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White House Chief of Staff Mark Meadows pats Dr. Sean Conley, the White House physician, on the back following a media briefing about U.S. President Donald Trump's health at Walter Reed National Military Medical Center, in Bethesda, Md. on Oct. 3, 2020.


U.S. President Donald Trump is continuing to battle COVID-19 in hospital amid conflicting messages and false information from the White House over his health status.

Mr. Trump has suffered low oxygen saturation in his blood and is being treated with a steroid typically reserved for severe cases of the disease, his medical team said Sunday. But Sean Conley, the White House physician, insisted that the President has “continued to improve” and could be discharged as early as Monday. It is not known exactly how long he has had the illness.

Mr. Trump, who has shown a cavalier attitude toward the virus, staged a photo opportunity outside Walter Reed hospital Sunday afternoon. Despite having a potentially deadly contagious disease, the President got into an SUV with his Secret Service bodyguards and had them drive him around the block while he waved to reporters and supporters gathered outside.

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A few minutes earlier, he tweeted a video in which he said he had been meeting with “soldiers and first responders” at the hospital.

“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 a book’ school,” said the President, who looked paler than usual and had a slight hitch in his voice. “And I get it and I understand it and it’s a very interesting thing.”

Dr. Conley said Sunday that Mr. Trump had been treated with dexamethasone after his oxygen levels fell on both Friday and Saturday. National Institutes for Health guidelines recommend it be used to improve lung function for people in intensive care on ventilators, but not in less-serious cases.

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The White House physician also said Mr. Trump had shown a high fever on Friday and been given oxygen. He had said, the previous day, that the President did not receive oxygen Friday. Asked to explain the about-face, Dr. Conley said he had been trying to keep an “upbeat attitude” on Saturday.

“I didn’t want to give any information that might steer the course of illness in another direction,” he told reporters outside the hospital. Dr. Conley also said there were “some expected findings” in a scan of the President’s lungs, but would not say what those findings were.

On Saturday, shortly after Dr. Conley’s positive assessment, White House Chief of Staff Mark Meadows had delivered the opposite message. He told reporters that Mr. Trump’s vital signs had been “very concerning” and that the President was “not on a clear path to a full recovery.” Mr. Meadows originally asked that his comments be kept off the record, but parts of them were picked up by a live microphone.

Leana Wen, a public-health expert at George Washington University, said that if there is some medical information Mr. Trump has asked not be disclosed publicly, Dr. Conley should simply say so rather than “obfuscate” the details.

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“I’m extremely concerned we are having to put together the pieces, as if we’re playing detective work instead of just getting the full truth,” she said.

Dr. Wen said that, if Mr. Trump only came down with the illness on Thursday, when he had his first positive test, it would make no sense to discharge him on Monday, given that days seven to 10 of a COVID-19 case can be the most fraught. The fact that the medical team is considering releasing him could suggest the President has been infected significantly longer.

White House Press Secretary Kayleigh McEnany on Sunday would not say when Mr. Trump was last tested before Thursday, leaving open the possibility that he had been ill for several days – during which he travelled to rallies, a fundraiser and a debate with Democratic presidential nominee Joe Biden – without taking measures to protect the people he interacted with.

Mr. Trump is in several categories that put him at a higher risk of developing serious complications from the infection. He is a 74-year-old man with a body mass index of 30.5, which classifies him as obese, and has high cholesterol.

“He’s unquestionably at quite high risk,” said Prabhat Jha, an epidemiologist at the University of Toronto. “At the same time, he has access to care and monitoring that is unprecedented.”

The disease has often proven unpredictable. When British Prime Minister Boris Johnson became ill in the spring, he reported only mild symptoms for days before suddenly getting so sick he was nearly put on a ventilator.

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Dr. Jha said the event that may have initiated the COVID-19 outbreak among Mr. Trump and his circle – the announcement in the Rose Garden last weekend of the President’s Supreme Court nominee, Amy Coney Barrett – contained significant lessons on how “super-spreader” incidents work.

While guests were given a rapid test, such screening can miss people who are infected but asymptomatic. The lack of physical distancing and masks, meanwhile, may have let the virus spread. And several people who were exposed, including Vice-President Mike Pence and Attorney-General Bill Barr, have chosen not to isolate after testing negative, even though they could still be incubating the virus. “This is a good teaching moment of what not to do,” Dr. Jha said.

But with the Nov. 3 election less than a month away, and Mr. Trump’s handling of the pandemic a key campaign issue, the President and his team appear to be minimizing his health status. Some of Walter Reed’s own doctors criticized Mr. Trump’s flouting of quarantine Sunday.

“Every single person in the vehicle during that completely unnecessary presidential ‘drive-by’ just now has to be quarantined for 14 days. They might get sick. They may die. For political theater,” tweeted Dr. James Phillips, an attending physician at the hospital. “The irresponsibility is astounding.”

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