What we know and don’t know about the president’s health

President Trump remains hospitalized with the coronavirus but, despite daily medical briefings, much about the president’s health continues to be unclear. 

Officials have given at times conflicting answers, and the president’s doctor, Sean Conley, has not answered a number of questions at his press conferences, acknowledging Sunday that he left the impression the day before he was “trying to hide something.”

Thus far, it’s not apparent just how severe the president’s case of COVID-19 is.

But here’s what we do know – and what we don’t – about the president’s health, as of the most recent press briefing on Sunday: 

What we know:

His doctors appear upbeat 

Doctors projected a positive message about the president’s condition at press conferences Saturday and Sunday. 

“Since we spoke last the president has continued to improve,” Conley said on Sunday. “As with any illness there are frequent ups and downs over the course.”

Trump is not currently on supplemental oxygen and is able to get up and walk around, doctors said, even adding he could be released Monday, though some experts questioned that prediction. 

“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,” said Dr. Brian Garabaldi, part of the president’s medical team. 

However, a number of observers have questioned the upbeat messaging, particularly after inconsistencies between press briefings.

There have been drops in Trump’s oxygen level

At the same time, Conley revealed Sunday that Trump has had two episodes of “transient drops in his oxygen saturation.” During one of those drops, on Friday morning, Trump received supplemental oxygen, something Conley did not reveal on Saturday. 

“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,” Conley said Sunday about not disclosing that fact on Saturday. 

Adding to the confusion, Conley said he would have to “check with the nursing staff” when asked if Trump also received supplemental oxygen during his second drop in oxygen levels on Saturday.  

Trump is on a number of medications

Doctors announced Sunday that Trump is now on the steroid dexamethasone in response to the low oxygen levels. 

“In response to transient low oxygen levels, as Dr. Conley has discussed, we did initiate dexamethasone therapy, and he received his first dose of that yesterday,” Garabaldi said.  

That is the third medication that the White House has said Trump has been given, in addition to the antiviral drug remdesivir and an experimental antibody therapy from Regeneron.

What we don’t know:

Why Trump is receiving the drugs he is  

The array of three different medications prescribed to Trump, including an experimental antibody treatment not yet authorized by the Food and Drug Administration, raises questions about the severity of Trump’s illness.  

The World Health Organization recommends dexamethasone only for those with “severe and critical COVID-19.” 

“Dexamethasone was found to be beneficial ONLY in patients on a ventilator OR on oxygen,” tweeted Dr. Craig Spencer, Director of Global Health in Emergency Medicine at Columbia University Medical Center. “NOT on patients who don’t need oxygen. There was even the possibility of harm in that patient population.”

Dr. Bob Wachter, chair of the department of medicine at the University of California-San Francisco, said he expects Trump’s oxygen levels dropped below 90 percent, which would help explain giving him dexamethasone. 

Conley was evasive on that question, saying only, “It wasn’t down into the low 80s or anything,” when asked if Trump’s oxygen level dropped below 90, indicating it could have been in the mid or high-80s, which Wachter called “quite low.” 

“I’m sure they spent hours discussing, because he’s sort of on the border,” Wachter said of the decision to give dexamethasone, but added it’s a “reasonable” decision. 

What Trump’s chest scans showed

Another relevant area where Conley was not fully transparent is on the findings of the president’s chest scans. Asked if Trump has pneumonia or damage to the lungs, Conley said, “we’re tracking all of that, there’s some expected findings but nothing of any major clinical concern,” without elaborating. 

That answer raised concern from experts.

“What the hell does that mean?” Wachter said. “The ‘expected finding’ is normal and if it’s not there’s a finding.”

He added the doctors should disclose what that finding was and the answer could indicate Trump has pneumonia. 

Between the cagey answer on the chest scans and on oxygen levels dropping below 90 percent, Wachter said “he certainly has a moderately severe case [of COVID-19].”

“The talk about him going home tomorrow is craziness,” he added. 

When Trump contracted the virus

Aside from the specifics of the president’s condition, it remains unknown when Trump contracted the virus.

The White House has not said when Trump last tested negative, which is important information for determining how long he might have had the virus and when he became infectious. He has had an array of events in the past week, possibly exposing a wide range of people. 

Trump went to a fundraiser in New Jersey on Thursday after learning his top aide Hope Hicks had tested positive and hours before his own positive test, for example. But events earlier in the week could have exposed others too, depending on when Trump became infected.   

White House communications director Alyssa Farah said Sunday she didn’t have information on when Trump took his first coronavirus test on Thursday. While she said she would track the answer down, “there’s certain sensitivities on how that information is shared.”

Asked about the trip to New Jersey on Thursday, she said the decision was “made by White House operations because he wasn’t deemed to pose a threat but I’ll get you an answer on the specifics.”