Live Updates: Trump Tests Positive For Coronavirus President Trump says he and first lady Melania Trump have tested positive for the virus. Here is the latest news on their condition and what it means for the U.S. and the world.

Live Updates: Trump Tests Positive For Coronavirus

The President And First Lady Test Positive For Coronavirus

President Trump addressed a rally on Saturday, nine days after he tested positive for the coronavirus. Several health experts told NPR that based on what Trump's doctors have said about Trump's coronavirus experience, he's likely no longer contagious. Samuel Corum/Getty Images hide caption

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President Trump addressed a rally on Saturday, nine days after he tested positive for the coronavirus. Several health experts told NPR that based on what Trump's doctors have said about Trump's coronavirus experience, he's likely no longer contagious.

Samuel Corum/Getty Images

Ask an infectious disease doctor whether the president still has coronavirus, and you quickly realize that "having" the virus is a concept that exists more among laypeople than doctors.

"We try to avoid that question," says Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center of Health Security. "It becomes much harder to explain to people, well why is the test positive when you're saying he's not contagious? It's because, that far out, it's not viable virus."

Dr. Sean Conley, the physician to the president, said Saturday that the president was "no longer a transmission risk to others," and that there was "no longer evidence of actively replicating virus." But in reporting on the letter, several media outlets noted that Conley didn't say the president had tested negative for COVID-19, raising concern among some experts.

So does the president have coronavirus or not?

"It's not surprising to me that people are having difficulty interpreting the letter," Adalja tells NPR. "It makes sense to me because I do this all this time."

Adalja, who has treated several dozen coronavirus patients, says he wouldn't characterize the president as still having coronavirus. "He's recovered from COVID-19," Adalja says. There may be "remnants of coronaviral debris" present, but "that does not correlate with, or confer, infectiousness or contagiousness to other people."

"I think it's hard sometimes, even with my patients, when I explain: 'Yes, your test is still positive, but no, you're not contagious anymore,' " Adalja added. "That's sometimes hard to tell patients. That's sometimes hard to tell family members, it's hard to tell employers. ... So that's why many of us have gotten away from the testing strategy in mild to moderate patients, because it puts you in this conundrum, and you can't convince people."

In fact, infectious disease doctors tell NPR, the Centers for Disease Control and Prevention no longer recommends using test results to determine whether it's safe for a patient to stop self-isolating.

Some level of positive test results can persist for many weeks following infection, even if a person can no longer transmit SARS-CoV-2, says Dr. Helen Boucher, chief of the infectious diseases department at Tufts Medical Center.

"This is the basis of the CDC's time-based removal from isolation," Boucher says. "Testing positive for viral particles does not imply infectiousness."

Studies show that a patient's contagious period spans from 1-2 days before onset of symptoms, until 7-8 days after. That's the basis of the CDC's recommendation that patients with mild cases self-isolate for 10 days after symptoms begin. For more serious cases, the CDC recommends up to 20 days of isolation.

Conley's letter noted that the president's test results showed decreasing viral loads, and increasing "cycle threshold times" — which is often seen in recovering patients, Boucher says.

Conley also indicated that Trump had been fever-free for "well over 24 hours," and all of his symptoms had "improved" — implying that Trump still does have some symptoms of the virus.

"That is not surprising because it sometimes takes weeks or even longer for all symptoms of COVID-19 to completely resolve," says Dr. Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital and Harvard Medical School. "With each passing day, however, it becomes less likely that his symptoms will worsen."

Trump's doctor also said that testing had indicated "undetectable subgenomic mRNA." That's a very sophisticated test that looks for infectious virus being shed by the patient, Adalja said.

Given Trump's improving test results, several doctors NPR consulted said Trump is likely out of the woods at this point. "I think he's pretty much in the clear," Adalja said. "We were worried more about that around day 6 or 7 of illness, and I think he's passed through that pretty well."

But not every doctor is so certain. "This note by Dr. Conley was really cryptic," says Dr. Ashish Jha, dean of Brown University's School of Public Health.

"I think the president is more or less coming out of that window where things could get worse, but we've definitely seen people 10, 12 days out after the infection getting quite sick," Jha told NPR's Lulu Garcia-Navarro on Weekend Edition. "And obviously, we hope that doesn't happen for the president. So we're not quite out of that window yet."

Experts agree that it's still important that Trump be monitored, especially since he previously required oxygen — an indication that Trump had more than just a mild case.

"I and my colleagues watch all of our COVID patients until they are fully better; this can take weeks to months," Boucher says. "It's important to remember that we're only 8-9 months in with this new disease and have much to learn."

President Trump gave remarks at his first public event since testing positive for the coronavirus earlier this month. Alex Brandon/AP hide caption

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Alex Brandon/AP

President Trump gave remarks at his first public event since testing positive for the coronavirus earlier this month.

Alex Brandon/AP

Updated at 10:05 p.m. ET

President Trump is no longer contagious and is safe to discontinue isolating, his doctor said Saturday evening, nine days after testing positive for the coronavirus.

"This evening I am happy to report that in addition to the President meeting the CDC criteria for the safe discontinuation of isolation, this morning's COVID PCR sample demonstrates, by currently recognized standards, he is no longer considered a transmission risk to others," White House physician Dr. Sean Conley said in a memo.

"Now at day 10 from symptom onset, fever-free for well over 24 hours and all symptoms improved, the assortment of advanced diagnostic tests obtained reveal there is no longer evidence of actively replicating virus," Conley added, stopping short of saying that Trump had tested negative for the coronavirus. He also did not say whether the president was still exhibiting symptoms.

The news comes hours after Trump delivered remarks at his first public event since testing positive for the coronavirus on Oct. 1. The Saturday appearance left public health experts questioning the timing so soon after his diagnosis and hospitalization.

From the White House balcony, Trump addressed supporters gathered at the South Lawn for what was billed as a "peaceful protest for law and order."

Often deviating from prepared remarks, Trump hit on his standard campaign rhetoric and political attacks before a mostly masked crowd of several hundred that largely disregarded social distancing.

The president relitigated recent debate performances, mentioned immigration, called his political opponents "radical left" and attacked Democratic presidential nominee Joe Biden.

"The other day in the debate, Biden couldn't even use the words 'law enforcement,' " Trump told the crowd.

Trump said the politics of what he called the "radical socialist left" were alienating Latino and Black voters.

"Black and Latino Americans are rejecting the radical socialist left and they're embracing our pro-jobs, pro-worker, pro-police — we want law and order. We have to have law and order," Trump said.

During his speech, Trump only briefly mentioned health and his COVID-19 diagnosis. He did tell the crowd he "was feeling great" and thanked supporters for their prayers but did not say whether he still had COVID-19.

On Thursday, Dr. Conley had said that he anticipated "the president's safe return to public engagements" by Saturday.

The White House said this week that it would update when the president had tested negative for the coronavirus. But by Saturday evening, no such announcement had come.

More than two dozen coronavirus cases have been tied to the White House or people who spent time with Trump.

Trump plans to attend a campaign rally in Florida on Monday.

Chris Christie announced he was released from a N.J. hospital Saturday, a week after checking in for mild COVID-19 symptoms. The former New Jersey governor was one of several Republicans to test positive after attending a Sept. 26 event (pictured above) at the White House. Alex Brandon/AP hide caption

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Alex Brandon/AP

Chris Christie announced he was released from a N.J. hospital Saturday, a week after checking in for mild COVID-19 symptoms. The former New Jersey governor was one of several Republicans to test positive after attending a Sept. 26 event (pictured above) at the White House.

Alex Brandon/AP

Former New Jersey Gov. Chris Christie has been released from a hospital a week after announcing he had tested positive for the coronavirus.

Christie checked himself into the Morristown Medical Center in New Jersey on Oct. 3 after announcing his test result. At the time, Christie called the visit an "important precautionary measure," citing a history of asthma. Christie is also overweight, which can be an added risk for coronavirus patients.

On Saturday, Christie announced that he had been released after his seven-day stay.

"I am happy to let you know that this morning I was released from Morristown Medical Center. I want to thank the extraordinary doctors & nurses who cared for me for the last week," Christie tweeted, promising to have "more to say" this next week.

A one-time rival turned Trump ally, Christie was one of several high-profile Republicans to test positive for the virus after attending a Rose Garden event last month for Supreme Court nominee Amy Coney Barrett. Christie also helped President Trump prep for his Sept. 29 debate against Joe Biden, which came three days before the president announced he had tested positive for the coronavirus.

The Rose Garden ceremony and an accompanying indoor reception — dubbed a "superspreader" event by Dr. Anthony Fauci in an interview with CBS — has served as a flashpoint after multiple attendees announced positive results in the days since.

In addition to the president and first lady Melania Trump, the list of White House officials who have announced positive test results has grown to include advisers Hope Hicks and Stephen Miller and press secretary Kayleigh McEnany.

Three Republican senators have also revealed they have tested positive, as has former Trump adviser Kellyanne Conway, Republican National Committee Chairwoman Ronna McDaniel and campaign manager Bill Stepien.

The slew of cases among prominent Republicans has heightened scrutiny on how seriously the president and his allies have taken the coronavirus.

Public health experts worldwide recommend practices such as social distancing and wearing masks to slow the spread of the virus. But at the Rose Garden ceremony, masks were eschewed by many attendees. Videos, pictures and accounts from the event showed a convivial atmosphere where hugging and close contact were commonplace.

President Trump walks out of Walter Reed National Military Medical Center Monday. Evan Vucci/AP hide caption

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Evan Vucci/AP

President Trump walks out of Walter Reed National Military Medical Center Monday.

Evan Vucci/AP

Updated at 8:47 p.m. ET

President Trump plans to deliver remarks on Saturday at an outdoor event, his first public event since being hospitalized for the coronavirus, a White House official confirmed to NPR's Tamara Keith. The official was not authorized to speak publicly about the plans.

The event, first reported by ABC News, is expected to take place on the South Lawn of the White House.

Earlier, White House spokeswoman Alyssa Farah had said the White House would give an update when Trump tests negative for the virus and is cleared by his medical team.

Speaking to Fox News on Friday in a pre-recorded, televised interview, Trump said he felt "really, really strong" in his recovery after bouts of weakness following his initial diagnosis.

Trump's doctor said Thursday that he expected Trump would be ready to resume public activities on Saturday.

When asked on Fox about his most recent testing for the virus, Trump said: "I have been retested, and I haven't even found out numbers or anything yet. And I know I'm at the bottom of the scale or free."

Trump added that he would be tested again "probably tomorrow," but he did not say definitively that he had tested negative for the virus. And White House physician Sean Conley has not issued any updates on Trump's conditions since late Thursday.

The news last week that the president had contracted the coronavirus threw into chaos an already tumultuous election year.

Questions about the president's health and Republicans' ability to fast-track Trump's nominee to the Supreme Court, Amy Coney Barrett, remain, even as Trump has assured the American public of his full recovery and Senate GOP lawmakers push to begin hearing proceedings for Barrett's confirmation.

Several attendees to Trump's Sept. 26 Rose Garden announcement of Barrett's nomination have since tested positive for the coronavirus, including the first lady, White House press secretary Kayleigh McEnany, and close Trump contacts Kellyanne Conway and Chris Christie.

Late Friday afternoon, the Trump campaign announced the president would deliver remarks at the Orlando Sanford International Airport in Florida on Monday at 7 p.m. ET.

This will be the first time Trump has traveled since an Oct. 1 fundraiser, after which he tested positive for the coronavirus.

A Marine is posted Thursday outside the West Wing of the White House, signifying the president is in the Oval Office. President Trump's physician said that he could return to public engagements as soon as Saturday. Evan Vucci/AP hide caption

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Evan Vucci/AP

A Marine is posted Thursday outside the West Wing of the White House, signifying the president is in the Oval Office. President Trump's physician said that he could return to public engagements as soon as Saturday.

Evan Vucci/AP

Doctors and public health experts are concerned that Saturday may be too soon for President Trump to resume activities, both for his own health and the safety of those around him.

"Reckless," Dr. Eric Topol of the Scripps Research Translational Institute said in an email after Trump's physician said the president could resume "public engagements" as soon as Saturday.

Trump has said he wants to do events as early as Saturday, but the White House has not released information about what his schedule will entail. His doctors last updated the public on his condition late Thursday, and it was not clear when the next update would be provided.

"We need the timeline of when he got infected ... to prove he isn't infectious," Topol wrote.

COVID-19 patients are supposed to remain in isolation for at least 10 days after their symptoms began to ensure they aren't still contagious and don't spread the virus to other people, according to guidelines from the Centers for Disease Control and Prevention.

"If his symptoms started Wednesday, that would imply that he was maximally infectious around the time of the debate," Dr. Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital in Boston, said in an interview with NPR.

In that case, Saturday would be in line with the CDC's 10-day recommendation. But that scenario would also raise questions about the president's presence at the debate. If his symptoms began later, Saturday would be too soon, Walensky and others said.

"He is around other very important people. He should not put anyone in harm's way," Dr. Michael Mina, an infectious disease specialist at the Harvard T.H. Chan School of Public Health, wrote in an email.

"We know he fails to use a mask and continues to act irresponsibly in that manner," Mina wrote. "They should be working as diligently as possible to ensure that the president does not pose a clear and present danger to any other people."

Moreover, the CDC recommends people with more serious cases of the disease remain in isolation even longer — for up to 20 days. It's unclear how to characterize the president's case since so little information has been released. His doctors have given conflicting information, sometime suggesting it was a mild case. At the same time, he received treatment typically used in severe cases.

"I think it's not likely the case that the president had a severe bout, but again, more transparency would make that an easier determination to make," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

The steroid the president was prescribed could also potentially extend how long he may be infectious by suppressing his immune system's response to the virus, several experts said.

"The game changer here is the steroids," Dr. Ashish Jha, dean of the Brown School of Public Health, said in an interview. "There is now pretty good evidence it can lengthen viral shedding in COVID-19."

Allowing the president to resume activities prematurely "certainly is consistent with the idea of at every turn doing less than is appropriate," said Marc Lipsitch, a professor of epidemiology at the Harvard T.H. Chan School of Public Health.

It's not known whether Trump's medical team has performed the kind of sophisticated testing that would detect living virus in his body, because information has been limited. That testing would be the only way to know for sure that Trump isn't contagious.

"If they find virus protein or they find culturable virus, then he would be likely to still be at risk of transmitting virus," Mina said. "If they find no viable virus and no protein, then it would be reasonable to assume that he is no longer infectious."

Beyond the implications for people around him, it was inadvisable for the president to resume activities for his own health, several doctors said.

"This is a 74-year-old gentleman who just had hospitalizing disease — perhaps a hospitalizing viral pneumonia," Walensky said. "Being out and about on the campaign trail may, in fact, not be the best thing for him. People generally take a little bit more time than that to convalesce."

Steroids tend to mask symptoms, making people feel like they're better than they really are, she noted.

Several experts said the scant information released about the president provides little insight into his current condition. A single measurement of his respiratory rate is meaningless, for example, they said. What would be more important is his blood oxygen level and respiratory rate after he exercises, they said.

"I would be interested in the oxygen saturation when he walks because it provides information about respiratory reserve," said Dr. Rajesh Gandhi, another infectious disease expert at Massachusetts General Hospital.

Religious leaders urge people of faith to pray for political leaders, both in general and when those elected officials are ill, even if people disagree with those leaders' policies. Paula Bronstein/AP hide caption

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Paula Bronstein/AP

Religious leaders urge people of faith to pray for political leaders, both in general and when those elected officials are ill, even if people disagree with those leaders' policies.

Paula Bronstein/AP

Within minutes of President Trump's announcement that he and his wife, Melania, had tested positive for the coronavirus, he got a compassionate message from one of his harshest critics.

Rachel Maddow of MSNBC tweeted, "God bless the president and the first lady. If you pray, please pray for their speedy and complete recovery. ... This virus is horrific and merciless – no one would wish its wrath on anyone."

Maddow's message was unsurprising. Public figures are often careful to wish their adversaries well when they fall ill, and clergy of various religious traditions routinely ask their followers to pray for their leaders during times of crisis. Trump's coronavirus infection was no exception.

Given Trump's record of divisive rhetoric, however, some commentaries have been highly nuanced.

"You should pray for any human being to recover from sickness," says the Rev. William Barber II, co-chairperson of the Poor People's Campaign and an activist minister at Greenleaf Christian Church in Goldsboro, N.C. "But that's not enough. That's not the full dimension of prayer."

Barber considers Trump "an enemy in public policy," but he insists he has no hatred for Trump as a person.

"We pray that in the midst of COVID, he would have compassion. We pray for his repentance. We pray for his restoration," Barber says.

In Barber's own Pentecostal tradition, he says, when members of a congregation pray for someone who has fallen ill, they would offer "more layered" prayers.

"They would say, 'We pray for you and we pray that you see yourself. We pray that you hear from God. We pray that you get up better than you went down. We pray that you don't do the same thing. We pray that when you get up, you have more compassion for those who are sick.' "

Trump failed personally to take precautions against the virus, rejected the advice of public health experts and insisted that the country return quickly to normal activities. Some of his detractors therefore were probably tempted to conclude that by getting sick himself, he got what was coming to him.

Pray for, not against

Many faith leaders, however, warn their followers against rejoicing in another's suffering.

"Down that road lies self-destruction," says Rabbi Pamela Gottfried of Congregation Bet Haverim in Atlanta. "That kind of prayer takes a toll on the person. It's not good for the one who is praying those things."

Gottfried says she tells young people that the purpose of praying for anyone to heal is "to open up compassion in ourselves. We're really praying for ourselves to be more compassionate and put aside what in the face of illness and death are petty disagreements or political disagreements."

Alan Cross, a Southern Baptist pastor in Petaluma, Calif., who writes often on issues of justice, says he has been praying regularly with his congregation for Trump, "for his health and for wisdom."

"We are all in deep need of mercy, and we're all in need of grace," Cross says. "I pray for the well-being of our leaders. I want them to have wisdom. I want them to lead well. I pray for all our leaders that way."

Cross and other Christian ministers cite the apostle Paul's instruction in 1 Timothy 2:2, in which he advises Christians to pray "for kings and for all that are in authority; that we may lead a quiet and peaceable life in all godliness and honesty."

When he is critical of some leader, Cross says, "I don't want to be personal. I don't want to despise that person. Rather, I pray that they would act in a wise and just manner."

Anne Graham Lotz, the daughter of evangelist Billy Graham, says that when she first heard that Trump was infected with COVID, "I was earnestly praying that the Lord would spare him, that he would heal him and that doctors would make the right and wise choices with his care."

"And I believe the Lord answered that prayer," Lotz says.

Lotz supported Trump's election, but she says she would have prayed in a similar fashion for any U.S. president "because that's what the Bible tells us to do."

It now appears that the coronavirus outbreak at the White House may have originated at Trump's announcement of Amy Coney Barrett as his nominee for the Supreme Court. Lotz, who has written several books on the power and meaning of prayer and has her own ministry, says she noticed that the White House event came just as evangelical leaders were hosting a "Day of Prayer and Repentance" on the National Mall in Washington.

"Maybe the fact that so many people were struck with COVID that very afternoon was God's way of getting those people to look up," Lotz says. "When I look at my own life, when everything's going really well, I'm not as inclined to look up. It's when disaster or disease or death strikes, that's when we cry out to God. I think that's why he lets bad things happen to us, because then he gets our attention."

New Scrutiny On Trump's Gold Star Family Event After COVID-19 Outbreak

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President Donald Trump and First Lady Melania Trump join guests in singing "America the Beautiful" during a reception in honor of Gold Star Families on Sept. 27, in the East Room of the White House. Andrea Hanks/White House hide caption

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Andrea Hanks/White House

President Donald Trump and First Lady Melania Trump join guests in singing "America the Beautiful" during a reception in honor of Gold Star Families on Sept. 27, in the East Room of the White House.

Andrea Hanks/White House

A growing list of attendees to a reception last month for President Trump's Supreme Court nominee Amy Coney Barrett have tested positive for coronavirus.

But the next day, the annual Gold Star Mother's Day event was held indoors at the White House, and official photos from the reception show very few people wearing masks.

Gold Star Mother's Day has been around since the 1930s, but was highlighted recently by Presidents Obama and Trump with White House receptions. Despite this year's event landing in the midst of the coronavirus pandemic, the White House decided not to cancel it. President Trump says when he met these family members and heard their stories, he couldn't bear to keep them at arms-length.

"They come within an inch of my face sometimes, they want to hug me, and they want to kiss me. And they do. And, frankly, I'm not telling them to back up. I'm not doing it. But I did say it's like, it's obviously dangerous, it's a dangerous thing I guess if you go by the COVID thing," Trump told Fox Business on Thursday.

The family of United States Marine Capt. Jesse Melton III poses for a photo with President Donald Trump and First Lady Melania Trump during the reception. Andrea Hanks/White House hide caption

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Andrea Hanks/White House

The family of United States Marine Capt. Jesse Melton III poses for a photo with President Donald Trump and First Lady Melania Trump during the reception.

Andrea Hanks/White House

Days after the event, the president and first lady tested positive. Vice Commandant of the Coast Guard Admiral Charles Ray was also at the Gold Star reception. Later he too had a positive test. Now, more than a week later, the Joint Chiefs of Staff are in quarantine. One more of them is known to have tested positive, Assistant Marine Commandant Gen. Gary Thomas.

About 20 Gold star families were in attendance from all over the country. They were given rapid COVID tests before entering the event, but there is some controversy around the accuracy of those tests.

The White House later clarified that the president wasn't blaming anyone present for him getting the virus. He has been at many events, talking to many people, according to spokeswoman Alyssa Farah who said there is no evidence that anyone became sick from that event.

"We did take a lot of precautions for that event," Farah said. "So based on contact tracing, the data we have, we don't think it arose from that event."

On Wednesday, White House deputy press secretary Brian Morgenstern said the White House only traces contacts of people who are diagnosed by the White House Medical Unit, he said, and then under a specific guideline.

"They look back 48 hours to find people who may have been within 6-feet for at least 15 minutes," he explained. "It's the CDC guideline. And the purpose is to mitigate further transmission of the virus. It's not to go back and identify Patient Zero."

The White House defended holding these events indoors, saying the president needs to continue the business of government.

President Trump returns to the White House on Monday from Walter Reed National Military Medical Center. Win McNamee/Getty Images hide caption

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President Trump returns to the White House on Monday from Walter Reed National Military Medical Center.

Win McNamee/Getty Images

Updated at 7:43 p.m. ET

White House physician Sean Conley said in a memo Thursday that "I fully anticipate the president's safe return to public engagements" on Saturday, based on the date he tested positive for the coronavirus and his response to treatment.

Conley did not provide any information about whether Trump has or will be tested for the virus. He said Trump's physical example "has remained stable and devoid of any indications to suggest progression of illness."

Conley's estimation of Trump's return to the public is a bit sooner than what the doctor had suggested on Monday.

"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," Conley said at the time.

In the Thursday memo, Conley said Trump has responded "extremely well to treatment" and said there is no sign of "adverse therapeutic effects."

"Today the President has completed his course of therapy for COVID-19 as prescribed by his team of physicians," Conley said.

"Saturday 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."

The memo comes as Trump and his campaign fight with the Commission on Presidential Debates, which decided to make the next debate – scheduled for Oct. 15 in Miami – virtual for safety reasons. Trump said he was not interested in that idea.

Trump's illness, and the virus's rapid spread through some of the top Republican circles in Washington, led to increased scrutiny on the administration's response to the coronavirus that has already claimed the lives of more than 200,000 Americans.

The president has repeatedly downplayed the risk of the coronavirus and contradicted public health officials on the importance of social distancing and wearing masks.

Still, despite having been "very sick" with the virus early on, Trump on Wednesday said he felt it was a "blessing from God" that he had contracted the illness. He touted antibody-based drug REGN-COV2, made by the biotech company Regeneron, for having "cured" him.

As of this week, nearly two dozen close contacts to the White House, including the president and first lady Melania Trump, had publicly tested positive for the virus.

Dexamethasone is a low-cost, anti-inflammatory drug that has been shown to reduce the risk of death in patients with COVID-19. Nati Harnik/AP hide caption

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Nati Harnik/AP

Dexamethasone is a low-cost, anti-inflammatory drug that has been shown to reduce the risk of death in patients with COVID-19.

Nati Harnik/AP

Editor's note: Since we published this story, Trump's physician said that the president has completed his treatment for COVID-19.

President Trump told Fox Business Network on Thursday that he will be taking a steroid for COVID-19 for a "little bit longer." As his physicians told reporters last weekend, Trump started taking the drug on Saturday while he was still at the Walter Reed National Military Medical Center.

The steroid, dexamethasone, is now part of the "standard of care" for COVID-19, said Dr. Celine Gounder, assistant professor of medicine and infectious diseases at New York University School of Medicine.

"It's an old drug, it's cheap," she said. "Of all the drugs we're using for COVID, it's the one that we have the most experience with."

Dexamethasone is an anti-inflammatory drug used for a range of ailments, including arthritis, kidney, blood and thyroid disorders and severe allergies. The drug is on the World Health Organization's list of essential medicines and is also used to treat certain types of cancer.

Earlier this year, a large clinical trial in the U.K. found that giving dexamethasone to patients hospitalized with COVID-19 reduced their risk of dying. Patients were given 6 milligrams of the drug for 10 days.

The study, published in The New England Journal of Medicine in July, found the drug cut mortality by a third among severely ill COVID-19 patients who were on ventilators, and by a fifth for patients receiving supplemental oxygen. It was found not to have any benefits for patients with mild illness, and there was some evidence of potential harm.

Later in the course of the disease, COVID-19 can cause the immune system to go into overdrive, damaging the lungs and other organs. That's what can happen to people who are severely ill. Dexamethasone helps these patients by tamping down the body's immune response.

The Infectious Diseases Society of America now recommends giving 6 milligrams of the drug for 10 days to critically ill COVID-19 patients on ventilators and those requiring oxygen support. But it recommends not using the drug on people with mild illness who do not require supplemental oxygen.

While this commonly used drug is generally safe, there are a range of known side effects. "By far, the most common is hyperglycemia, so that's where your blood sugars will shoot up," Gounder said.

Also quite common, especially among older patients are a range of psychiatric side effects, she added.

"Anything from feeling like you're on top of the world ... your arthritic aches and pains of age just melt away, you have lots of energy," she said. "There may be some grandiosity."

The drug can also cause agitation, insomnia and even, psychosis, Gounder said. "My own father was treated with high-dose steroids as part of his lymphoma regimen and developed acute psychosis requiring psychiatric hospitalization."

All these side effects point to the need to monitor people on these drugs carefully, she added.

If the president's doctors had prescribed him the recommended course of treatment, Trump would have finished the steroid therapy early next week. On Thursday evening, White House physician Dr. Sean Conley said Trump has completed his COVID-19 treatment.

President Trump is seen removing his mask upon his return to the White House from Walter Reed National Military Medical Center on Monday, days after he tested positive for the coronavirus. Win McNamee/Getty Images hide caption

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Win McNamee/Getty Images

President Trump is seen removing his mask upon his return to the White House from Walter Reed National Military Medical Center on Monday, days after he tested positive for the coronavirus.

Win McNamee/Getty Images

Updated Thursday at 12:48 a.m. ET

President Trump on Wednesday boasted of his improved health in a video posted to Twitter, calling his coronavirus diagnosis "a blessing from God."

The president's video address is one of several he has posted to the social media site in the days since he was admitted to and ultimately released from Walter Reed National Military Medical Center in Bethesda, Md.

Trump has undertaken a number of treatments for the virus, including Remdesivir, the intravenous antiviral medication, and a single dose of Regeneron's experimental antibody cocktail.

"I went in, I wasn't feeling so hot, and within a very short period of time, they gave me Regeneron. It's called Regeneron. And other things, too, but I think this was the key. But they gave me Regeneron. And it was, like, unbelievable. I felt good immediately," Trump said in the nearly five -minute video. The antibody-based drug Trump was referencing, REGN-COV2, is made by the biotech company Regeneron.

"They call them therapeutic, but to me, it wasn't therapeutic. It just made me better. OK? I call that a cure," Trump said.

While more than 200,000 Americans have died so far from the coronavirus, Trump referred to his own experience as a "blessing."

"I think this was a blessing from God that I caught it. This was a blessing in disguise. I caught it, I heard about this drug. I said 'Let me take it' — it was my suggestion, I said 'Let me take it.' And it was incredible the way it worked. Incredible," Trump said in the Wednesday Twitter video, vowing that the drug would be free and that he would make China "pay a big price" for the virus having made its way to U.S. shores.

"I want everybody to be given the same treatment as your president because I feel great, I feel, like, perfect," he said.

Shortly after the video landed on Twitter, White House chief of staff Mark Meadows said on Fox News that two therapeutic treatments for COVID-19 have been submitted to the FDA for emergency use authorization. "Two of them were put in for EUA today," he said. He did not provide further details.

The drug company Lilly did file for emergency use authorization Wednesday for one of its antibody treatments; Regeneron confirmed late Wednesday it had applied for REGN-COV2 as well.

The drugs referenced by Trump have only been available in very limited circumstances. The clinical evidence in support of the drugs is preliminary, perhaps enough to support emergency use but short of the level needed for a full-blown approval by the Food and Drug Administration. Questions about effectiveness and safety remain.

Trump's contraction of the coronavirus, which causes the illness known as COVID-19, upended Washington politics just weeks before a contentious general election race for the White House and key congressional seats.

In addition to the president, nearly two dozen close White House contacts, including the first lady, have tested positive for the virus since Friday. The burst of cases forced into the spotlight the administration's handling of the virus, as well as Trump's general downplaying of the pandemic and his undermining of conventional health guidance to wear masks and avoid crowds to help slow the spread of the virus.

Many of those in Trump's close contacts who recently contracted the virus also attended a Sept. 26 event held at the White House Rose Garden to announce Trump's nomination of Judge Amy Coney Barrett to the Supreme Court.

But Trump and others have been at a flurry of events in the last couple weeks, given the crucial time in the campaign.

NPR science correspondent Joe Palca contributed to this report.

A U.S. Marine stands watch Wednesday outside the doors of the White House West Wing. According to the White House, President Trump was in the Oval Office on Wednesday afternoon, even as he continues to be monitored for COVID-19. Chip Somodevilla/Getty Images hide caption

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Chip Somodevilla/Getty Images

A U.S. Marine stands watch Wednesday outside the doors of the White House West Wing. According to the White House, President Trump was in the Oval Office on Wednesday afternoon, even as he continues to be monitored for COVID-19.

Chip Somodevilla/Getty Images

President Trump returned to the Oval Office on Wednesday for the first time since he was hospitalized last week, the White House confirmed.

It is unclear exactly what preventive measures are being taken to prevent further spread of the virus in the White House complex. Already more than a dozen close aides and associates of the president have tested positive for the coronavirus.

White House official Ben Williamson said on Twitter that the administration was taking steps to ensure it was safe for Trump to work out of the Oval Office instead of the residence.

Trump was briefed on the economic relief negotiations and Hurricane Delta, according to White House spokesman Brian Morgenstern.

Trump tweeted that he's talked to the governors of Texas and Louisiana about preparations for the hurricane.

Since Trump announced that he tested positive for the coronavirus late last week, the White House has tried to make the case that the president is still on the job. They released pictures of him signing papers and on the phone while he was at Walter Reed National Military Medical Center in Bethesda, Md.

Trump's physician, Sean Conley, released a memo Wednesday saying that the president has been fever-free for more than four days and that his vital signs remain stable and in a normal range. Conley also said that Trump has been symptom-free for more than 24 hours.

Trump has needed supplemental oxygen on at least two occasions since he tested positive for the virus. But Conley said Trump has not needed any oxygen since his initial hospitalization.

Conley's memo also said it was "of note" that the president's labs on Monday detected antibodies not detected Thursday night. But Trump received an antibody treatment on Friday. The maker of that treatment, Regeneron, said in a statement that it is "likely" the test is detecting antibodies from the therapy rather than "self-made" antibodies. In other words, the results are not necessarily an indication of whether or not the president has developed immunity in a way that would clear the infection.

The White House has provided only short written updates from Trump's doctor over the past two days; the medical team held briefings from Walter Reed over the weekend. Conley has not provided information on the state of Trump's lungs or the last time he tested negative for the coronavirus and other relevant details about the president's care.

NPR health policy reporter Selena Simmons-Duffin contributed to this report.

J. Scott Applewhite/AP
The U.S. Capitol
J. Scott Applewhite/AP

Updated at 12:52 p.m.

White House chief of staff Mark Meadows said Wednesday that he and Treasury Secretary Steven Mnuchin are discussing potential stand-alone bills for aid to airlines, small businesses and Americans. He said the Trump administration was "still willing to be engaged" on piecemeal aid bills, though it was not optimistic about a comprehensive aid bill.

The White House has suggested various versions of a piecemeal approach since at least July. Democrats have rejected those proposals saying the size and scope of the health and economic crises requires a comprehensive response.

Trump said on Twitter on Tuesday that he had ended talks with Congress about more stimulus, but on Wednesday morning, Drew Hammill, a top aide to House Speaker Nancy Pelosi, D-Calif., tweeted that she spoke with Mnuchin "by phone at 9:33 a.m. The Secretary inquired about a standalone airlines bill. The Speaker reminded him that Republicans blocked that bill on Friday & asked him to review the DeFazio bill so that they could have an informed conversation."

Pelosi has in recent weeks called on airlines to delay furloughs and layoffs, saying Congress is working on relief for the industry. She promised to pass a stand-alone measure to renew a lapsed payroll support program for airlines or include that provision in a broader bill.

Earlier this month, Transportation and Infrastructure Committee Chairman Peter DeFazio, D-Ore., tried to pass the provision by unanimous agreement, but it was rejected on the procedural grounds that he did not have a signoff from GOP leaders.

Meadows told Fox News on Wednesday that Trump's tweet came right after a call that Trump had with Senate Leader Mitch McConnell, House Republican leader Kevin McCarthy, and Meadows. Meadows said that Trump felt it was "better to be transparent" with Americans on the "prognosis" for a comprehensive aid package.

Meadows offered a similar strategy in mid-September after a bipartisan group of House members, known as the Problem Solvers Caucus, attempted to bridge the gap between the White House and House leaders. At the time, Pelosi called it a "moral choice" and said a comprehensive bill was needed.

"We can't — some people said, well we'll do this bill and then we'll do another bill," Pelosi said in an September 16 interview on MSNBC. "You think the Administration is going to do another bill? All they want is to have the president's name on a check going out, $300, and — and that's all he — he really cares about."

Conversations between Pelosi and Mnuchin were suspended Tuesday when Trump tweeted the end to the talks. Mnuchin and Pelosi were set to meet again later in the afternoon but the tweet upended those plans.

"Today, once again, President Trump showed his true colors: putting himself first at the expense of the country, with the full complicity of the GOP Members of Congress, Pelosi said in a statement Tuesday. "Clearly, the White House is in complete disarray."

She told reporters Wednesday: "All the President wants is his name on a check. And ... we're here to honor our heroes, crush the virus, put money in the pockets of the American people beyond a check with his name on it."

Meadows said on Wednesday that Pelosi had not been "negotiating in good faith" and had insisted on $2.2 trillion to $2.4 trillion in aid including "incredibly high numbers" for "bailouts in blue-run states" that were higher than needed. He said the White House had offered $1.6 trillion and was "willing to look at more" but said Pelosi "would rather spend zero." He accused her of not wanting to send out government aid checks to Americans before the Nov. 3 election.

On Stephen Miller, the top aide who on Tuesday tested positive for the coronavirus, Meadows said Miller had self-isolated since Hope Hicks had become ill because he had "very close contact" with Hicks. "We kind of had anticipated that," Meadows said.

He said the White House has "condoned off different working groups" to prevent further spread and make sure people are safe.

On Trump's tweets last night about declassifying documents related to the investigation of Russian interference in the 2016 election, Meadows said, "Hopefully, we'll see documents in coming days."

'It Is Reckless.' Trump Placing White House Staff At Risk Of COVID-19, Author Says

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A member of the White House cleaning staff sanitizes the James S. Brady Press Briefing Room on October 5. Win McNamee/Getty Images hide caption

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Win McNamee/Getty Images

A member of the White House cleaning staff sanitizes the James S. Brady Press Briefing Room on October 5.

Win McNamee/Getty Images

On Monday, President Donald Trump returned to the White House after spending the weekend in the hospital being treated for COVID-19. Nearly a dozen members of the president's circle have also tested positive for the coronavirus in recent days, heightening alarm that scores of non-political White House employees are now at risk of exposure.

"There [are] about 90 of them," Kate Andersen Brower, author of The Residence: Inside the Private World of the White House, said in an interview on NPR's Morning Edition on Wednesday. "You have butlers, ushers, painters, engineers, plumbers. It's a huge universe of people that most people don't even know exists at the White House."

Brower, who interviewed more than 50 White House staff members for her book, said the people who work most closely with the first family are "the people you'd be the most concerned about. And primarily they're the butlers and the housekeepers on the second floor of the White House."

It remains unclear to what extent staff may have been exposed to the coronavirus. Not every member of the White House residence staff has direct contact with the first family. Asked Sunday if the White House would say how many staffers have been infected, Press Secretary Kayleigh McEnany — who announced her own positive test on Monday — said it would not, citing privacy concerns.

The residence has had "hospital grade disinfection policies" in place since March, according to a statement released Tuesday by the White House, and since April, residence staff have been required to wear masks at all times. The staff that has direct contact with the first family is tested daily for the virus, and support staff are tested every 48 hours, according to the statement.

"With the recent positive results of the President and First Lady, staff wear full PPE and continue to take all necessary precautions, which include updated procedures to protect against cross contamination," the White House said.

But Brower said that's not enough.

"This is still putting them at risk," she said. "These are people who feel a great deal of pressure to work. They have mortgages to pay. So it is reckless to put them in this position."

Brower said these jobs aren't political: They're staff members who stay in their positions for decades, through Democratic and Republican administrations alike.

"They are so dedicated to the president, whoever the president is," Brower said. "They serve from one administration to the next, regardless of party. And I've interviewed several of them in the past couple of days — several former workers — and they're very concerned for their friends who are still working in the White House."

Concern is growing for members of the Secret Service, too, who are similarly in close contact with the First Family. On Sunday, at least two agents were sealed inside an SUV with the president as he drove outside the hospital to wave to supporters. He wore a mask, and the agents wore masks and protective smocks.

"Agents are already worrying about guns and knives and bombs," J.J. Hensley, a novelist who used to work for the Secret Service, told NPR on Tuesday. "Now they have to worry about COVID-19."

Ziad Buchh and Catherine Whelan produced and edited the audio version of this story.

A nurse with the Washington, D.C. Dept. of Health is shown administering a coronavirus test last month. D.C. is now seeing a spike in demand for testing. Alex Brandon/AP hide caption

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Alex Brandon/AP

A nurse with the Washington, D.C. Dept. of Health is shown administering a coronavirus test last month. D.C. is now seeing a spike in demand for testing.

Alex Brandon/AP

As the scope of the White House coronavirus cluster comes into focus, D.C. residents are expressing frustration and concern about how the outbreak might affect the local community. Local government officials are reporting a surge in demand for coronavirus testing.

"It's not just about the politicians that have tested positive," D.C. resident Megan Peterman, 39, said Tuesday after she was tested at the Judiciary Square public testing site. "People work in the White House, and those people also shop at my grocery store and are out about town. It feels frankly really scary."

On Monday, John Falcicchio, D.C. Mayor Muriel Bowser's chief of staff, said the city had performed 3,962 coronavirus tests that day, an 81% increase from the previous Monday.

"While we do not have data on what compelled people to get tested today, it would be hard to imagine that the recent news did not drive more people to do so," Falcicchio said in an emailed statement. "We will continue to monitor the demand this week and urge residents if they need a test to get a test."

Wait times were long on Tuesday morning at Judiciary Square, the District's largest public testing site. Some people said it took more than an hour to get tested. And while many said their immediate reasons for seeking a test were not related to the White House outbreak, the issue wasn't far from their minds.

Jason Qu said the line was four times longer at this testing location than he'd seen it in the past. He thought the news from the White House was likely a factor.

"I think it's put the issue of testing back on people's radar," he said.

Others in line at the public testing site had been more directly affected. A White House reporter, who wished to remain anonymous for job-related reasons, said she and her colleagues were frustrated by the lack of information and advice provided to people who work in the building about the outbreak.

"They've done nothing to take responsibility for what happened, and we're all just kind of left in the lurch, knowing we were at this super-spreader event."

Andrei, a Capitol Hill staffer who declined to give his last name because he was concerned about jeopardizing his employment, said he was frustrated that the extent of the spread of the coronavirus in Congress is not yet known.

"I work in Congress, and I have friends who I know are rightfully concerned about the lack of information about who was infected, and whether their bosses might have been," he said.

Lauren Drew, who was also waiting for a test, said her boyfriend was a member of the media and sometimes has to go to work at the White House, on Capitol Hill, or at Trump campaign rallies. The couple have attempted to quarantine for 14 days and get tested when that happens.

"I think about all the people who do have to go there for their job, the people who service the White House, and I am so worried for all of them, and so angry that they've let this get so out of hand," she said.

George Washington University epidemiologist Dr. Amanda Castel said most D.C. residents shouldn't worry about the White House outbreak. But she noted that the extent of it is still unknown.

"If people weren't practicing social distancing and wearing masks consistently, we may see that this evolves into what we would consider to be a super-spreader event."

President Donald Trump gives thumbs up as he stands on the Blue Room Balcony upon returning to the White House on Monday. Alex Brandon/AP hide caption

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Alex Brandon/AP

President Donald Trump gives thumbs up as he stands on the Blue Room Balcony upon returning to the White House on Monday.

Alex Brandon/AP

Some domestic workers and others impacted by COVID-19 are reacting angrily to President Trump's urging to "get out there" and "Don't be afraid of Covid. Don't let it dominate your life," soon after he left Walter Reed National Military Medical Center on Monday, where he was treated for COVID-19.

They accuse the president of sounding not only reckless but callous about the more than 200,000 people in the U.S. who have died of COVID-19 and the more than 7 million who have been infected with the virus.

"Completely irresponsible," said Norma, a 46-year-old domestic worker, referring to President Trump's comments. "He's mocking us, the working poor," says the undocumented mother of three from Lakewood, N.J. She does not want her last name used due to her immigration status. "He can't tell us not to fear the virus — we're living it."

Norma was infected with the virus in April, and her mother died from it on July 10. "I'm still mourning her," she says.

"I'm still suffering from fatigue, chills and often my hands feel numb," she said. She had to stay home from work for more than 2 months after testing positive and she's only working about 80% now. "I don't have the means to see a doctor or take vitamins. I'm behind on my rent and other bills."

There are more than 2 million domestic workers like Norma in the U.S. – people who work in private homes cleaning and taking care of children, older adults and people with disabilities, according to the Economic Policy Institute. The vast majority of these workers are women, and over half are women of color.

"The administration's failure to act over the past six months have put the lives of millions of domestic workers across the country at risk," said Ai-jen Poo, executive director of the National Domestic Workers Alliance. She added that the administration's actions over the past week, flouting the CDC's coronavirus guidance at a White House gathering on September 26 while refusing to wear a face mask, "have put the lives of essential domestic workers in the White House at additional unnecessary risk."

"The outbreak of coronavirus at our highest level of government highlights the urgent need to provide essential worker protections and comprehensive COVID relief for all of us," Poo said.

Jossie Flor Sapunar works with CASA in Action, an organization that mobilizes the vote in immigrant and people of color communities in the Mid-Atlantic region. She said that when people saw Trump's tweets, they saw his privilege.

"He has a personal helicopter, a fleet of doctors, the best health care," Sapunar said. She noted that many of the people most exposed to the virus every day often don't even have health care: "Grocery store workers, gas station workers, health care workers, cleaning personnel, they don't have that type of privilege."

"He disregards the virus, disregards the science," Sapunar said of the president's actions. She said his response to the pandemic has been reckless for the country, but also toward his staff who trust him.

The White House staff is largely Black and Latino, according to The Washington Post. Dozens of full-time cooks, butlers, ushers, housekeepers, florists make sure the official residence runs smoothly.

White House residence staff have been required to wear face masks at all times since April, according to a statement released on Tuesday by the office of First Lady Melania Trump.

The statement also noted other precautionary measures taken in the residence, such as "hospital grade disinfection policies" since March. The reduced staff has been tested daily, is encouraged to work remotely and the White House medical staff have been charged with leading health workshops to answer staff concerns.

Still, Sapunar said Trump's behavior reveals a power imbalance. Not only has he repeatedly downplayed the risks, she said, but he has spread dangerous ideas like injecting yourself with bleach to prevent infection.

"Right now, things are not fair and that makes folks angry," she said. "That's why we are mobilizing people our hardest, because four years of Trump is four years of disaster for Black and immigrant communities."

Despite public health recommendations that people infected with the coronavirus isolate themselves to prevent further transmission, President Trump rode with Secret Service agents past his supporters outside Walter Reed National Military Medical Center on Sunday. Alex Edelman/AFP via Getty Images hide caption

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Alex Edelman/AFP via Getty Images

Despite public health recommendations that people infected with the coronavirus isolate themselves to prevent further transmission, President Trump rode with Secret Service agents past his supporters outside Walter Reed National Military Medical Center on Sunday.

Alex Edelman/AFP via Getty Images

Updated at 5:15 p.m. ET

Last Thursday afternoon, when Hope Hicks tested positive for the coronavirus, President Trump was aboard Marine One, on his way to a campaign fundraiser at his New Jersey golf club.

Hicks, a top Trump aide, had traveled with the president to a Minnesota fundraiser and rally the day before and reportedly felt ill on the plane ride back. "The CDC guidelines are pretty clear when you identify [someone] who is infected," says Howard Koh, former assistant secretary of health in the U.S. Department of Health and Human Services in the Obama administration.

Anybody who had recently come in close contact with Hicks — defined as spending more than 15 minutes within 6 feet of her, in the previous two days — is to take precautions so they don't spread the virus to others.

"I assume the president was one of those persons," Koh says. "And according to the guidelines, the quarantine should have started at that point, for 14 days."

Instead, Trump greeted over 200 supporters at the New Jersey fundraiser, flew back to Washington and mingled with dozens of aides. A few hours later, the president tweeted that he and first lady Melania Trump had also tested positive for coronavirus.

From the time Hicks began showing symptoms of COVID-19, the Trump campaign and White House repeatedly made missteps that health experts say dangerously amplified the risks of spreading the virus to others.

The president's failure to quarantine was a critical crossroads at which he and his team chose to flout rather than follow pandemic safeguards — a path they have stuck to, even as test results showed the virus spreading through the White House. The White House has declined to do contact tracing of a Rose Garden celebration held several days before Trump and other Republican attendees tested positive.

And the president has struggled to balance the public health recommendation to isolate with his desire to be seen publicly as Election Day approaches.

Much of the New Jersey fundraiser took place outdoors, which reduces the risk of transmission. But Trump also reportedly met indoors, with a select group of around 19 top donors for 45 minutes. While the donors sat indoors more than 6 feet apart, according to CNN, nobody wore masks — which increases the risks of the virus accumulating in the air and spreading to people more than 6 feet away.

"If you're indoors, basically, you're all sharing the air in that room," said Kim Prather, an aerosols scientist at the University of California, San Diego, in a call with reporters this week, "We always have to remember that some masks are absolutely essential when you're indoors."

New Jersey Gov. Phil Murphy said via Twitter that health officials are working with the CDC to contact and monitor everyone who showed up to the fundraiser. Attendees are being advised to quarantine and monitor themselves for symptoms for two weeks. But some attendees do not plan to comply.

That's another consequence of the president's defiance of public health safeguards, says Lindsay Wiley, a health law professor at American University: "It just sends such a strong signal to the general public that these recommendations aren't important to pay attention to and aren't necessary to follow."

It's risky, because the CDC's public health guidance contains tried-and-true recipes for dealing with coronavirus outbreaks in the absence of vaccines and therapeutics. Since no cures or prophylactics are available, the public health guidance focuses mainly on preventing the spread of coronavirus, through measures such as mask-wearing, improving fresh air flow indoors, testing likely cases and keeping people who may be infected away from others.

Once the president was diagnosed with coronavirus, public health guidelines dictated that he be isolated.

"That means nobody around him for 10 days," the duration after symptom onset when he's most likely to be contagious, says Dr. Ali Khan, dean of the College of Public Health at the University of Nebraska Medical Center.

But the president, in between medical treatments at Walter Reed National Military Medical Center, took a ride down the street in a sealed SUV, exposing his Secret Service bodyguards to coronavirus in the process. "[Not isolating] is an advantage and a privilege of his office that is not afforded to pretty much any other American," Khan says.

When the president was diagnosed, anybody who had come in close contact with him — or any other recently confirmed cases — should also have quarantined for 14 days. "The only exception for that is, occasionally, essential workers," Khan says, adding that the exception was originally meant for health care workers at low risk of being infected, who would be wearing full protective gear around patients. The administration has since expanded the definition to 16 industries, including law enforcement and agriculture.

White House press secretary Kayleigh McEnany described herself as an "essential worker" and continued to speak with reporters while not wearing a mask. McEnany said she had trusted that negative test results meant she was not carrying the virus. Then, on Monday, McEnany announced that she, too, had tested positive for coronavirus.

"It appears that the White House has declared themselves essential workers that are not subject to quarantine rules," Khan says.

The outbreak among the president's circle demonstrates that relying solely on routine testing is an imperfect strategy. People are prone to false negative results in the early stages of infection, when they can still spread the disease, says Dr. William Lang, former director of the White House Medical Unit and deputy physician to the president in the George W. Bush administration.

"Testing reduces risk, but it does not eliminate risk. Wearing masks does not eliminate risk, it reduces risk," and the same goes for keeping a 6-foot distance from others, says Lang. "You don't rely on any one thing to satisfactorily reduce your risk of COVID-19. You've got to do it all."

The president returned Monday evening to the White House from hospitalization at Walter Reed National Military Medical Center, still in recovery from COVID-19 and well within the window of being contagious. In a statement, White House spokesman Judd Deere said, "Physical access to the president will be significantly limited and appropriate PPE will be worn when near him."

However, White House Deputy Press Secretary Brian Morgenstern told NPR's Mary Louise Kelly on Tuesday that masks are not currently mandated inside the White House. And the White House still won't say the total number of coronavirus cases among White House personnel.

But the list of people in the president's circle testing positive grows daily, and it's not clear to observers that those exposed will quarantine. Further, the president says he plans to proceed with a scheduled debate in Miami on Oct. 15 with Democratic presidential candidate Joe Biden, which is fine by CDC guidelines, so long as the president's symptoms resolve.

President Trump leaves Walter Reed National Military Medical Center in Bethesda, Md., on Monday. He announced Tuesday he was pausing negotiations on a coronavirus relief package. Saul Loeb/AFP via Getty Images hide caption

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Saul Loeb/AFP via Getty Images

President Trump leaves Walter Reed National Military Medical Center in Bethesda, Md., on Monday. He announced Tuesday he was pausing negotiations on a coronavirus relief package.

Saul Loeb/AFP via Getty Images

Updated at 4:55 p.m. ET

President Trump says he has ordered his representatives to stop talks with Democrats on a new round of COVID-19 aid until after the election.

In a series of tweets, Trump said he has rejected Democrats' latest proposal for a more than $2 trillion relief bill because House Speaker Nancy Pelosi "is not negotiating in good faith." Lawmakers had hoped to approve some relief measures before the election amid a recent decline in job growth and fears the economy could worsen without speedy intervention from Congress. Instead the president said any vote on legislation would wait until after the election.

Deputy press secretary Brian Morgenstern told NPR's All Things Considered that there "hadn't been good faith negotiations on the side of the Democrats for quite a long time."

Senate Majority Leader Mitch McConnell, R-Ky., told reporters Tuesday he supports Trump's decision. "Well, I think his view was that they were not gonna produce a result, and we needed to concentrate on what's achievable," he said.

Pelosi, D-Calif., accused Trump of abandoning first responders, teachers, children and people who have lost their jobs due to the coronavirus.

"President Trump showed his true colors: putting himself first at the expense of the country, with the full complicity of the GOP Members of Congress," Pelosi said in a statement. "Walking away from coronavirus talks demonstrates that President Trump is unwilling to crush the virus, as is required by the Heroes Act."

Pelosi was in the midst of active talks with Treasury Secretary Steven Mnuchin in hopes of reaching a compromise on COVID-19 relief before the November election. The two continued to disagree on key portions, such as funding for state and local governments, but were set to continue talks. Pelosi also signaled to the airline industry that there were efforts to provide some help in the next bill.

Trump had been largely absent from any coronavirus-related negotiations since lawmakers began working on relief measures this spring. The talks were led almost exclusively by Mnuchin, with the occasional participation of White House chief of staff Mark Meadows.

The abrupt ending to the talks comes on the heels of a Saturday tweet in which the president demanded an immediate agreement, saying, "OUR GREAT USA WANTS & NEEDS STIMULUS."

In his tweets, Trump said he instructed McConnell to focus instead on approving Amy Coney Barrett to replace the late Justice Ruth Bader Ginsburg on the Supreme Court. Trump spoke with congressional GOP leaders by phone shortly before tweeting his instructions, according to aides familiar with the call.

Trump ended the talks hours after Federal Reserve Chairman Jerome Powell urged more relief to help the economy recover from the recession caused by the pandemic.

"Too little support would lead to a weak recovery, creating unnecessary hardship for households and businesses," Powell said in a virtual address to the National Association for Business Economics. "Over time, household insolvencies and business bankruptcies would rise, harming the productive capacity of the economy, and holding back wage growth."

The stark warning comes as recent job reports showed a sharp decline in job growth and companies, including major airlines, have begun a fresh round of layoffs.

Talks have been stalled for months, and lawmakers remain far apart on how much should be included in the next round of relief.

Trump made the announcement during his first full day back at the White House after a weekend at Walter Reed National Military Medical Center. He is continuing to receive treatment for COVID-19.

Facebook and Twitter took action against social media posts released by President Trump from the White House on Tuesday morning. J. Scott Applewhite/AP hide caption

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J. Scott Applewhite/AP

Facebook and Twitter took action against social media posts released by President Trump from the White House on Tuesday morning.

J. Scott Applewhite/AP

Facebook and Twitter took measures to screen against misinformation after President Trump put posts on both sites that falsely claimed COVID-19 is less deadly than the flu in "most populations."

Facebook took down Trump's post, saying that users are not allowed to make false claims about the severity of the pandemic. The social network says the post broke its rules against harmful misinformation.

Twitter allowed the president's tweet to stay up with a warning label. The company said it is in violation of Twitter's "rules about spreading misleading and potentially harmful information related to COVID-19." But it added that the company "has determined that it may be in the public's interest for the Tweet to remain accessible."

Both companies have previously taken action against posts shared by the president because of violations to their rules.

Trump, who is currently being treated for COVID-19, has been downplaying the severity of the disease that has killed more than 210,000 in the U.S.

"Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu," Trump said in the tweet. "Are we going to close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!" However, during the 2019-2020 flu season, the Centers for Disease Control and Prevention estimates that 38 million people in the U.S. got the flu and 21,909 of them died.

More than 7.4 million Americans have contracted COVID-19 so far this year, according to data from Johns Hopkins University.

Fatality rates for the respiratory illnesses vary by age, with older people at higher risk than younger ones for both diseases.

The overall mortality rate for seasonal flu is typically below 0.1%, according to the World Health Organization. The rate at which people in the U.S. infected with the coronavirus die has been estimated at between about 0.5% and a little over 1%.

Editor's note: Facebook is among NPR's financial supporters.

NPR's Shannon Bond contributed to this report.

Army Gen. Mark Milley, the chairman of the Joint Chiefs of Staff, is among several top military officials who are quarantining at home. They attended meetings last week with Adm. Charles Ray, the vice commandant of the Coast Guard, who has tested positive for COVID-19. Alex Brandon/AP hide caption

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Alex Brandon/AP

Army Gen. Mark Milley, the chairman of the Joint Chiefs of Staff, is among several top military officials who are quarantining at home. They attended meetings last week with Adm. Charles Ray, the vice commandant of the Coast Guard, who has tested positive for COVID-19.

Alex Brandon/AP

Most members of the Pentagon's Joint Chiefs of Staff are quarantining at home after Adm. Charles Ray, the vice commandant of the U.S. Coast Guard, tested positive for COVID-19, the military said Tuesday.

Ray is not a member of the Joint Chiefs, the nation's top military officers, but he was at Pentagon meetings last week with others who are.

It's not clear how Ray was infected, though he did attend a White House ceremony on Sept. 27, just one day after President Trump introduced Amy Coney Barrett as his Supreme Court nominee. Multiple people at that event contracted COVID.

"Out of an abundance of caution, all potential close contacts from these [Pentagon] meetings are self-quarantining and have been tested this morning," Pentagon spokesman Jonathan Hoffman said in a statement. "No Pentagon contacts have exhibited symptoms and we have no additional positive tests to report at this time."

It appears six of the seven members of the Joint Chiefs are quarantining, including the chairman, Army Gen. Mark Milley, and the vice chairman, Air Force Gen. John Hyten. The other members include the heads of the Army, Navy, Air Force, Marines and the National Guard.

The Marine commandant, Gen. David Berger, was not at the meetings with Ray and is the lone member of the Joint Chiefs not in quarantine, according to the military.

However, the head of the National Security Agency, Army Gen. Paul Nakasone, was present at the meetings and will self-quarantine as well.

The members of the Joint Chiefs have homes on military bases in the Washington area, mostly near the Pentagon, which include secure communications.

"There is no change to the operational readiness or mission capability of the U.S. Armed Forces," Hoffman added. "We are conducting additional contact tracing and taking appropriate precautions to protect the force and the mission."

President Trump takes off his face mask Monday night as he arrives at the White House upon his return from Walter Reed National Military Medical Center. Nicholas Kamm/AFP via Getty Images hide caption

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Nicholas Kamm/AFP via Getty Images

President Trump takes off his face mask Monday night as he arrives at the White House upon his return from Walter Reed National Military Medical Center.

Nicholas Kamm/AFP via Getty Images

President Trump, who is still receiving treatment for COVID-19, tweeted Tuesday morning that he is "feeling great" and plans to move forward with the second presidential debate slated for Oct. 15 in Miami.

His pronouncement comes less than one day after he left Walter Reed National Military Medical Center, where he spent almost 72 hours receiving treatment for COVID-19. Trump's physicians reported Tuesday that the president had a "restful first night at home, and today he reports no symptoms" and has stable vital signs.

His physician, Sean Conley, told reporters Monday that although he is cautiously optimistic about the president's prognosis, medical staff will remain on guard for another week.

Conley also said, "We'll see," when asked about any potential campaign travel for the president. The next debate is in nine days, casting uncertainty on what is possible for the president to do both in terms of his own recovery as well as concerns over exposure.

Trump, who reportedly views illness a sign of weakness, has tried to project an image of strength in the midst of a White House in chaos as increasing numbers of staff test positive for the virus and the president's medical team and staff send mixed messages on his symptoms and treatment.

Upon his return to the White House on Monday evening, Trump walked up the staircase to the South Portico entrance, turned to face the cameras, removed his mask and gave two thumbs-up.

White House Communications Director Alyssa Farah told Fox News the president's appearance on the White House balcony was meant to communicate confidence to the American people.

Over the weekend, it seemed possible that Trump would take on a different tone when talking about the severity of COVID-19 now that he is a patient battling the disease.

"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 book' school," he said in a video on Sunday. (It's worth noting that Trump has been briefed extensively about the pandemic by members of his White House Coronavirus Task Force and other advisers.)

But by the time he was discharged from Walter Reed, the president had undermined any possibility of changing his rhetoric to push back against criticism that he doesn't take it seriously.

He quickly uploaded a video to Twitter upon arriving at the White House in which he told Americans not to be afraid of the coronavirus and to "get out there."

He doubled down on that message with a tweet: "Don't be afraid of COVID." It sparked outrage as people reacted with their own experiences of losing loved ones to the disease, which has sickened millions and killed more than 210,000 Americans.

Vice President Mike Pence and his wife, Karen Pence, walk toward Air Force Two on Monday en route to Utah for debate prep. Jacquelyn Martin/AP hide caption

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Jacquelyn Martin/AP

Vice President Mike Pence and his wife, Karen Pence, walk toward Air Force Two on Monday en route to Utah for debate prep.

Jacquelyn Martin/AP

Updated at 2:30 p.m. ET

Vice President Pence tested negative for the virus on Tuesday and remains symptom-free, his physician Dr. Jess Schonau said in a memo. Even so, his team says it is taking extra precautions as he picks up campaign trips for President Trump, who has returned to the White House.

Pence "has remained healthy, without any COVID-19 symptoms, and has continued to have daily COVID-19 antigen tests and intermittent PCR tests which have all resulted as negatives," Schonau wrote.

Pence is tested daily, Schonau said. He reiterated that, under guidelines from the Centers for Disease Control and Prevention, Pence is not considered a close contact of Trump or any other senior White House officials, meaning he is clear to "go about his normal activities and does not need to quarantine."

However, Pence had an active schedule prior to Trump's positive test. He was with the president on Sept. 28, a few days before he tested positive, and at the Sept. 26 Rose Garden event for Judge Amy Coney Barrett. At least eight people who attended have now tested positive for the coronavirus.

On Monday, on his way to Utah in advance Wednesday's vice presidential debate, Pence said he was looking forward to get back on the campaign trail.

Pence was speaking at Joint Base Andrews just minutes after the president announced he would be leaving Walter Reed National Military Medical Center.

"When the president told me he was headed back to the White House, he told me to head to Utah, and we're looking very much looking forward to the vice presidential debate," Pence said just before boarding Air Force Two, without taking questions from reporters.

His team members are working hard to make sure he, and they, remain safe during the trip.

Pence will debate Democratic vice presidential nominee Kamala Harris at 9 p.m. ET Wednesday in Salt Lake City.

The Trump campaign said Pence will do more of the campaigning as Trump recovers from the coronavirus. That includes trips through key swing states starting Thursday.

Pence's chief of staff, Marc Short, said the extra work doesn't change much.

"He's honored to pick up some additional travel, but I'm not sure that he sees the role differently," Short said. "The president is healthy and making decisions."

The vice president has been busy over the last four days, Short said. Pence has joined some campaign calls, led a coronavirus task force meeting and participated in a national security call.

Short said that "out of abundance of caution," he had been "self-isolating at his residence so that we can make sure that this week goes on."

Short said the team is takings steps to ensure Pence remains in a protected environment throughout his travels. He added that staff is also taking other precautions to avoid further spread of the virus.

"We began encouraging staff to not come into the building unless it was essential late Thursday night after we got the president's diagnosis," Short said.

President Trump removes his mask upon returning to the White House on Monday after undergoing treatment for COVID-19 at Walter Reed National Military Medical Center in Bethesda, Md. Alex Brandon/AP hide caption

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Alex Brandon/AP

President Trump removes his mask upon returning to the White House on Monday after undergoing treatment for COVID-19 at Walter Reed National Military Medical Center in Bethesda, Md.

Alex Brandon/AP

President Trump, who spent the weekend in the hospital being treated for COVID-19, made a theatrical return to the White House on Monday evening, disembarking Marine One and walking the staircase to the South Portico entrance, where he turned to face the cameras, removed his mask and gave his signature two thumbs up.

Shortly before, a masked Trump had emerged from Walter Reed National Military Medical Center, where he was receiving treatment, pumping his fist and giving a thumbs up as he ignored questions from reporters.

In a video recorded at the White House that he tweeted later, the president seemed somewhat more circumspect about a virus that he has often downplayed, along with measures to halt its spread, such as wearing masks.

Trump thanked the staff of Walter Reed and said that during his three-night stay he had "learned so much about coronavirus."

"One thing that's for certain – don't let it dominate you. Don't be afraid of it. You're going to beat it," he said. "We have the best medical equipment. We have the best medicines. All developed recently. And you're going to beat it."

"I went, I didn't feel so good," he said, but added that "two days ago, I could have left two days ago. Two days ago I felt great, like better than I have in a long time. I said just recently, better than 20 years ago."

Trump's physician, Sean Conley, said he is cautiously optimistic about the president's prognosis but that medical staff needed to remain on guard for another week.

"Over the past 24 hours, the president's condition has continued to improve," Conley told reporters at a news briefing Monday. "He's met or exceeded all standard hospital discharge criteria."

"Although he may not be entirely out of the woods yet, the team and I agree that all our evaluations, and most importantly, his clinical status, support the president's safe return home, where he will be surrounded by world-class medical care, 24/7."

The president's treatment has included the steroid dexamethasone and a five-day course of remdesivir. Dr. Brian Garibaldi told reporters on Monday that Trump would get a fifth dose of remdesivir at the White House on Tuesday night and that he continues to receive a steroid.

Asked by a reporter if he had concerns about a possible worsening or reversal of the president's condition, Conley responded: "You're absolutely right."

"That's why we all remain cautiously optimistic and on guard, because we are in a bit of uncharted territory when it comes to a patient who received the therapies he has so early in the course," Conley said.

"The first week of COVID, and in particular the days seven to 10, are the most critical in determining the likely course of this illness. At this time the team and I are extremely happy with the progress the president has made," he said.

Trump tweeted early Friday that he and the first lady had tested positive for the coronavirus just hours after they went into quarantine following a positive test for White House adviser Hope Hicks. Since then, at least nine others in Trump's inner circle have tested positive for the virus that causes COVID-19.

Critics have charged that the Trump administration's slow response to the growing pandemic — and the mixed messages coming from the president about the use of masks — helped the virus gain a foothold in the U.S., where it has spread rapidly. The first U.S. case was detected in January, and since then, nearly 7.5 million Americans have become infected with more than 210,000 COVID-19 deaths — the highest of any country.

In the video on Monday, the president defended his actions regarding the pandemic, particularly his decision to open up the economy even as the disease showed no signs of waning.

"We're going back to work. We're going to be out front," he said. "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," he said.

"Nobody that's a leader would not do what I did," the president added. "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. Get out there. Be careful," he said.

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