Trump doctors say president's oxygen dropped twice but insist he's improving

Donald Trump’s doctors have said his oxygen levels had dipped suddenly twice in two days and he was on medication normally prescribed for severe coronavirus cases, but they insisted his condition was improving and he could be discharged as early as Monday.

The mixed messages delivered outside Walter Reed hospital in the Washington suburbs, added to the confusion over the president’s condition as well as suspicions that the medical team were providing a misleadingly rosy account, on White House instructions.

The president’s physician, Sean Conley, admitted having misled reporters in a press briefing on Saturday when he insisted that the president had not been given supplemental oxygen. He revealed that Trump was put on oxygen on Friday morning after worrying signs emerged, and that Conley had not reported the development because he did not want to spoil the “upbeat attitude” of the president and his medical team.

“Late Friday morning when I returned to the bedside, President had a high fever and his oxygen saturation was transiently dipping below 94%,” Dr Conley said on Sunday, providing details he had concealed the previous day. “Given these two developments I was concerned for possible rapid progression of the illness. I recommended the president we try some supplemental oxygen. See how he’d respond. He was fairly adamant that he didn’t need it.”

The doctors appeared to have convinced Trump to take the oxygen feed. “He stayed on that for about an hour maybe, and then it was off and gone.”

Asked why he earlier denied the president had been put on oxygen, Conley responded: “I was trying to reflect the upbeat attitude that the team, the president, the course of illness, has had.”

He added: “I didn’t want to give any information that might steer the course of illness in another direction, and in do­ing so it came off that we were try­ing to hide some­thing, which wasn’t nec­es­sar­ily true.”

Trump’s illness has upended the US election, which is due to take place on 3 November. His Democratic challenger, Joe Biden, pulled his attack ads off the air when Trump went into hospital.

The medical briefing on Sunday also revealed that Trump’s blood oxygen had dipped for a second time on Saturday, but it was unclear how low it had sunk in the two incidents. Conley was vague on the specifics.

“It was below 94%, it wasn’t down in the low 80s or anything,” the doctor said.

Oxygen saturation is an important measure of the seriousness of any coronavirus infection. Normal levels are between 95 and 100%, and any drop below 90% would be considered grave.

Conley was also vague on the result of a scan of the president’s lungs, saying that it had shown “expected findings”, without clarifying what that meant. The medical team ended the press conference and re-entered the hospital as journalists asked for more details.

They said that the president had been prescribed Remdesivir, an antiviral medication and dexamethasone, a steroid which the World Health Organization recommends for only “severe and critical” Covid-19 cases. Trump has also been given monoclonal antibodies (antibodies all generated from the same parent cell), an experimental treatment which has so far been prescribed to less than 10 people, before finishing trials, for “compassionate use”.

However, Dr Brian Garibaldi, another member of the medical team said Trump was feeling well and his condition was improving.

“If he continues to look and feel as well as he does today, our hope is that we can plan for a discharge as early as tomorrow to the White House where he can continue his treatment course,” Garibaldi said.

Trump is 74 years old and clinically obese, putting him at higher risk of serious complications.

The White House has advanced medical facilities, but the suggestion that Trump would return home after two incidents of hypoxia (low oxygen) and being on medication normally reserved for severe cases, surprised many health professionals.

Robert Wachter, the chair of the department of medicine at the University of California in San Francisco said “it seems like an awful call”.

“It seems like Trump is stable, but remains at high risk, given transient hypoxemia, some findings on chest imaging,” Wachter wrote on Twitter. “The happy talk and evasions are clearly at Trump’s direction, putting the docs in a terrible position. No way he’s ready for discharge tomorrow.”

Alongside the mixed signals about the president’s current health, there is also uncertainty as to when and how he was infected, how long he had known, and how many people he may have infected since becoming aware he had the disease.

The contact-tracing effort has focused on a White House event on 26 September to celebrate the nomination of Trump’s pick for the supreme court, Amy Coney Barrett, where more than 150 senior White House officials and top Republicans mingled without masks outside and inside, shaking hands, clustering in small groups and hugging each other.

Among those who attended and have now tested positive: the former New Jersey governor Chris Christie, former White House counselor Kellyanne Conway, the president of the University of Notre Dame, John Jenkins, and at least two Republican senators, Mike Lee of Utah and Thom Tillis of North Carolina.

Also infected are the president’s campaign manager, Bill Stepien, the head of the Republican National Committee, Ronna McDaniel, and Senator Ron Johnson of Wisconsin, who were not at the Barrett event, raising the prospect that the White House and Republican party held more than one event that resulted in the spread of the virus among their top ranks.

Talking to the press after the medical briefing, the White House spokeswoman Alyssa Farah would not answer questions on when the president was first tested on Thursday. Asked why he had decided to travel to his golf course in Bedminster, New Jersey, that day, even after his close adviser, Hope Hicks, had been confirmed positive, Farah said it “was a decision made by White House operations because he wasn’t deemed to pose a threat”. Trump took part in two fundraising receptions at Bedminster on Thursday as well as a roundtable with supporters. Attendees have since been sent emails from the Trump Organization, advising them to see a doctor if they started suffering symptoms.

The New Jersey health department said on Sunday the White House had supplied the names of 206 people who had attended Thursday’s Trump events in Bedminster.

Asked about Conley’s initial denial that the president was on oxygen, Farah said: “When you’re treating a patient, you want to project confidence, you want to lift their spirits and that was the intent.”