Trump Might Be Again in Public by Saturday. Consultants Fear It’s Too Quickly.

Trump Could Be Back in Public by Saturday. Experts Worry It’s Too Soon.

The White House Doctor, Dr. Sean P. Conley, in a memo released Thursday, predicted President Trump could safely return to public engagements on Saturday based on the date he tested positive for the coronavirus and his response to treatments.

The document, which provided a brief overview of Mr. Trump's vital signs, said the president had completed his "therapy for Covid-19" and had "remained stable with no evidence of disease progression".

However, the news of Mr. Trump's potentially imminent return to public appearances or the campaign path met with skepticism and concern from medical experts who considered it premature and questioned whether the end of his isolation would comply with the guidelines of the Centers for Control and Prevention Diseases corresponded.

In a video released Wednesday, the president said his battle with the coronavirus was a "blessing from God" and depicted the experimental antibody treatment he received from drug company Regeneron as a "cure".

After the publication of Dr. Conley's memo, Mr Trump's re-election campaign released a statement calling for the second presidential debate on Thursday, as originally planned. The document states that there is "no medical reason why the Presidential Debate Commission should move, postpone or otherwise modify the debate in a virtual environment".

However, experts said the resumption of public duties could worsen the state of the president, which could still deteriorate rapidly over the next few days. Covid-19, an unpredictable disease, can suddenly and unexpectedly worsen during a patient's second week of illness.

Based on the information provided, "No, I would not approve him to take up public engagements on Saturday," said Dr. Phyllis Tien, an infectious disease doctor at the University of California at San Francisco, where she directs and advises Covid. 19 clinical studies.

The memo listed the president's heart rate (69 beats per minute), blood pressure (127/81), respiratory rate (15 to 17 breaths per minute) and blood oxygen content (96 to 98 percent without supplemental oxygen). The memo did not show Mr Trump's temperature.

All of these vital signs are in the normal range, said Dr. Krutika Kuppalli, a South Carolina-based infectious disease doctor. But the numbers are just a snapshot, she added. More meaningful would be statistics that record the president's vital signs as he moves, said Dr. Kuppalli. "If he goes, will his oxygen drop?" She said. "Is his heart rate increasing? Does he have to work harder? That would be important to know. "

If the president recently discontinued dexamethasone, a steroid normally only given to critically ill Covid-19 patients, his wellbeing could deteriorate in the next few days, said Dr. Kuppalli.

Dr. Conley's statements on Monday suggested Mr Trump could be at risk through Saturday and Sunday. "We're looking forward to this weekend," he said at a press conference. "If we can get through by Monday and it stays the same – or improves, even better – then we'll all take that last deep sigh of relief."

An inappropriately expedited return to the public by Mr Trump could also endanger others through close contact.

According to C.D.C. Guidelines: People with mild to moderate cases of Covid-19 are most likely to "stay infectious for no more than 10 days after symptoms appear". In the statement by Dr. Conley referred to Saturday as "Day 10 since Thursday's diagnosis".

Dr. Tien said she was skeptical of such an assessment. The numerous treatments Mr Trump received suggest that his illness was serious, which could extend the duration of his recommended isolation to 20 days after symptoms appeared.

Mr Trump could potentially end his isolation early if he tested negative for the virus with a very accurate laboratory test, said Dr. Tien. However, no such results were reported in Thursday's memo mentioning only a "course of advanced diagnostics".

Such a vague phrase could be interpreted to mean a definitive test for infectivity which "does not exist to my knowledge," said Dr. Taison Bell, an intensive care physician at the University of Virginia. "I wish I could learn from Dr. Conley what you're doing."

Even if Mr Trump meets the criteria for a mild or moderate case of Covid-19, a release from isolation on Saturday may not be successful. Although the president is known to be diagnosed on October 1, the point at which his symptoms appeared remains bleak. If they first manifested on September 30th, Saturday could qualify as 10 days after symptoms appeared. If they started on October 1st, day 10 would be Sunday.

The C.D.C. states that “for most people with Covid-19 disease, isolation and precautions can generally be stopped 10 days after symptoms appear and the fever resolved for at least 24 hours without the use of antipyretic drugs and with other symptoms improving. ”

"I don't know how I would classify his disease," said Dr. Bell. "Without knowing him as a patient, it is difficult to make that decision." Nevertheless, given the risks, it is advisable to proceed with caution.

"That's bigger than him," said Dr. Kuppalli. “Everyone will have a different point of view. But I would still be on the safe side and keep him isolated for 20 days. "


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