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Trump Says He'll Return To The White House Soon. Is It Safe?

AILSA CHANG, HOST:

This evening, President Trump walked out of Walter Reed National Military Medical Center three days after he entered for COVID-19 treatment. After a short ride on Marine One, he's now back at the White House. Earlier today, Trump tweeted that he is, quote, "feeling really good," and his doctors say he will continue receiving some care there. But major questions remain about his health, his treatment and the White House messaging around the coronavirus. To talk more about what we do know, we're joined now by NPR science correspondent Richard Harris and NPR White House correspondent Tamara Keith.

Hey to both of you.

TAMARA KEITH, BYLINE: Hello.

RICHARD HARRIS, BYLINE: Greetings.

CHANG: Greetings. All right, Tam, let's start with you. The president's departure - you're back at the White House now, but you were at Walter Reed earlier. How did he look?

KEITH: So this was really a cinematic production, all unfurling at sunset with this gold and pink sky.

CHANG: (Laughter).

KEITH: It was made for film. And it was filmed, and a video has already been released on the president's Twitter account. He walked out of Walter Reed in a suit and a tie and a mask. He descended a couple of short stairs. He walked past the pool, where we were - the press pool - for pictures, waved, pumped his fists. He didn't respond to a reporter's question, just gave a thumbs up and said, thank you very much, everybody. He then took Marine One back to the White House. When he got there, he walked up the staircase of the south portico entrance of the White House to the residence area. He took off his mask at the top of the stairs, stood, smiled, waved, saluted Marine One as it took back off with his mask there in his pocket.

HARRIS: Yeah, and taking off his mask - I mean, let's remember. The mask is to protect the people around him.

KEITH: Right.

HARRIS: And we should note the president's doctors had previously cautioned that he could potentially be infectious for another week, so that's kind of a quite a strong message to send to his staff inside the White House waiting for him.

CHANG: Exactly. Well, I mean, Tam, the president has been tweeting about how great he's been feeling. His doctors briefed the public earlier. Can you just catch us up on how they are all framing his health at this moment.

KEITH: Yeah, so the way that they are framing his health is not exactly the way that he is framing his health. I asked Dr. Conley, who is the White House physician and overseeing the president's care, whether they are still concerned about a possible reversal or, you know, whether they will be watching him because sometimes with coronavirus, it comes and it goes. And it may get worse later. And he said that they aren't going to feel secure until next Monday, a week from today. Meanwhile, President Trump put out a video taped at the White House without a mask on just moments ago. And he says the message that he got from his experience was, don't let this virus dominate you. Don't be afraid of it. You're going to beat it. And he said, don't let it take over your lives. We're going back.

CHANG: OK. Well, putting those remarks aside, Richard, just given the treatment report that we got this afternoon, what can we infer about the president's health?

HARRIS: Well, doctors who are watching along with the rest of us are really quite puzzled by this. We hear he's in really good health now - no fever and his oxygen levels are high. But at least one of the drugs he's getting is really only appropriate for people who have had severe disease, so the doctors I talked to today can't quite figure out what's going on. When the president first got sick, the doctors gave him an experimental cocktail of monoclonal antibodies, which are supposed to block the virus. That idea is promising but unproven as of now. He also got the drug remdesivir, which is designed to prevent the virus from replicating. That one really does make sense. Plus, he got vitamin D, zinc and a few other unproven COVID remedies. His doctors wouldn't say if he got drugs to prevent blood clots, which is a common and serious consequence of COVID-19. But the real puzzler is the dexamethasone, a cheap and widely available steroid that works well for people with advanced disease but is not recommended for people with mild to moderate disease.

CHANG: I mean, it seems like Walter Reed has been throwing the kitchen sink at the president. Is there any concern that he is getting overtreated at this point?

HARRIS: Yeah, a lot of doctors are concerned that might be the case. Either the president was really sicker than the doctors have been letting on or they are overmedicating him. This is a known phenomenon actually called VIP syndrome. And I talked today about that with Dr. Mitchell Levy, who's the chief of critical care medicine at Brown University.

MITCHELL LEVY: The VIP syndrome is not just that VIPs demand therapies. It's simply that they're treated differently. And this is really the case for doctors, spouses and their family. And so their loved ones are often treated in a way that's outside the usual standard of care, which is never good.

HARRIS: And that's not good because there are potential serious downsides of doing this. In this case, steroids are designed to suppress the immune system. And you don't want to do that if the immune system is effectively fighting off the virus...

CHANG: Right.

HARRIS: ...As it tends to do early on in the course of the disease. Doctors generally want to suppress the immune system later on to prevent it from becoming overactive and doing more damage, so it's not clear whether giving him steroids now was a good idea or potentially could backfire.

CHANG: There was also something that came up that the president's physician, Sean Conley, mentioned. You know, he came to share some information, and then he invoked HIPAA to protect the patient's privacy in that instance. What did you make of that?

KEITH: Well, so we were pressing him, trying to get information about imaging that's been taken of the president's lungs. The reason people would like to know about that is, did the president have pneumonia? - which is one of the common things that happens with the coronavirus. And so we've been asking this. The White House press corps has been asking this for two days, so today he, again, was evasive. And I finally just said, what's going on here?

So you're actively not telling us what those lung scans showed, just to be clear.

SEAN CONLEY: So there are HIPAA rules and regulations that restrict me in sharing certain things for his safety and his own health and reasons.

KEITH: So here's the thing. HIPAA is - it is something that can protect the privacy of patients, but Dr. Conley has been more than willing to release certain information.

CHANG: Right.

KEITH: It seems clear that his patient just doesn't want other potentially negative information released.

CHANG: And, Tam, I mean, we have been mentioning that the president has tweeted that he's feeling really, really good. That's just kind of an extension of the whole White House approach to all of this since news broke last week about the president's condition, right?

KEITH: Yes. I mean, it's actually sort of an extension of the White House approach to the coronavirus more broadly in that President Trump has created this bubble around himself where coronavirus isn't that bad and the United States is turning the corner. And now he's had this very serious illness. We don't know where he is in the disease progression, and he's saying that he's planning to get out on the campaign trail soon.

CHANG: That is NPR White House correspondent Tamara Keith and science correspondent Richard Harris.

Thank you to both of you.

KEITH: You're welcome.

HARRIS: Sure. Transcript provided by NPR, Copyright NPR.