Physician Clarifies Contradictory Statements But Maintains Trump Is 'Doing Well'
LULU GARCIA-NAVARRO, HOST:
The president could be headed back to the White House as soon as Monday - that from the president's medical team, who held a briefing today. Here's a clip from that - Dr. Sean Conley speaking in front of Walter Reed National Military Medical Center.
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SEAN CONLEY: Over the course of his illness, the president has experienced two episodes of transient drops in his oxygen saturation.
GARCIA-NAVARRO: And there was much more information from today's briefing, particularly compared to yesterday's. Let's welcome NPR science correspondent Richard Harris. Good morning, Richard.
RICHARD HARRIS, BYLINE: Hello, Lulu.
GARCIA-NAVARRO: And Dr. Carlos del Rio, an epidemiologist at Emory University. Hello to you.
CARLOS DEL RIO: How are you, Lulu?
GARCIA-NAVARRO: I'm well. Richard, I'm going to start with you. But let's hear first a clip from Dr. Brian Garibaldi on the treatments the president has received.
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BRIAN GARIBALDI: We continue to plan to use a five-day course of remdesivir in response to transient low oxygen levels, as Dr. Conley has discussed. We did initiate dexamethasone therapy, and he received his first dose of that yesterday. And our plan is to continue that for the time being.
GARCIA-NAVARRO: All right, Richard, what does that tell you?
HARRIS: Well, that tells me that the president was - had fairly serious course of disease, and he's getting sort of the top-line treatment to address it. The dexamethasone is a steroid. It's a drug that helps tamp down inflammation, which can be a really bad sign in somebody whose immune system may be starting to overreact to the virus. So doctors come to realize that this is actually capable of saving lives in people. This is the only drug that has actually been demonstrated to do that with coronavirus. And so they've given it to him. That will really help stabilize his immune system. That's the hope.
And, of course, the remdesivir is a drug that is designed to stop the virus from mass-producing itself inside the body. The FDA has authorized its use - but specifically people who are really sick enough that they need help breathing. And it's now become evident that the president's had a couple of episodes where his oxygen levels were dropping and at least one instance where they gave him supplemental oxygen. So it looks as though he's, you know, getting pretty aggressive treatment for his condition, which seems appropriate. And surprising to me is how quickly they expect that he may actually be able to go home, maybe as soon as tomorrow.
GARCIA-NAVARRO: Well, Dr. Del Rio, let's talk about that. We heard in the clip in the introduction the doctors there talking about the president's oxygen levels. As we know with COVID-19, it does affect the lungs. And oxygen saturation is a real big indicator about how well you're doing. So what did you hear there?
DEL RIO: Well, you know, I heard several things. I heard that he - you know, he was - the way I'm beginning to put things together - he was initially diagnosed. He's got mild disease, like, you know, 84% of people with COVID have mild disease. But they made a decision to give him one of these two monoclonal antibodies, the Regeneron one. And that's currently being studied in people with mild disease who don't need to be in the hospital. But then his oxygen saturation drops, and the decision is to transfer him to the hospital because once your oxygen saturation drops below 94%, even if it's transitory, you are immediately in the category of no longer mild or moderate but in the category of severe disease. And it is in those patients that both remdesivir and dexamethasone has proven to be effective. And that's exactly what the president has received. He's received remdesivir, and he's received dexamethasone. And that's where he currently is right now.
GARCIA-NAVARRO: Dr. Del Rio, this is important. So I'm going to put this to you. All along, they had been describing the president's symptoms as mild. You seem to be suggesting that the moment his oxygen levels dropped, and he was given supplemental oxygen and then put on these experimental treatments, you could no longer categorize what he was experiencing as mild symptoms.
DEL RIO: That is correct. That is correct. At that point in time, the president is no longer having mild disease. He's having severe disease, and he's put in a different category. And, you know, that explains why Mark Meadows was concerned, as expressed. Explains why he was - actually, he told us, you know, the president - we were very concerned. And, you know, in exactly that, I think he's - you know, he was telling the truth.
GARCIA-NAVARRO: But then I guess the question is, you're a doctor. Why wouldn't the president's doctors have explained it in the same way? I mean, we heard today Dr. Conley say that he wanted to give an upbeat assessment, but that seems at odds with perhaps what the truth may have been.
DEL RIO: Well, that is correct. I mean, I don't want to say, you know, but I was, quite frankly, very disappointed by the press briefing yesterday. I think the press briefing yesterday was a spin. He was speaking like a spin doctor. He wasn't speaking like a medical doctor. And, you know, the job of all of us in medicine when you're doing something like this, especially when somebody who is as important as the president, is to speak the truth and to be transparent. And I think, you know, unfortunately, we are in an administration where transparency and truth have not been at the forefront of this response. And we're seeing even in this case, when the president is the patient.
GARCIA-NAVARRO: Mara Liasson, senior political correspondent, is joining us now. I'd like to get your take now. Yesterday's press conference from the medical team didn't clear a lot up, as Dr. Del Rio said, sounded more like spin doctors than real doctors. What about today?
MARA LIASSON, BYLINE: Well, today cleared some things up. Yes, he was given oxygen, but it also raised questions. I think that when they're asked a simple question like, is there oxygen in his room? - and he says, I don't want to talk about that. I think the vast majority of people listening say, oh, that's a yes. Or to say his blood oxygen level was below 94, but not in the low 80s or anything - does that mean it's 85? And why can't they just say that? I think that as long as these briefings raise as many questions as they answer or more questions than they answer, it's not good for the White House because - credibility is such a cliche. But credibility is the coin of the realm now.
I mean, the president of the United States has been hospitalized. And people want to know what his condition really is. Now, it's one thing to say he's resting comfortably or in good spirits or he's doing really well. That's kind of generic. But, you know, this is a disease that can take a lot of turns. They're talking about discharging him tomorrow, where he'll stay in the White House. Will he be able to fulfill his duties? What about the campaign? There's still a lot of questions.
GARCIA-NAVARRO: And, of course, we are less than a month away from an election, in an election where the polls are showing the president at this particular point in time lagging significantly behind former Vice President Joe Biden, the Democratic presidential nominee.
Dr. Del Rio, I'd like to come back to you on this particular question. Looking forward, if he is indeed discharged back to the White House on Monday, what are the long-term effects of an illness like COVID-19? Even if he's doing well now, what should we all be looking for?
DEL RIO: Well, let's say a couple of things. Number one, even though he's being discharged to the White House, he's not being discharged as a patient. He still continues to be a patient who will continually receiving the IV remdesivir and the dexamethasone in the White House. So he's still a patient. And most importantly, somebody infected with COVID like him will still be infectious for approximately 10 days. And if you look at the criteria that we all looked at, it's, you know, somewhere between 10 and 14 days the person is still infectious.
So he will still need to be in isolation. People that have contact with him will still need to be dressed in full PPE. So, no, he's not going to be back to normal. Just because he's back at the White House doesn't mean he's - he's still a patient. And let's be real clear about that, whether it's in the hospital at Walter Reed. He will continue to be a patient. Once he gets over, you know, completion of remdesivir, assuming everything goes well with remdesivir - he recovers. Ten to 14 days go by. He's no longer infectious. He's out of isolation. Then he can continue. Then he will be, you know - he will be officially, you know, discharged.
But we have seen patients with COVID. And increasingly, we've seen people that have long-terms impacts of COVID, long-term consequences. And those are primarily of three levels - that could be at the level of the brain, at the level of the heart and the level of the lung. And I'm sure he's going to be monitored very closely for those. Many patients with COVID will tell you that even after they've, quote, "fully recovered," they continue to be extremely tired. They continue to have headaches. They continue to have malaise. They continue to have this brain fog, just don't feel normally. So I suspect that he's not going to be normal. And it's going to be really hard to have a full schedule, to be campaigning, to be here, to be there if he goes in that direction.
GARCIA-NAVARRO: And, Mara Liasson, that will definitely have an impact on many things.
LIASSON: Oh, on many things. I mean, look. There are two debates coming up, two presidential debates. Is he going to be well enough to attend them. They're the last two chances that he'll have to change the dynamic of this race. What about campaigning? What about just the basic message of the campaign? The president said that COVID-19 was in the rearview mirror, and, you know, it was something the country was moving past. Clearly, he's not able to make that case anymore.
GARCIA-NAVARRO: I'm going to leave the last word to you, Richard Harris, because there's still quite a bit we don't know. And that is about when the president was infected, who infected him and who he may have infected.
HARRIS: Indeed. I mean, we saw this cluster of cases around the time of the White House event last Saturday introducing the nominee for the Supreme Court. And it seems as though a lot of the disease had spread at that time. But we don't, in fact, know whether the president got it then or another time. We don't know whether he was infectious when he was sharing the stage with Vice President Biden on Tuesday when they were debating together. He had events Wednesday. He had another event Thursday. And so, you know, clearly, people can spread this disease before they're showing symptoms. So there are concerns about how widely his - you know, his activities have actually spread coronavirus. That will - still remains to be seen. And I hope we will learn more about that in the coming days.
GARCIA-NAVARRO: That is NPR's science correspondent Richard Harris and NPR national political correspondent Mara Liasson and Dr. Carlos del Rio, an epidemiologist from Emory University. Thanks to you all.
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