- 1 White House Physician Says Trump Had Been Given Supplemental Oxygen and Dexamethasone
President Trump’s medical team acknowledged delivering an overly rosy description of the president’s illness on Saturday.
Medical experts said that despite the relatively upbeat tone of the news conference Sunday, the details of his treatment and the fact that his oxygen levels have been dropping showed that the illness has progressed beyond a mild case of Covid-19.
The doctors said that Mr. Trump had a “high fever” on Friday, and that there had been two incidents when his oxygen levels dropped — one on Friday and one on Saturday. They said Mr. Trump received oxygen at the White House on Friday; they were not clear about whether it was administered again on Saturday.
“This is no longer aspirationally positive,” said Dr. Esther Choo, a professor of emergency medicine at Oregon Health & Science University. “And it’s much more than just an ‘abundance of caution’ kind of thing.”
Mr. Trump’s oxygen levels dropped to 93 percent at one point, his doctors said; that is below the 95 percent level that is considered the lower limit of the normal range. Many medical experts consider patients to have severe Covid-19 if their oxygen levels drop below 94 percent.
“He got the therapies that anybody going into any good hospital in the United States would receive today,” said Dr. Carlos del Rio, a professor of medicine at Emory University in Atlanta. He said even if Mr. Trump is discharged from the hospital, “He’s not going to your house or my house, he’s going to the White House.” The White House is equipped with a medical suite.
Dr. Conley said that the president had been given the steroid dexamethasone on Saturday, in addition to remdesivir, an antiviral drug. Dexamethasone has been shown to help patients who are severely ill with Covid-19, but it is typically not used in mild or moderate cases of the disease.
A large study of dexamethasone in Britain found that the drug helped those who had been sick for more than a week, reducing deaths by one-third among patients on mechanical ventilators and by one-fifth among patients receiving supplemental oxygen by other means.
The World Health Organization issued guidelines on Sept. 2 recommending that dexamethasone only be given to patients with “severe and critical Covid-19.” The National Institutes of Health has issued similar guidance, specifying that the drug is recommended only for people who require a mechanical ventilator to help them breathe, or who need supplemental oxygen.
Regeneron’s antibody cocktail is being tested early in the course of the infection, because it fights the virus itself and could prevent it from spreading throughout the body. Remdesivir is also an antiviral drug, but has been commonly used along with dexamethasone, which reduces the body’s immune response and is given later in the illness, when some people’s immune systems go into overdrive and attack their vital organs.
On Friday, Mr. Trump was given an infusion of an experimental antibody cocktail that is being tested by the drug maker Regeneron. Mr. Trump is also receiving a five-day course of remdesivir, another experimental drug that is used in hospitalized patients and has been granted emergency authorization by the Food and Drug Administration.
The briefing came a day after a messy and contradictory presentation on Friday about whether Mr. Trump had serious medical issues.
Even though he has had low-oxygen episodes and is receiving dexamethasone, the doctors said Mr. Trump was doing better and might be discharged from the hospital and return to the White House as early as Monday.
Dr. Sean Conley, the White House physician, told reporters on Saturday that his team was working with the agency to trace contacts. But according to the federal official, while the C.D.C. had a team of experts on standby to help the White House, it has not been approached to do so.
The White House has not sought help from the Centers for Disease Control and Prevention to trace the contacts of people who attended a celebration in the Rose Garden on Sept. 26 for Judge Amy Coney Barrett, according to a federal official familiar with the matter.
“I think they have an obligation to understand how the infection was introduced into that environment,” he said of the White House. “There doesn’t seem to be a very concerted effort underway.”
In an interview Sunday on the CBS program “Face the Nation,” Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration, also offered evidence suggesting that no robust contact tracing effort was underway. Dr. Gottlieb said he had spoken to several officials who attended the Rose Garden event and who had not been spoken to by any contact tracers.
Some attendees have since tested negative, but that does not necessarily mean they are not infected. Negative results are common early in the course of infection, when the levels of virus in the body are still low. For that reason, C.D.C. guidelines recommend that anyone who has been in close contact with an infected person should stay in quarantine for two weeks even if they test negative.
The celebration of Judge Barrett’s nomination to the Supreme Court on Saturday is looking more and more like a “super spreader event.” At least seven attendees, including President Trump and Melania Trump, have already tested positive.
Since Saturday, President Trump has debated former Vice President Joe Biden, spoken at a rally attended by thousands of people in Minnesota, met with supporters at a golf club in New Jersey and conferred with dozens of aides at the White House, all while not wearing a mask.
The lack of attention to contact tracing could have devastating consequences for the hundreds of people who have come into proximity with those who may have become infected on Saturday. Any of them could have caught the virus and gone on to transmit it to many more people.
The C.D.C. has experts who are trained in contact tracing and could have immediately put an operation into place to trace contacts of President Trump and others who have been infected. The experts would have worked with health departments of the states in which incidents occurred. In the case of the White House, “we would help if we were asked,” the official said. But no such request came through, he said: “We don’t get involved unless we’re asked to get involved.”
Chris Christie, the former governor of New Jersey who helped the president prepare for Tuesday’s debate, has tested positive and been hospitalized.
On Sunday, Mr. Trump’s medical team clarified that they had given an overly rosy description of the president’s illness on Saturday.
Since the moment shortly before 1 a.m. on Friday when President Trump first revealed to the nation that he had tested positive for the coronavirus, conflicting information offered by his doctors and aides has added confusion to an already anxious moment, leaving Americans to wonder whether the president’s condition was improving or was “very concerning.”
Here is a timeline of information released before Sunday on Mr. Trump’s health:
But it remained unclear exactly when his illness had been diagnosed, when he had first developed symptoms, how severe those symptoms were and whether he had been treated with oxygen at any point.
“The team and I are extremely happy with the progress the president has made,” Dr. Conley said then.
Early Saturday, in the first official briefing by Mr. Trump’s doctors since he fell ill, the White House physician, Sean P. Conley, painted a relentlessly positive assessment of Mr. Trump’s condition.
Dr. Conley and others on the team declined to provide important specifics, and left an impression that the president had been known to be sick a day earlier than previously reported, forcing them to backtrack later.
His tone was a bit more guarded in the latest update. Dr. Conley said in a statement Saturday night that while the president is “not yet out of the woods, the team remains cautiously optimistic.”
“None at this moment, and yesterday with the team, while we were all here, he was not on oxygen,” Dr. Conley said, leaving open whether there had been a period on Friday when he was on oxygen.
At the morning briefing, Dr. Conley said that the president was not receiving supplemental oxygen at that time, but he repeatedly declined to say definitively whether Mr. Trump had ever been on oxygen.
Dr. Conley also appeared to indicate that the president’s infection was first diagnosed on Wednesday, and not on Thursday night, as Mr. Trump had said when he disclosed the positive test on Twitter early Friday. As Dr. Conley was describing what he said was the president’s progress, he said that Mr. Trump was “just 72 hours into the diagnosis now,” which would have put the diagnosis at midday on Wednesday.
Two people close to the White House said in separate interviews with The New York Times that the president had experienced trouble breathing on Friday and that his blood oxygen level had dropped, prompting his doctors to give him supplemental oxygen at the White House and then to transfer him to Walter Reed.
“We’re still not on a clear path to a full recovery,” he said.
After the early briefing on Saturday, Mark Meadows, the White House chief of staff, offered a far more sobering assessment of the president’s condition than the doctors had. Speaking to reporters outside Walter Reed, Mr. Meadows described the president’s vital signs as “very concerning.”
Mr. Trump was said by three administration officials and people close to him to indeed be in better shape, which added to the frustration among some White House advisers that Dr. Conley and Mr. Meadows had created such confusion.
Mr. Meadows, whose comments were said to have angered the president, later called to Fox News and said that Mr. Trump had shown “unbelievable improvement.”
The people who tested positive were not employees who come in direct contact with the president and the first lady, one of the people familiar with the diagnoses said. But the positive results again raise questions about how and when President Trump may have been exposed to the virus.
Two members of the White House residence staff tested positive for the coronavirus roughly three weeks ago, according to two people familiar with the diagnoses.
The White House “does take any positive case seriously and has extensive plans and procedures in place to prevent further spread,” he said. “A full and complete contact trace consistent with C.D.C. guidelines is included in that and appropriate notifications and recommendations are made. “
Judd Deere, a spokesman for the president, declined to comment specifically on the diagnoses, referring to a statement about not commenting on the personal health of individuals.
A spokeswoman for Kenzo, the company he founded, confirmed the news.
Kenzo Takada, the designer whose exuberant prints and volumes helped break the Paris barrier and bring Japanese fashion to the world, died on Sunday at a hospital in Paris. He was 81. The cause was complications from the novel coronavirus.
Known for his beaming smile and mischievous sense of fun, Mr. Takada, who was generally referred to only as Kenzo, shook up the established French fashion world when he arrived — via boat — from Japan in 1964. Though he initially planned to stay only six months, he ended up living in the city for 56 years, and his work opened doors not only for the highly influential Japanese designers who came after him, such as Yohji Yamamoto and Rei Kawakubo, but he also created a new kind of mix-and-match aesthetic that crossed borders and cultures, embraced diversity and influenced a generation.
“Kenzo Takada was incredibly creative,” said Jonathan Bouchet Manheim, chief executive of K-3, the lifestyle company that Mr. Takada founded in January, though he had retired from fashion in 1999. “With a stroke of genius, he imagined a new artistic and colorful story combining East and West — his native Japan and his life in Paris. He had a zest for life …. Kenzo Takada was the epitome of the art of living.”
Amid the muddled and conflicting information about President Trump’s condition, his allies seized on a video and photos the president posted online in an attempt to rally around a more consistent — and positive — message.
He died in the middle of Paris Fashion Week, which has been struggling to go on despite the pandemic. A smattering of live shows are taking place at a highly reduced capacity and with mask-wearing guests. The week began as Paris announced that the city is poised to, once again, shut down restaurants and bars if new cases continue to increase.
“If only all elected officials had this work ethic,” his son Eric Trump wrote above photographs released by the White House appearing to show the president working from an office suite at Walter Reed hospital. He added that his father “is a true warrior. I have admired this unrelenting drive my entire life.”
After Mr. Trump posted the four-minute video Saturday evening on Twitter, his family and aides amplified the message that Mr. Trump was in good condition and working hard despite his illness. In the video, he wears a suit and describes feeling well — despite a warning from his own chief of staff that he did not yet face “a clear path to recovery.”
And Mr. Trump’s daughter Ivanka, who also posted the video, said she had spoken to her father and that “he is as optimistic, thankful and strong as he looks and sounds in this message to America.”
“One take, from the heart, no teleprompter,” Jason Miller, a senior adviser to Mr. Trump’s campaign, wrote in a tweet reposting Mr. Trump’s direct-to-camera video. “Over to you, Sleepy Joe!” he added, in a jab at Mr. Trump’s Democratic rival, former Vice President Joseph R. Biden Jr. (While there was no evidence of a teleprompter, Mr. Trump does look down at notes in front of him as he speaks.)
Others noted a moment in the video when Mr. Trump’s shoulders suddenly hunch and his face begins to contort midsentence as though he is about to cough before he returns to normal. Video experts said that modern editing tools can smooth out edits that would once have appeared abrupt and noticeable, though The New York Times was not able to verify the claims. The White House did not comment on whether the video had been edited.
At the same time, however, Democratic and liberal critics of the president pounced on the video and images of the president as suspicious and potentially misleading. Some online sleuths noted that official photos of Mr. Trump appearing to sign documents in two different rooms, and wearing slightly different outfits, contained metadata with time stamps showing they were taken 10 minutes apart. The metadata later appeared to have been deleted.
“As I was writing this letter, the Covid-19 pandemic unexpectedly erupted, exposing our false securities,” Francis said in the encyclical, the most authoritative form of papal teaching. “Aside from the different ways that various countries responded to the crisis, their inability to work together became quite evident. For all our hyper-connectivity, we witnessed a fragmentation that made it more difficult to resolve problems that affect us all,” he added.
Pope Francis criticized the failures of global cooperation in response to the coronavirus pandemic in a document released on Sunday that underscores the priorities of his pontificate.
Released amid another Vatican financial scandal and after changes in church rules regarding sex abuse, the letter steered clear of other contentious subjects. It instead returned often to some of the church’s hobbyhorses, including a secularism that has produced what the church sees as a throwaway, consumerist culture.
“Anyone who thinks that the only lesson to be learned was the need to improve what we were already doing, or to refine existing systems and regulations, is denying reality,” the pope said.
“If only we might keep in mind all those elderly persons who died for lack of respirators, partly as a result of the dismantling, year after year, of health care systems. If only this immense sorrow may not prove useless, but enable us to take a step forward toward a new style of life,” he wrote.
Francis argued that this was apparent in the treatment of older people during the pandemic.
On Sunday, more than 40,000 people were expected to run the London Marathon — just not together.
The pope also warned that the forces of “myopic, extremist, resentful and aggressive nationalism are on the rise.”
Those who took part in the geographically distanced race were told to log their performances on a dedicated app to claim their medals and official T-shirts.
Instead, runners were scattered across Britain and more than 100 other countries, after organizers encouraged the vast majority of participants to run 26.2 miles at a time that worked for them wherever they happened to be.
Brigid Kosgei of Kenya, who won the 2019 edition and is the current world-record holder in the women’s marathon, defended her title on Sunday, finishing in 2 hours 18 minutes 58 seconds.
The official course in St. James’s Park in central London — 19 laps of 1.3 miles each, plus an additional 1,470 yards — was restricted to a relative handful of elite runners. The race, which was postponed from April, is one of the only major marathons to be maintained in any form this year.
“I struggled up to the moment I finished,” she said.
Kosgei, 26, told the BBC that while it was “wonderful to race,” her preparation had been affected by the pandemic.
Prince Harry said Saturday in a message published by the race’s organizers that “the amazing tenacity of runners from around the world is a reminder of our strength and sense of community during these difficult times.”
In the men’s race, the Ethiopian runner Shura Kitata, 24, won in a sprint finish, crossing the line in 2:05.41, a second before Vincent Kipchumba of Kenya. World-record holder Eliud Kipchoge of Kenya, who has won the London Marathon four times, came in eighth.
But this year, the government has asked South Koreans to stay home, to avoid exacerbating the country’s latest coronavirus outbreak.
In a normal year, millions of people in South Korea would be spending this weekend visiting family in their hometowns in celebration of Chuseok, the rough Korean equivalent of Thanksgiving.
“Watching my parents grow older and change often worries me, but seeing them in person puts my mind at ease again,” said Joo Jae-wook, 57, a retired salesman who has traveled with his brothers to their hometown every Chuseok for the past three decades. “But this year I can’t even do that.”
Many South Koreans have grudgingly followed orders, but their acquiescence comes with an emotional price: A normally joyful time of year now feels empty of its sacred rituals, and clouded with feelings of anxiety and disorientation.
Last week, President Moon Jae-in told the nation that South Korea’s people were observing Chuseok at a “difficult time,” and that their sacrifices would be rewarded. “The government will surely repay the people who have endured the difficulties by succeeding in controlling the virus and protecting the economy,” he said.
South Korea, a nation of about 50 million, has reported 421 deaths and more than 24,000 coronavirus infections since the pandemic began, including almost 500 new cases in the past week. The country’s response has been widely praised as a model, but a recent outbreak that began in Seoul has tested the government’s strategy of using social-distancing restrictions and extensive tracking to keep the virus at bay without shutting down the economy.
The United Kingdom reported a record 12,871 new cases on Saturday evening, double the number daily infections from Friday. The nation is working to contain a second coronavirus wave, and the government said the spike was the result of a “technical issue” that delayed the publication of some cases. Prime Minister Boris Johnson said on Sunday that the situation would be “bumpy” until Christmas and potentially longer. Britons, he added, should behave “fearlessly, but with common sense.”
In other global developments:
France reported some 17,000 new cases of infection on Saturday as an ongoing surge in cases forced the closure of bars and restaurants in the southern port of Marseilles. Rising infection rates mean similar closures could soon apply in the capital, Paris.
Two prominent Israeli officials said on Twitter that they had tested positive for the virus: Gila Gamliel, the environmental protection minister, and Ayman Odeh, a prominent Arab lawmaker posted.
Russia on Sunday recorded more than 10,000 new infections for the first time since mid-May during the outbreak’s peak there, reporting 10,499 cases. President Vladimir V. Putin, who encouraged his country to return to normal, has built himself a virus-free bubble that far outstrips the protective measures taken by many of his foreign counterparts.
Poland’s government said the country surpassed 100,000 total cases on Sunday for the first time.
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India on Sunday reported 75,829 new infections and 940 deaths, a day after it became the third country after the United States and Brazil to pass 100,000 deaths.
From Sunday through Tuesday he will be in Tokyo, where he will participate in a meeting of foreign ministers from Australia, India and Japan to discuss the pandemic and other issues.
As President Trump remains hospitalized with Covid-19, Secretary of State Mike Pompeo will cut short a trip to Asia this week, canceling stops in South Korea and Mongolia but continuing with a visit to Japan.
Mr. Pompeo earlier alluded to the possibility of curtailing his Asia visit because of the novel coronavirus infections in the president’s circle.
“Secretary Pompeo expects to be traveling to Asia again in October and will work to reschedule visits on that trip, that is now just a few weeks off,” a State Department spokeswoman, Morgan Ortagus, said in a brief written statement Saturday. She did not specify why the schedule had been changed.
Mr. Pompeo said that he had tested negative on Friday and had last met with Mr. Trump on Sept. 15.
“If we can’t — if have to postpone a trip or cancel something, we’ll figure out how to get it back on the schedule,” he told reporters on Friday. “But I’m hopeful we can at least make sure we get to Asia for sure — some important things, but we’ll see. If the medical situation doesn’t permit it, we won’t do that. We won’t put anybody at risk.”
Being located in small towns, having minimal fraternity and sorority life, and aggressively enforcing social-distancing measures all help in suppressing the contagion, experts say. But one major thread connects the most successful campuses: extensive testing.
As campuses across the United States struggle to carry on amid Covid-19 illnesses and outbreaks, a determined minority are beating the pandemic — at least for the moment — by holding infections to a minimum and allowing students to continue living in dorms and attend in-person classes.
The program has allowed Colby College, with about 2,000 students on its rural Maine campus, to test each student before and after arrival on campus, then twice weekly thereafter, using a nasal swab PCR test that takes less than three minutes to conduct. Faculty and staff members are also tested twice weekly. So far, the campus has had 11 positive tests, a few of which turned out to be false positives, said David Greene, the school’s president.
Small colleges in New England — where the Broad Institute, a large academic laboratory affiliated with M.I.T. and Harvard, is supporting a regional testing and screening program with more than 100 colleges — are showing particularly low rates of infection. The partnership tests students frequently and pays $25 to $30 per test to have the samples processed overnight at the institute’s lab in Cambridge, Mass.
“It could have been 150 people, and we kept it to one person,” Mr. Greene said.
In one case, the testing identified a student who had apparently caught the coronavirus on the way to campus and did not have a sufficient viral load to test positively upon entry, he said. By the time the infection was caught in the next round of testing two days later, contact tracing revealed that a roommate had been infected.
The city plans to test a random sample of 10 to 20 percent of people, including students and adults, in each city school once a month starting next week, already a herculean task.
New York reopened classrooms for hundreds of thousands of students last week, after a tumultuous summer of last-minute changes. But the city’s ambitious plan to randomly test students for the coronavirus in each of its 1,800 public schools will probably be insufficient to catch outbreaks before they spread beyond a handful of students, according to new estimates of the spread of infections in city schools.
“The outbreaks could be quite large by the time they are detected by the monthly, 10-to-20-percent testing,” said Anna Bershteyn, the lead author of the new analysis and assistant professor of population health at N.Y.U.
But in order to reliably detect outbreaks and prevent them from spinning out of control, New York may need to test about half of the students at each school twice a month, researchers at New York University estimated. Experiences in Germany, Israel and other countries suggest that outbreaks could spread quickly despite the city’s relatively low rate of infection, the researchers said.
The finding underscores how daunting testing will be in any district trying to reopen for some in-person classes, and particularly in New York, which is home to a system of 1.1 million students, about half of whom returned to classrooms this week.
The testing issue took on fresh urgency this week, when Mayor Bill de Blasio reported that the city’s average test positivity rate, which has been extremely low throughout the summer, had begun to tick up. If the virus continues to surge, the entire public school system could shutter.
The Patriots confirmed a positive test but did not identify the player. In a statement released Saturday, the team said the player entered isolation and that subsequent testing on players and staff members who had been in contact with him had come back negative.
The N.F.L. postponed a highly anticipated game scheduled for Sunday between the New England Patriots and the Kansas City Chiefs until Monday or Tuesday after positive coronavirus tests on both teams. According to multiple reports, Cam Newton, the Patriots quarterback, was among those who tested positive.
In a statement, the league said that the Patriots and the Chiefs were consulting with infectious disease experts and working closely with the N.F.L. and the players’ association “to evaluate multiple close contacts, perform additional testing and monitor developments.”
The new positive tests come after the N.F.L. spent much of the week scrambling to address an outbreak of positive tests among the Tennessee Titans. That team reported 11 positive tests among players and team personnel, which forced the league to push its scheduled Week 4 game against the Pittsburgh Steelers back to Oct. 25, Week 7 of the football calendar.
“There is no way under the sun that Pence should be anywhere but in his home,” said Dr. Rochelle Walensky, an infectious disease expert at Harvard University. “He was sitting in a sea of people with Covid; there is no way he should go anywhere.”
Vice President Mike Pence, who would be the most powerful man in the nation should President Trump become too ill to continue his duties, has been on the campaign trail despite having been in close contact with the president and being at high risk of having the virus himself.
Mr. Pence was last in contact with the president on Tuesday morning at the White House. He may have also been in close contact with several others who tested positive after having attended the White House event last Saturday to announce the nomination of Judge Amy Coney Barrett.
Mr. Pence and Karen Pence, the second lady, tested negative for the coronavirus for a third day on Sunday, a senior administration official said. They have been tested every day since Mr. Trump and first lady Melania Trump tested positive for the coronavirus, which officials have said was Thursday. But it is possible to test negative and still be infected early in the course of the virus.
And it puts Mr. Pence and anyone who came into contact with Mr. Trump on Tuesday squarely at risk. Chris Christie, the former governor of New Jersey, who helped the president at the White House with debate preparation from last Saturday through Tuesday, has tested positive.
Mr. Trump began feeling symptoms as early as Wednesday, and several studies have shown that people are most infectious from one to two days before showing symptoms to about two days after. This could mean that Mr. Trump was already highly infectious on Tuesday.
Mr. Biden has continued to campaign, traveling to Grand Rapids, Mich., on Friday, and holding a virtual town hall with a union on Saturday. He is usually seen wearing a mask at campaign events.
Former Vice President Joseph R. Biden Jr. is also at risk of being infected, experts say. Although he and Mr. Trump stood more than 12 feet apart at the debate, they were indoors. Studies have shown that indoors, the virus can travel farther than six feet, prompting experts to recommend that Mr. Biden also quarantine and get tested daily.
Mr. Pence’s team has said that he tested negative for the coronavirus on Friday, Saturday and Sunday. But tests for the virus can produce false negatives if used too early in the course of infection. The virus can take up to 14 days to show symptoms, which is why the Centers for Disease Control and Prevention recommends that anyone who has been in close contact with an infected person quarantine for 14 days.
Mr. Pence, meanwhile, has traveled to several states and participated in outdoor and indoor campaign events. On Wednesday, he attended a packed fund-raiser in Atlanta, and on Thursday spoke at two indoor events in Iowa. He did not wear a mask on either day, nor did most attendees.
He is scheduled to hold a rally at a police-equipment manufacturer in Arizona on Thursday.
Trump campaign officials said Sunday that Mr. Pence had no plans to curtail his public appearances. “He will be hitting the trail,” Jason Miller, the campaign’s senior adviser, told CNN. “And he’s going to have a very full, aggressive schedule.”
Donald McNeil Jr. contributed reporting.
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