President Trump’s return to the White House on Monday was met with surprise by doctors, who were divided over the risk presented by his early departure from Walter Reed Medical Center after just four days.
In a tweet announcing the plan, Trump on Monday said he was “feeling really good!” and “better than I did 20 years ago!” and encouraged his supporters to not “be afraid of Covid.”
“Don’t let it dominate your life,” he wrote.
Doctors cautioned that without knowing when Trump first became infected, and how much virus he is carrying, his risk of developing further complications is difficult to determine. But they offered some general observations.
Calling the decision “highly concerning,” the University of South Carolina’s Department of Epidemiology and Biostatistics chairman Dr. Anthony Alberg pointed to Trump’s age and reported comorbidities, including hypertension, which increase his risk significantly.
“We’re talking about a patient who’s had low oxygen levels at least twice and was started right away on an experimental therapy, monoclonal antibodies, to stimulate the immune system and prevent viral replication,” Alberg said. “And then he was also placed on remdesivir — again, an experimental therapy to decrease viral replication. And then the clue that’s most concerning is the steroids.”
Steroids such as dexamethasone, which Trump is taking, are typically given to patients “in the advanced stages of disease to prevent lung inflammation, and to help a patient who’s really having difficulty breathing, to breathe” he said. “When you look at that regimen of therapies, it points towards a picture of a patient that is not doing that great.”
According to Alberg, Trump’s age and known comorbidities significantly increase his risk of developing a severe COVID-19 case.
And he said that the potential complications from the president’s “very aggressive treatment regimen” would lead him to favor hospital over home care “in case anything trended in an unfavorable direction.”
Trump’s doctors say that he has been administered supplemental oxygen twice but have released few other details, including when the president last tested negative for the disease.
Centers for Disease Control and Prevention guidelines suggest coronavirus patients allow 10 days to pass from when symptoms first appear before leaving the hospital, and at least 24 hours since the last fever without the use of fever-reducing medication.
“You’re talking about the health and well being of a human being,” Alberg said.
Dr. David Buchin, an obesity specialist at New York’s Northwell Health-Huntington Hospital, said he thought Trump looked “pretty good” in videos greeting supporters on a brief drive outside Walter Reed Medical Center on Sunday.
“He wasn’t coughing. He didn’t look sick,” Buchin said. “A lot of these COVID patients look very, very sick.”
He said he didn’t see much wrong with Trump returning to his residence.
“It really depends on his oxygenation, his bloodwork, his X-ray,” Buchin continued. “If all of those checked out fine, there’s really no reason why he couldn’t go back.”
“He is 74. His BMI is 30.5, so he is obese. So he has those two risk factors,” Buchin added.
It is not known whether the White House has a negative-pressure room, which controls the spread of airborne disease. White House Physician Dr. Sean Conley refused to say whether or not the president is in a negative pressure room, which would indicate that he remains in a disease phase that could infect others around him.
Anthony Harris, a workplace safety expert and medical doctor, said that depending on the timeline of infection, Trump may still be able to transmit the virus.
“Having him come back so soon is alarming to many, and certainly for me, from an occupational hazard standpoint,” Harris said, and could place Trump’s aides and Secret Service officers at further risk.
Dr. Carolyn Banister, a drug discovery and biomedical sciences professor at the University of South Carolina, who was part of the team that developed the Saliva Assay Free Expedited test and the guidelines for administering it, said that symptoms tend to lag behind infection, meaning the most contagious period falls typically in the days leading up to and immediately after symptoms arise.
Banister said Trump’s quick departure from Walter Reed presents “a little bit of a risk,” but “he has excellent health care.”
