Doctors say Trump taking steroid dexamethasone after oxygen dip

The medical team treating Donald Trump, who tested positive for the novel coronavirus late last week, says the president was given the steroid dexamethasone because his blood oxygen levels dipped but “continued to improve” and could return to the White House as soon as Monday.

The medical team spoke to reporters on Sunday from Walter Reed National Military Medical Center, where Trump was admitted on Friday following the diagnosis, which came just more than a month before the presidential election on November 3.

“Since we spoke last, the president has continued to improve. As with any illness, there are frequent ups and downs over the course,” Trump’s physician Dr Sean Conley said.

Conley said Trump received supplemental oxygen at the White House when his blood oxygen level dipped before being taken to hospital.

Another member of the team, Dr Brian Garibaldi, said the 74-year-old was given the steroid dexamethasone on Saturday in response to “transient low oxygen levels”. The doctors said Trump’s blood oxygen levels were currently stable.

“He received his first dose of that yesterday and our plan is to continue that for the time being,” Garibaldi said, adding Trump was “up and around” and was feeling well.

“Our plan for today is to have him eat and drink, be up out of bed as much as possible, to be mobile,” Garibaldi said.

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

‘Worrying sign’

Despite the White House team’s positive prognosis, medical experts have raised questions about the president’s condition.

Dr Eric Feigl Ding, an epidemiologist and senior fellow at the Federation of American Scientists told Al Jazeera Trump being given dexamethasone is an “extremely worrying sign”.

“The WHO [World Health Organization] says it is only used for critical and severe patients. It actually recommends against [usage in] people who are not serious,” he said. “NIH [National Institutes of Health] also says it only for serious patients who are either on ventilators or supplemental oxygen, which Trump barely qualifies for.”

Feigl Ding added Trump is on a “really bad trajectory” and Monday is “a little premature for discharge”.

“What I heard in the news conference description suggested the President has more severe illness than the generally upbeat picture painted,” Dr Daniel McQuillen, an infectious disease specialist at Lahey Hospital & Medical Center in Burlington, Massachusetts, told Reuters news agency.

Given the patient is 74 years old, overweight and possibly at high risk of complications, “they were aggressive at the beginning,” said Dr Stuart Cohen, chief of infectious disease at California’s UC Davis Health.

COVID-19 generally comes in phases – the viral infection itself and in some cases an overreaction of the body’s immune system that can cause organ damage. Doctors say it can be hard to predict how each person responds, but even if he is discharged to the White House Trump would continue to be closely monitored.

“He’s not going to go to a home where there’s no medical care. There’s basically a hospital in the White House,” said Dr Walid Gellad, professor of medicine at University of Pittsburgh.

Contradictory messaging

Trump’s doctors also sought to respond to contradictory messaging from the White House on the president’s condition on Saturday.

Early in the morning, the medical team painted an optimistic picture of the president’s condition, saying he was improving and already wanted to return to the White House.

Minutes later, Mark Meadows, the president’s chief of staff, gave a less rosy assessment, telling reporters: “The president’s vitals over the last 24 hours were very concerning and the next 48 hours will be critical in terms of his care. We’re still not on a clear path to a full recovery.”

Conley, the White House doctor, said on Sunday he was “trying to reflect an upbeat attitude of the team and the president about the course his illness has had”.

“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 isn’t necessarily true,” he added.

Trump’s medical team added that Trump has not run a fever since Friday and his liver and kidney function remained normal after the second dose in a five-day course of remdesivir, an intravenous antiviral drug sold by Gilead Sciences that has been shown to shorten hospital stays in patients with COVID-19.

Several Republicans infected

Several prominent allies of the president have also tested positive for COVID-19 since Trump’s announcement, including his campaign manager Bill Stepien, Republican Party chair Ronna McDaniel, senators Mike Lee, Thom Tillis and Ron Johnson, former White House senior adviser Kellyanne Conway and former New Jersey Governor Chris Christie.

Meanwhile, Trump’s campaign said Vice President Mike Pence, who would assume the presidency if Trump were unable to carry out his duties, would have an “aggressive” schedule this week, as would Trump’s three oldest children.

“We can’t stay in our basement or shut down the economy indefinitely. We have to take it head-on,” Trump campaign Senior Advisor Jason Miller told the news channel ABC.