneron.
Dr. Conley revealed Trump was twice put on supplemental oxygen.
On Saturday, he said Trump was also taking zinc, vitamin D, famotidine used for heartburn, and melatonin, which can help with sleep.
Trump also takes a daily aspirin, which can help with cholesterol. Conley said Trump had not been on any medication to reduce fever in 72 hours.
Will his condition go downhill?
Despite Conley’s up-beat assessment, he did acknowledge that his high-powered patient ‘may not entirely be out of the woods yet.’
COVID patients sometimes have a spike in symptoms a week or more after they contract the virus. Nevertheless, he said the White House medical unit is capable of handling whatever comes – an indication that Trump’s team is capable of handling another fever spike, administering oxygen, or even more drastic means of keeping a patient breathing like a ventilator.
The White House medical team can also organize an effort to helicopter Trump back to the hospital if needed.
‘We all remain cautiously optimistic and on guard,’ Conley said. ‘Because we’re in a bit of uncharted territory when it comes to a patient that received the therapies that he has so early in the course.’
‘So, we’re looking to this weekend. If we can get through to Monday with him remaining the same or improving, better yet, then we will all take that final deep sigh of relief,’ he added.
Conley was referring to doctors administering doses of experimental drug Remdesevir, an anti-viral medication. It has been shown to have a positive effect on patients suffering a moderate case of COVID-19 when given later in the process. In Trump’s case, the president got his first dose on Friday, his team said. He is to receive his final dose out of five from the White House Tuesday.
When did he last test negative?
Conley repeatedly refused to state when the president last tested negative for COVID-19.
The answer is important, both for those who might conduct contact tracing to see who might have been exposed, and to anyone seeking to evaluate whether the White House took the correct response and has been truthful about it.
Trump announced early Friday morning, close to 1 am, that he and first lady Melania Trump had tested positive.
Trump held back the information in a Thursday night interview with Fox News host Sean Hannity, after Bloomberg News had already reported longtime aide Hope Hicks had tested positive.
‘I’ll get my test back either tonight or tomorrow morning,’ Trump told the host.
The Wall Street Journal reported that Trump had already gotten a positive result in his rapid test at that point.
The White House learned about Hicks’ positive result shortly before Marine One took off for the trip to New Jersey, where Trump had a scheduled fundraiser at his golf club, even pulling some staff off the trip.
New Jersey Gov. Tom Wolfe tweeted that the state had identified 2-6 attendees at two Trump fundraising events, with 19 staff members involved.
When can Trump hit the campaign trail?
‘As far as travel goes, we’ll see,’ Conley told reporters Monday.
He said key is confirming there is no remaining ‘live virus’ in Trump’s system.
‘We talk about a ten-day window.’
‘There’s a possibility it’s earlier than that. There’s a chance it’s a little bit later,’ he said.