In the first public briefing since President Donald Trump’s COVID-19 diagnosis, White House physician Dr. Sean Conley would not answer several questions about whether the president had been on oxygen at any point previously, if he had lung damage or when he last received a negative coronavirus test.
Conley, who has served as Physician to the President since 2018, appeared with a team of nine clinicians outside Walter Reed National Military Medical Center for less than 20 minutes Saturday morning and fielded dozens of questions from reporters. Doctors said the president had been fever-free for over 24 hours, had received an experimental antibody therapy and was undergoing a five-day course of the drug remdesivir.
“We remain cautiously optimistic, but he’s doing great,” Conley said.
But he also created confusion about the timeline of Trump’s diagnosis and the severity of his disease. Health and national security experts said the obfuscation was unnecessary and could continue to erode the administration’s credibility.
Your questions, answered:Who gave Trump coronavirus? What is the Regeneron antibody ‘cocktail’?
Asked repeatedly whether Trump had been on oxygen at any point, Conley gave at least eight variations of answers, ranging from “He’s not on oxygen right now” to “Right now, all indicators are that he’ll remain off of oxygen going forward.”
Ultimately, Conley said: “Thursday no oxygen, none at this moment, and yeah, yesterday with the team, while we were all here, he was not on oxygen.”
However, Trump was administered oxygen at the White House on Friday before leaving for Walter Reed, the Associated Press reported citing an unnamed source. White House officials declined to answer questions from USA TODAY about whether oxygen was administered.
In sharp contrast to Conley’s depiction, White House chief of staff Mark Meadows told the Associated Press on Saturday that the president’s vitals over the last 24 hours were “very concerning” and the next 48 hours will be critical for his care.
Oxygen needs are common for COVID-19 patients, doctors say
Several health experts said it’s not uncommon for people with COVID-19 to have intermittent oxygen needs.
Early on in the course of the disease, the coronavirus can cause injury to the lungs by damaging the cells that allow oxygen to pass into the bloodstream, said Dr. Russell Buhr, a professor of pulmonary and critical care medicine at the University of California, Los Angeles.
“If those cells are damaged, we compensate by administering supplemental oxygen so the lungs are getting more oxygen than they would from the air in the room,” said Buhr, who has cared for over 100 patients with COVID-19.
Patients hospitalized with COVID-19 tend to need a bit of oxygen when they first arrive at the hospital, often when they’ve already been sick at home for between three days and a week.
Dr. Matthew G. Heinz, a hospital physician in Tucson, Arizona, said it’s standard procedure to provide any patient with oxygen who is experiencing a respiratory illness.
“It’s very likely that at some point early in his disease course, or during his transfer to Walter Reed, that the president at least transiently received supplemental oxygen — this would be expected and is the standard of care for any concerning, symptomatic respiratory illness especially coronavirus,” Heinz said.
“It’s good news that the president appears to be doing better, but we must have total honesty and transparency going forward,” Heinz said. “Dr. Conley’s evasive and overly positive assessment of the president is not what the country needs right now.
Dr. Armand Dorian, chief medical officer of USC Verdugo Hills Hospital north of Los Angeles, said it was curious that Conley wouldn’t be more specific about the president’s need for supplemental oxygen.
“I am not sure if it is a lack of media experience or if the administration feels it might be a sign of weakness or national security concern” to say the president had been on supplemental oxygen, Dorian said via email. It was “completely not necessary to create this new confusion. And truthfully not a big deal to have just said he needed it but no longer.”
It also wouldn’t be unusual for Trump’s physicians to give him some oxygen “for his own comfort,” said Dr. William Schaffner, a professor of preventive medicine and health policy at Vanderbilt University.
“There’s no reason to hide that in any way that I can see, medically,” he said.
Who has tested positive? A running list of those close to the White House being tested and their results
Mixed messaging:Trump’s condition was ‘very concerning’ over past day
Conley told reporters that the president’s cardiac, kidney and liver function were all normal, and he was having daily ultrasounds and lab work. He also provided information on the president’s heart rate, blood pressure and oxygen levels, saying Trump had an oxygen saturation level of 96%, within the normal range for a healthy person. But he would not comment on whether the president has any lung damage.
“I’m not going to go into specifics about what the findings of any of those are,” he said.
Asked when the president last tested negative for COVID-19, Conley again did not provide specifics.
“I’m not going to get into all the testing going back, but he and all the staff routinely are tested,” he said.
Conley initially said that the president was “72 hours into the diagnosis,” but then said Trump had been diagnosed Thursday evening. After the briefing, Conley issued a statement saying that he had intended to say “day three” into the diagnosis.
‘It is the public’s business to know what’s going on,’ security experts say
National security experts have also raised the issue of transparency.
Former Defense Secretary Leon Panetta said Friday that Trump’s COVID-19 hospitalization raises serious national security concerns and that adversaries should be expected to exploit U.S. vulnerabilities.
At the same time, it is “extremely important to keep the public fully informed about what is happening,” he said.
“It is particularly critical that information about the president’s health is presented openly. The tendency is ‘don’t panic the public, don’t tell the full story.’ But I think it’s essential that the public know exactly what is going on,” Panetta said. “I really urge the White House not to pull any punches. Have the doctors stand up and make very clear news with regards to the president’s heath. It is the public’s business to know what’s going on.”
The steady flow of lies and misinformation from the White House have eroded the administration’s credibility leading to a crisis over what to believe about President Trump’s health, said David Lapan, the former spokesman for Homeland Security, the Defense Department and Marine Corps.
In the early days of the Trump administration, Trump compelled his spokesman to exaggerate the size of the crowd at his inauguration.
“This is a president who has squandered away his credibility from Day One,” Lapan said. “Now when it’s needed most, it’s not there. Can you trust anything that comes out of this administration?”
The stakes could hardly be higher, Lapan said. U.S. adversaries can be expected to exploit perceived gaps in the military’s ability to respond to provocation and allies wonder if American forces can be relied upon to back them up.
“From a national security perspective, that’s never good,” Lapan said.
In any event, it may be too late to recover trust, he said.
“Credibility does not come back quickly. We’re paying the price at the most dangerous time. Can you trust anything that comes out of this administration? Are you lying to me now, or were you lying to me then? How can I trust what they say?”
Lack of clarity raises ethical concerns
The Trump administration is not alone in its reticence to reveal information about the president’s health. Franklin Delano Roosevelt, Dwight D. Eisenhower, John F. Kennedy, Woodrow Wilson and Ronald Reagan all struggled with health issues while in office.
But a lack of clarity from the president’s doctors amid a pandemic has several new ethical implications, said Arthur Caplan, a professor of bioethics at NYU School of Medicine.
“The nation absolutely must have accurate information. That’s partly because there are people out there who may have been exposed,” Caplan said. “There are other lives at risk – and their families and friends – and anything less than full disclosure is unconscionable.”
Americans are facing big decisions about who to vote for in the upcoming election, and many may be wondering why the president is receiving an experimental drug, Caplan said. Some may be inclined to try it too, he said.
When it comes to high-profile elected officials like the president, the normal rules of doctor-patient confidentiality should not apply, said Caplan, who has long been a proponent of having an independent assessment of the president’s physicals.
“We’ve never really set that expectation, so the doctors who treat politicians still think their first duty is to the patient, not the public,” he said. “But I think that’s not accurate due to the nature of the influence and power that they hold.”
Contributing: David Jackson, John Fritze, Elizabeth Weise and Karen Weintraub, USA TODAY