SEAN CONLEY, WHITE HOUSE PHYSICIAN: Good afternoon, everyone, thank you for being here. Over the past 24 hours, the president has continued to improve. He’s met or exceeded all standard hospital discharge criteria. He’ll receive another dose of Remdesivir here today and then we plan to get him home. It’s been more than 72 hours since his last fever.
Oxygen levels, including ambulatory saturations and his work of breathing are all normal. Though he may not entirely be out of the woods yet, the team and I agree that all our evaluations and most importantly his clinical status support the president’s safe return home, where he’ll be surrounded by world class medical care 24/7. I’d like to bring Dr. Duli up to review some more specifics.
SEAN DOOLEY, PULMONARY CRITICAL CARE DOCTOR: Good afternoon, just a brief update this morning, as Dr. Connelly mentioned, the president uh continues to do very well. His vital signs this morning were notable for a temperature of 98.1. His blood pressure was 134 over 78, the respiratory rate of 17 respirations per minute. His heart rate was 68 beats per minute and his last oxyhemoglobin saturation was 97% on room air.
He currently does not endorse any respiratory complaints. And aside from our evaluation with the multidisciplinary team this morning has maintained a full schedule ambulating and working on the White House medical unit. And I’ll turn it over to Dr. Garibaldi and again discuss therapeutics.
BRIAN GARIBALDI, PULMONARY CRITICAL CARE DOCTOR: Hi, good afternoon. And again, I just wanted to echo the sentiment of what an honor it is to to be part of this wonderful team here at Walter Reed.
Yesterday evening, the president received his third dose of Remdesivir. He tolerated that infusion without difficulty and his kidney and liver function continue to be normal. Our plan is to give the fourth dose of Remdesivir this evening before he goes back to the White House. And we’ve made arrangements to deliver the fifth and final dose of his treatment course at the White House tomorrow evening.
He continues on dexamethasone. And again, the plan for today is to continue to be up and out of bed, eat and drink and work as he is able. And I’d like to turn it over to Dr. Jason Blaylock, who’s an infectious disease specialist and the chief of medicine here at Walter Reed, to give some updates on infection control. Thank you.
BLAYLOCK: Good afternoon, everyone. First of all, I just want to say what an honor it’s been to be part of this medical team behind me and to care for the president. Since the president’s arrival at Walter Reed, he’s received medical management that remains in line with national clinical societal guidelines for treatment of covid-19 infection.
In addition, both myself and Dr. West Campbell have worked very closely with various laboratories in the area, state of the art facilities to include USAMRIID and rare on obtaining advanced diagnostic testing to really inform the White House medical team of both the status of the president as well as his ability to transmit virus to others.
Also, we have worked very closely with the Walter Reed team to ensure that we are looking very closely at infection control, prevention strategies and the right posture so that the president can safely return to his residence. And with that, I’m going to turn it over to Dr. Conley, who will answer any final questions.
CONLEY: I mentioned it Saturday, but I’d like to reiterate myself just how grateful the president and I are to the men and women of Walter Reed, our colleagues at Johns Hopkins, as well as the many federal private institutions that we receive support from. And so long as everything continues on the track that we’re experiencing right now, this time, the president already tweeted out, is to get him home later today. With that I’ll take a couple of questions.
REPORTER: How can the president be discharged back to the White House when he was given steroids? You said that he’s still on those steroids. Those are medicines, as you know, that are usually given to COVID patients who are on ventilators or, um, with low oxygen. So did you over-treat him? And if he’s still on that medication, how is it safe for him to return to the White House?
CONLEY: So we send patients home with medications all the time. In fact, yesterday afternoon, he probably met most of his discharge requirements safely from the hospital. And he’s returning to a facility, the White House medical unit that’s staffed 24/7 top notch physicians, nurses, PAs, logisticians and the unit here, the team here behind me is going to continue to support us in that nature.
REPORTER: Dr. Conley, What infection control measures are you taking and how is it safe for him to drive around in a cloth mask yesterday? And how is it safe for him now to return to the White House where there have been so many cases? How is any of this safe?
CONLEY: So the the president has been surrounded by medical and security staff for days wearing full PPE. Um, and yesterday, uh, the U.S. Secret Service agents were in that same level of PPE for a very short period of time.
We’ve worked with our infectious disease experts, uh, to make some recommendations for how to keep everything safe down at the White House, for the president and those around him.
Um, we’re looking at where he’s going to be able to, uh, carry out his duties, uh, you know, office space. And, um, and I’ll just say that it’s in line with everything we’ve been doing upstairs, uh, for the the last several days.
REPORTER: Can you tell us please, on testing, can you tell us when he had his last negative test? Was it Thursday? Was it Wednesday? Do you remember when he had his last negative?
CONLEY: I don’t want to go backwards.
REPORTER: — will help with contact tracing. For people who were around him to know when he tested positive
CONLEY: I understand. The contact tracing as I understand it is being done. I’m not involved with that.
REPORTER: — recommendation that he leave. Or was this something he pushed for?
CONLEY: No so we try to get patients home and out of the hospital as quickly as is safe and reasonable. Every day a patient stays in the hospital unnecessarily is a risk to themselves. And right now there’s nothing that’s being done upstairs here that we can’t safely conduct down home.
REPORTER: Now you had said that seven to 10 days was a window that you’d be concerned about. I don’t think we’re there yet. So do you have concerns about potential worsening or reversal? And what are your plans for addressing that if it were to happen?
CONLEY: You’re you’re absolutely right. And that’s why we all remain cautiously optimistic, um, and on guard, because we’re in a bit of unchartered territory when it comes to a patient that received the therapies he has so early in the course. So we’re looking to this weekend, if we can get through to Monday with him remaining the same or improving better yet, then we will all take that final deep sigh of relief. But as I said, 24/7 world class medical care surrounding him down there. We’re not going to miss anything that we would’ve caught up here.
REPORTER: He’s physically got to be in the White House. And what does that look like? How do you keep him safely quarantined?
CONLEY: I wish I could go into that more, but. But I just can’t.
REPORTER: Doctor, why did you begin Dexamethasone treatment?
CONLEY: So that has something to do — yesterday, we talked about that. The several little, uh, temporary drops and his oxygen. And we had discussed that as a team and elected to start it early in case that persisted or worsened the potential risks and side effects. We all discussed. We looked at the data and decided that we’d rather, uh, you know, push ahead on it than hold and risk. Uh, you know, the opposite,
REPORDER: And what about CT scans and chest-x-rays. … campaigning?
CONLEY: As far as travel goes, um we’ll see.
REPORTER: Dr. Conley, on his mental status. Can you talk to about whether he has any neurological symptoms? Does he have any side effects from his medications, any fogginess from the virus?
CONLEY: No, I think you’ve seen the videos, and now the tweets and you’ll see him, uh, shortly. You know, uh, he’s — he’s back. Yeah.
REPORTER: Have you seen any evidence of pneumonia? Or any inflammation in his lungs at all?
CONLEY: So we we’ve done routine standard imaging. Um, I’m just not at liberty to discuss.
REPORTER: So you’re actively not telling us what those lung scans show, just to be clear.
CONLEY: So there are HIPAA rules and regulations that, uh, restrict me in sharing certain things, uh, for his safety and his own health …
REPORTER: Can you share how many times — you said his oxygen dropped several times. Can you share how many times he was on oxygen? You said you’d check with the nursing staff yesterday.
CONLEY: Yeah, yeah, yes, yeah, so he … The two episodes we talked about yesterday and both times, that he received a little bit of oxygen and recovered immediately.
REPORTER: Was that oxygen required?
CONLEY: Um, no, it wasn’t required. He wasn’t short of breath. He wasn’t looking ill. It was more of us trying to anticipate needs and see how he responded in both cases. He came right off. … He didn’t need it for very long at all.
REPORTER: You were on board Air Force One for multiple trips. Are you at all concerned about your own exposure and exposure to the medical team?
CONLEY: I am concerned. But as the CDC says, there are caveats for essential employees that as long as you continue to test negative, you remain symptom free and you keep a mask on when you’re out and about, which we do inside the hospital 24/7, then then you can carry on your duties.
REPORTER: … a patient man. Has he been itching to get out of here?
CONLEY: The president has been a phenomenal patient during his stay here. And he’s he’s been working hand in glove with us and the team. And today got to the point — he’s holding court with those of us around him, the whole team going over all the specifics, the testing, what the future is. And we we have been back and forth on what’s safe and what’s reasonable. And he has never once pushed us to do anything that was beyond safe and reasonable practice that we all first wanted.
REPORTER: Was there anyone on the president’s medical team that who recommended against the president leaving here and going back to the White House today?
REPORTER: Or any White House staffers?
CONLEY: No.
REPORTER: Doctor, the president said, “Don’t be afraid of COVID.” Do you agree with that? Should we not be afraid?
CONLEY: I’m not going to get into what the president says.
REPORTER: You said his heart, liver and kidney function was normal or improving. Um improving. Does that mean that there were effects? And is it all normal? Like, what’s up with that?
CONLEY: Yeah, … it’s all normal right now. I would say he appeared to be a little dehydrated Friday. … He was able to just drink and recover from that. … Everything looks great.
REPORTER: [unintelligible question] … campaigning out in the country?
CONLEY: The big first thing that we need to do is that there is no evidence of live virus still present that he could possibly transmit to others. And that’s what the infectious disease experts and some of our partners, military civilian entities, doing some of these advanced diagnostics just to see as soon as we can identify that routinely. We talk about a 10 day window, CDC guidelines, but we we’re checking him more routinely than just waiting 10 days. There’s a possibility it’s earlier than that. There’s a chance that it’s a little bit later. But we will know as soon as possible and then we will look at him clinically. How are you feeling? How are you doing?
REPORTER: Why did you decide not to use, administer, hydroxychloroquine to the president during his time here?
CONLEY: I’m not going to go into all of our debates about specific medicines and therapies, there are dozens of therapies that we were made aware of that we considered that we discussed and debated and looked at, you know, the existing literature on, um, and this is the regimen we chose.
REPORTER: Is he having some of the muscle aches? Has he lost his sense of taste and smell?
CONLEY: Uh, no, we were just talking about that, what symptoms he has left. And … he even the slight cough that he used to have, he doesn’t really complain of all. He hasn’t ever complained of muscle aches. … He’s up and back to his old self predominantly.
REPORTER: Just to be clear, how long will he still be actively shedding the virus?
CONLEY: So this this morning, I believe there is even an accounting by Dr. Faucci referencing a five day, the first five days of illness that that people are most likely to shed live virus. There’s a reason there’s the 10 days is because most people by that time, after seven days … most folks don’t have culturable live virus. They put it to 10 just to give some extra space. It’s never 100 percent between everybody. So we’ll see. I can’t — I’m not going to put a specific number, but we we look at that window is all I’ll say.
REPORTER: Will the president be confined to his residence? Or will he be allowed to return to the Oval Office?
CONLEY: We’re going to do whatever it takes for the president to safely conduct business wherever it is he needs to do within the residence and White House.
REPORTER: Is he on blood thinners? And also, has he been using-have you been giving him Tylenol? Advil? Or anything to bring his fever down?
CONLEY: Oh, that came up yesterday. I would like to say he has not been on any fever reducing medications for over 72 hours. Yeah, he’s on a routine regimen of COVID therapy. I’m not going to go into specifics as to what he is and is not on, but.
REPORTER: You said and I’m going to read this here, that the president had a mild cough, some nasal congestion and fatigue on Thursday. Now back to my colleague Jim Jacobs’ question. The reason — knowing when the president’s last negative test is important for that reason, your words, what you said and also for the contact tracing, but would you recommend it, that given those symptoms, that he go that the president go to that Bedminster fundraiser?
CONLEY: It’s not up to me necessarily the president’s schedule, but I would say that it wasn’t until after he returned that we really sat down, then knowing the news of the day that we really dove into how are you feeling? What’s what’s going on?
REPORTER: — those were the symptoms he was experiencing on Thursday.
CONLEY: I’m not going to get into … operations.
REPORTER: Doctor, when was his last negative test and what was his viral load?
CONLEY: I know everyone wants that. … I don’t have his viral load. Those are some of the diagnostics that we’re sending out that will really tell us when it’s safe for him to get back out and around people.
REPORTER: [unintelligible] … any abnormal test? Or any of his lab tests abnormal?
CONLEY: I’m not, again, a HIPAA kind of precludes me from going into too much depth and things that … I’m not liberty or doesn’t wish … to be discussed at some future point, maybe… but today, sorry. I think that’s it. Yeah. Thank you, guys. Thank you.
Kalyani Saxena is an intern with NPR’s Washington Desk.
Copyright 2020 NPR. To see more, visit https://www.npr.org.
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