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Latest On Trump COVID-19 Diagnosis: Oxygen Levels Dropped, Steroid Treatment

MICHEL MARTIN, HOST:

We're going to begin this hour with another update on the president's health. The president just released a video on Twitter.

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PRESIDENT DONALD TRUMP: I learned a lot about COVID. I learned it by really going to school. This is the real school.

MARTIN: He was then taken to drive by supporters who have been gathering outside Walter Reed National Military Medical Center, where he is hospitalized. Earlier today, his medical team there offered more details of his care, and they even said he could be discharged as soon as tomorrow. To talk about all of this, we have NPR White House correspondent Tamara Keith and NPR health correspondent Rhitu Chatterjee.

And, Rhitu, I'm going to start with you. Today we learned that the president saw his oxygen levels drop twice, Friday and yesterday, and that he got supplemental oxygen Friday at the White House. What has that told us about the course of the illness?

RHITU CHATTERJEE, BYLINE: There's a lot we still don't know. And, Michel, as you point out, his oxygen levels did drop. And White House physician Sean Conley today said that in response to those drops, doctors gave him another drug, dexamethasone, which is a steroid. So let's talk about this for a second. This drug has been shown to reduce the risk of death in patients with severe disease - very ill patients on ventilators - and also those who are on oxygen support. This drug doesn't benefit and can even do harm to patients with mild disease.

Now, Trump may have received this drug out of an abundance of caution, but it could also signal that he has a more severe case than his doctors have let on. Dr. Carlos Del Rio is an epidemiologist at Emory University who spoke to NPR on Weekend Edition Sunday, and he thinks that the dips in oxygen levels suggest severe disease.

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CARLOS DEL RIO: Once your oxygen saturation drops below 94%, even if it's transitory, you are immediately in the category of no longer mild or moderate, but you're in the category of severe disease. And it is in those patients that both Remdesivir and dexamethasone has proven to be effective. And that's exactly what the president has received. He's received Remdesivir, and he's received dexamethasone. And that's where he currently is right now.

CHATTERJEE: So these and other drugs he's getting may mean he has more than mild symptoms.

MARTIN: And what other interventions has he received?

CHATTERJEE: So Remdesivir, which Del Rio just mentioned, which is also used for people with more severe illness, as well as an experimental antibody cocktail from Regeneron Pharmaceuticals.

MARTIN: Tamara Keith, let's go to you. These briefings yesterday and today have at times offered a lack of clarity or conflicting details. Did you hear more about that today? What did you hear?

TAMARA KEITH, BYLINE: Well, we heard more conflicting details. We were not told yesterday about the supplemental oxygen. That was revealed today. Conley was almost comically evasive about it yesterday. Today, reporters asked what the scans of the president's lungs showed. And Conley was again evasive. The timeline about infection is not clear. Conley gave a timeline yesterday, and it had to be walked back. And then the overall tone of the briefing yesterday was much rosier than a comment given right after the fact by Chief of Staff Mark Meadows. Sean Conley, the doctor, was asked about that today.

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SEAN CONLEY: I was trying to reflect the upbeat attitude that the team, the president, his course of 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, you know, it came off that we were trying to hide something, which wasn't necessarily true.

KEITH: It raises the question of who these briefings are for. Are they to inform the American public? Are they to buck up the patient, who is watching on TV? Who is the real audience here? And I'll just say that there might be a clue in that the memorandums that come from the White House physician always start with this line - I release the following information with the permission of President Donald J. Trump. So President Trump is, it seems, likely determining what is said in these briefings.

MARTIN: Well, the medical team said that Trump could go back to the White House as soon as tomorrow. Tam, as briefly as you can, what's your reaction to that?

KEITH: Well, President Trump is a showman, and we saw that again today with this drive-by of supporters even as he's down in the polls. But that drive-by required a bunch of people to get into PPE. You had Secret Service agents in an SUV with the president in PPE. The whole justification that had been given by the White House for why he was going to the hospital was so that he could keep working by letting people stay safe in the White House because he has a highly infectious disease. If he goes back to the White House, that would sort of contradict the whole justification in the first place.

MARTIN: And, Rhitu, what about you? What's your reaction to this news that he may go home tomorrow?

CHATTERJEE: Well, he might, but even if he does, it's highly unlikely he's going to go back to business as normal because - and it's more likely that the hospital would be moving to the White House because he will still need to remain in isolation, and he will still need to continue his treatment. Remdesivir is a five-day treatment, and today doctors said he got his second dose on Saturday. So if he gets dose three today, that's still two more days of getting the drug. And dexamethasone too, the course of that drug goes for several days as well. Also, most people who recover from COVID-19 don't go back to feeling like their old selves right away. Many people feel under the weather for weeks, and there's risk of long-term damage to the brain, the heart, lungs and even the kidneys. So, really, we still have to wait and watch what recovery looks like for the president.

MARTIN: That is NPR health correspondent Rhitu Chatterjee and NPR White House correspondent Tamara Keith. Thank you both so much for sharing your expertise with us.

KEITH: You're welcome.

CHATTERJEE: Thank you, Michel. Transcript provided by NPR, Copyright NPR.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.
Tamara Keith has been a White House correspondent for NPR since 2014 and co-hosts the NPR Politics Podcast, the top political news podcast in America. Keith has chronicled the Trump administration from day one, putting this unorthodox presidency in context for NPR listeners, from early morning tweets to executive orders and investigations. She covered the final two years of the Obama presidency, and during the 2016 presidential campaign she was assigned to cover Hillary Clinton. In 2018, Keith was elected to serve on the board of the White House Correspondents' Association.