Power Up: Just how sick is Trump? Washington eager for details amid conflicting messages from White House

Many questions about the president’s condition — and the administration’s handling of the coronavirus outbreak within its own orbit — remain unanswered as the White House offers contradictory information about the status of his health. 

The White House has thus far painted an incomplete picture of the situation that required Trump to be admitted to Walter Reed National Military Medical Center on Friday. They gave notice that Trump has begun a steroid treatment usually reserved for patients with severe illness and that he’s suffered twice from bouts of low oxygen. Yet Trump and his medical team contend that he is doing well and could be discharged from Walter Reed as soon as Monday. 

Piling onto the confusion: Trump defied public health guidelines and briefly left the hospital to wave at his supporters from a motorcade parade to visit his supporters. Trump’s impromptu breach of quarantine, derided as cavalier by doctors and Secret Service, underscored open questions about the current health of the moderately obese 74 year-old who is being treated with a range of experimental therapeutics. 

An admission by White House doctor Sean Conley is fueling criticism of a lack of transparency: “Trump’s medical team tried to clear up the muddled picture it had created the previous day when White House doctor Sean Conley falsely suggested that Trump had not been given supplemental oxygen … Conley openly admitted to withholding truthful information about Trump’s plummeting blood-oxygen levels Friday, indicating he did so to put a positive spin on the president’s improving condition,” Toluse Olorunnipa, Josh Dawsey and Amy Goldstein report. 

• The reasoning: “I was trying to reflect the upbeat attitude that the team, the president, that his course of illness, has had,” Conley said Sunday. “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.”
• Zooming out: “The episode continued what has been a days-long torrent of falsehoods, obfuscation, evasion, misdirection and imprecision from those surrounding Trump as he faces the greatest threat to a president’s health in decades.”

The confusion has penetrated the halls of the White House, too: Not even Trump administration staffers trust what they’re hearing about the state of Trump’s health, despite being potentially exposed to the virus as well. 

THE NEXT CLUE: Whether Trump is actually released today. 

• “For a coronavirus patient admitted Friday to be sent home Monday ‘would be remarkably atypical,” Robert Wachter, chairman of the University of California at San Francisco’s department of medicine, told Toluse, Josh and Amy. “For someone sick enough to have required remdesivir and dexamethasone, I can’t think of a situation in which a patient would be okay to leave on day three, even with the White House’s medical capacity.” 
• Many infectious-disease experts say the medical details release suggest a more severe case of covid-19 than his physicians acknowledged, per the New York Times’s Katie Thomas and Roni Caryn Rabin: Trump’s oxygen levels dropped to a level that can indicate that a patient’s lungs are compromised, and the steroid dexamethasone may even be risky for those who have milder forms of the disease.
• “Suddenly, they’re throwing the kitchen sink at him,” Thomas McGinn, physician-in-chief at Northwell Health, the largest health care provider in New York State, told the Times. “It raises the question: Is he sicker than we’re hearing, or are they being overly aggressive because he is the president, in a way that could be potentially harmful?”
• More from NYT: “Some experts raised an additional possibility: that the president is directing his own care, and demanding intense treatment despite risks he may not fully understand. The pattern even has a name: V.I.P. syndrome, which describes prominent figures who receive poor medical care because doctors are too zealous in treating them — or defer too readily to their instructions.”

CONCERNS ABOUT A POLITICALLY-MOTIVATED RELEASE: Even some of Trump’s aides are concerned that Conley will release Trump from the hospital too early. “Trump, who historically hates hospitals and anything related to illness, has been hankering to get released, according to two people close to him, and some aides expressed fear that he would pressure Dr. Conley into releasing him by claiming to feel better than he actually does,” the New York Times’s Peter Baker and Maggie Haberman report. “But advisers were also troubled by the doctors’ prediction that they might release him on Monday because if they do not, it would signal that the president is not doing as well as indicated. They also worried that a premature return could lead to a second trip to the hospital if his condition worsens.” 

• Trump’s brief hospital break is likely to drive further criticism that he is throwing coronavirus precautions to the wind: “At this point, the president and senior people around him have violated all five core principles of the country’s coronavirus strategy,” Tom Bossert, Trump’s former homeland security adviser, told Toluse, Josh, and Amy. “I do not wish to be perceived as criticizing him while he is in this condition, but that needs to be pointed out. I am praying for his recovery.”
• The attending physician at Walter Reed: 

• “President Trump didn’t disclose a positive result from a rapid test for covid-19 on Thursday while awaiting the findings from a more thorough coronavirus screening, according to people familiar with the matter,” the Wall Street Journal’s Bender and Ballhaus report. “Mr. Trump received a positive result on Thursday evening before making an appearance on Fox News in which he didn’t reveal those results.”
• Trump urged his staff to keep a close hold on the spread of the virus among his circle, too: “As the virus spread among the people closest to him, Mr. Trump also asked one adviser not to disclose results of their own positive test. ‘Don’t tell anyone,’ Mr. Trump said, according to a person familiar with the conversation.”
• Trump’s own “campaign manager, Bill Stepien, didn’t know that Hope Hicks, one of the president’s closest White House aides, had tested positive on Thursday morning until news reports later that evening, according to a person familiar with the matter. The Trump campaign said Friday evening that Mr. Stepien had tested positive.”
• This isn’t the first time the White House has not been forthcoming with details about the president’s health: “In reporting for this book, I learned that in the hours leading up to Trump’s trip to the hospital [in November 2019], word went out in the West Wing for the vice president to be on standby to take over the powers of the presidency temporarily if Trump had to undergo a procedure that would have required him to be anesthetized,” New York Times reporter Michael Schmidt writes in his book “Donald Trump v. the United States: Inside the Struggle To Stop A President.”
• Vice President “Pence never assumed the powers of the presidency, and the reason for Trump’s trip to the doctor remains a mystery,” Schmidt adds.
• White House Correspondents’ Association criticized the decision to leave the hospital without notifying the journalists assigned to cover his every move:

DETAILS WE DON’T KNOW: White House press secretary Kayleigh McEnany declined to disclose when Trump last tested negative before the debate, citing “privacy concerns.” That detail would help those potentially exposed. 

• In contrast, Biden’s team announced on Saturday evening that the campaign will announce the results of every coronavirus test that the former vice president takes, our colleague Annie Linskey reports. Biden tested negative on Sunday, for the third time since he shared the debate stage with Trump, and is slated to travel to Florida on Monday for an NBC town hall.

Information has been scarce for those potentially caught in the White House outbreak, too. 

“Ninety percent of the [White House] complex most certainly learned about it in the news, as has been the case ever since,” a senior White House official told New York Magazine’s Olivia Nuzzi and Ben Jacobs on Saturday. “There are reports that COVID is spreading like wildfire through the White House. There are hundreds and hundreds of people who work on-complex, some who have families with high-risk family members. Since this whole thing started, not one email has gone out to tell employees what to do or what’s going on.”

• The White House staff finally received an email with instructions about the outbreak on Sunday evening, “telling them not to come to work if they have symptoms. If they develop them, they’re told to go home and contact their primary care provider,” CNN’s Kaitlan Collins reports. “Staff should not go to the White House Medical Unit clinic for any Covid-19 testing inquiries,” the note read.  
• But Trump’s chief of staff Mark Meadows has yet to deliver “guidance to the president’s aides about how they were expected to behave in a moment of crisis,” per the New York Times’s Annie Karni.  

SUPERSPREADING:  By Saturday, there was still “little evidence” that the White House had distributed guidance to the hundreds of people potentially exposed to the coronavirus or began contact tracing efforts to limit coronavirus exposure. Trump mingled with more than 200 people at his New Jersey gold club for a campaign fundraiser just hours before he tested positive for the coronavirus. “Less than a week before that, he welcomed 150 political allies and religious leaders — including several who are now infected — to the White House to meet the jurist he has nominated to the Supreme Court. In between, the president met with dozens of aides without wearing a mask — even in close quarters and after top aide Hope Hicks had tested positive. He appeared before thousands at a rally in Minnesota. And he held a nationally televised debate with former vice president Joe Biden after holing up with debate preppers,” our colleagues Josh Dawsey, Yasmeen Abutaleb, Isaac Stanley-Becker and Joel Achenbach report.  

• “The Centers for Disease Control and Prevention had a contact tracing team ready to go, according to multiple sources, but had not been asked to mobilize, even though [Conley] said at a press briefing that his team was working with the agency,” our colleagues Josh Dawsey, Yasmeen Abutaleb, Isaac Stanley-Becker and Joel Achenbach report. 
• “Conley also said he was coordinating with local health agencies, but officials in Minnesota, Ohio and New Jersey, where Trump held events in recent days, said they haven’t heard from the White House and are racing largely on their own to find people potentially exposed to the virus.”

COURT WATCH: Last week, the president and first Lady Melania Trump, who also tested positive for the virus, welcomed more than 150 guests to the White House Rose Garden to formally introduce Supreme Court nominee Amy Coney Barrett. Two Republican members of the Judiciary Committee in attendance — Mike Lee of Utah, who hugged and mingled with guests, and Sen. Thom Tillis of North Carolina — both tested positive for the virus. 

• This may throw off the tight timeline of Barrett’s confirmation process: “Sensing an opportunity to delay, Democrats are cranking up their push to postpone the Oct. 12 confirmation hearings, citing the safety of members, aides and Barrett herself — waging a public pressure campaign because they have no powers on their own to stop the proceedings,” our colleague Seung Min Kim reports. 
• Senate Majority Leader Charles E. Schumer (D-N.Y.) is demanding that all members get tested before a hearing, per a statement he provided to The Post: “Moving forward with the committee process when three senators have recently tested positive for covid-19 is irresponsible and dangerous, but doing so without requiring all members to be tested before a hearing in accordance with CDC best practices would be intentionally reckless,” Schumer said. “If Chairman [Lindsey] Graham doesn’t require testing, it may make some wonder if he just doesn’t want to know the results.”
• “Democrats are also eyeing their real opening: when GOP votes are needed to advance Barrett’s nomination in the committee and on the floor and a critical mass of Republican senators may remain positive for the novel coronavirus or in isolation when their in-person presence would be needed,” per Seung Min.

TRUMP CAMPAIGN HALTED AT TRICKY TIME: “October was supposed to be the turnaround month. After trailing Democratic nominee Joe Biden all year, Trump thought this past week would be his slingshot to securing a second term by disqualifying his opponent at their first debate together, expanding his coalition of voters, raising more money and staging bigger rallies,” Philip Rucker, Josh Dawsey and Annie Linskey report.

• Privately, Trump aides acknowledge the struggle: “Anytime the conversation is about coronavirus, it’s not helpful for us,” a senior administration official said. Aides also say Trump’s hospitalization ”undercuts what he views as his main attribute over Biden: That he appears stronger and tougher,” our colleagues write.

The Biden campaign has taken down its negative ads, but don’t expect any major changes: “His strategy to model best practices with the pandemic has drawn some criticism for being low-energy and casual, as if cosseting the candidate, but Biden’s advisers see recent developments as affirming,” our colleagues write.

• “At the end of the day, we’ve made a fundamental decision to model what a president should do,” senior adviser Anita Dunn said.

HEALTH EXPERTS NERVOUS ABOUT DEBATES: “The vice-presidential candidates are still scheduled to convene in Salt Lake City on Wednesday despite last week’s presidential debate resulting in at least 11 positive cases by people involved in preparations and one of the candidates onstage testing positive just two days later,” Michael Scherer reports.

• This time the candidates will be a little further apart: They will be situated about 12 feet from each other, “an increase from the planned seven-foot separation,” our colleague writes. “The change was made after Trump’s positive coronavirus test.”

But that arrangement is not virus proof: “The arrangement meets federal health guidelines but does not rule out transmission of the virus between the two candidates, given the possibility of aerosol spread, say public health experts. Nor does it ensure that others gathering for the event will be free of danger,” our colleague write.

• Key quote: “I don’t understand why we are still having these in person. We could put them in separate rooms. Put it on Zoom,” Tara C. Smith, an epidemiologist and professor at Kent State University’s College of Public Health, told our colleagues. “Especially for the current vice president. We don’t know what is happening with the president.”

A remote debate is not unprecedented:

The debate itself is receiving an increased focus: “Trump’s diagnosis with a potentially lethal virus — and the fact that he is 74 and Biden is 77 — was a stark reminder that either Vice President Pence or Sen. Kamala Harris (D-Calif.) could end up being president themselves, as opposed to just leading contenders for the nomination in 2024 and beyond,” the Times’s Adam Nagourney and Shane Goldmacher report.

• What’s at stake: For Pence, the debate “will most likely compel him to account for the administration’s record on a virus that has now infected 7.4 million Americans — including the most protected man in the country, Trump — and answer for his own stewardship as chairman of the federal coronavirus task force. For Harris, a former prosecutor, the debate is a chance to show that she is capable of being president in a national emergency, as well as to demonstrate that she can challenge the Trump record on covid-19 without seeming overly aggressive against an ailing president.”

CASES ARE RISING IN PARTS OF THE COUNTRY: “About two-thirds of all U.S. states reported an uptick in new coronavirus cases in the last week, according to data tracked by The Washington Post, indicating that colder temperatures in much of the country may be driving people indoors and helping to spread of the virus,” Teo Armus reports.

• What’s happening: “Several states in the once hard-hit Northeast were among those posting their largest new case counts in months. But many of the sharpest increases per capita came in the Midwest and Mountain West, including states like Wisconsin, Iowa, Utah and the Dakotas.” 

• More details: “Under the new restrictions, Mayor Bill de Blasio (D) would close all schools — public and private — in nine of the city’s 146 ZIP codes, as well as all nonessential businesses. Indoor and outdoor dining in restaurants in those areas will not be allowed.”

A memorial was held outside of the White House to mark the more than 200,000 deaths: “They gathered on the grassy Ellipse just south of the White House and in proximity to the Rose Garden, where those attending Trump’s announcement of his Supreme Court nominee flouted recommendations on wearing masks and social distancing. Trump and at least eight other people who attended the Sept. 26 ceremony have since tested positive for the coronavirus,” Michael Brice-Saddler reports.

• “It’s very important we get the message across that this is not a hoax or a conspiracy or a fake illness,” Brian Walter, a New York City subway worker whose father was died from covid-19, told our colleague. “Just because it hasn’t affected you personally doesn’t mean it’s not real. The events of last weekend prove that you can be isolated for a while, but if you make one wrong move, the virus could get you.” 

RELIEF DEAL STILL NOT IN SIGHT: “House Speaker Nancy Pelosi said there’s no deal yet on a new coronavirus relief package as Democrats wait to see whether the Trump administration will agree to terms,” Erica Werner reports.

• Where things stand: “Negotiations continued over the weekend, but there was little sign a breakthrough would be imminent. Pelosi asked airlines on Friday to hold off on impending furloughs of tens of thousands of workers pending a deal. United and American, the major carriers that have threatened furloughs, have said they can reverse them if there is a deal to extend payroll support for the industry that just expired, but Congress must act fast.”