WASHINGTON – President Donald J. Trump was sicker with Covid-19 in October than was publicly recognized at the time, with extremely low blood oxygen levels at one point and a lung problem related to coronavirus-related pneumonia, according to four people familiar with him.
His prognosis became so worrying before he was taken to the Walter Reed National Military Medical Center that officials believed he needed to be put on a ventilator, said two of those familiar with his condition.
Those familiar with Mr. Trump’s health reported having pulmonary infiltrates, which occur when the lungs are inflamed and contain substances such as fluid or bacteria. Their presence, especially when a patient shows other symptoms, can be a sign of an acute case of illness. They can be easily spotted on an x-ray or scan if parts of the lungs appear opaque or white.
Mr Trump’s blood oxygen levels alone were of extreme concern and, according to those familiar with his assessment, went back to the 1980s. The disease is considered severe when blood oxygen levels drop to the low 90s.
It was previously reported that Mr Trump had difficulty breathing and a fever on October 2, the day he was rushed to the hospital, and the type of treatment he was receiving indicated that his condition was serious. But the new details about his condition and efforts in the White House to give him special access to an unapproved drug to fight the virus help cement one of the worst episodes of Mr. Trump’s presidency.
The new revelations about Mr. Trump’s fight against the virus also underscore the limited and sometimes misleading nature of the information released about his condition at the time.
The former president resisted the handover from the White House to Walter Reed and relented when aides told him he could go alone or risk waiting until U.S. intelligence was forced to take him out if he fell ill, two people familiar with the events said.
While Mr. Trump was hospitalized with Walter Reed, his medical team tried to downplay the gravity of the situation, saying he was on an upswing. At 74 years of age and overweight, he was at risk for serious illness and received aggressive treatment. He left the hospital after three days of taking a short ride in his armored sport utility vehicle to wave to the crowd of trailers in front of the building.
A person close to the former president denied being seriously ill and reiterated the comments Mr Trump himself made after his illness.
There are still unanswered questions about whether Mr Trump was already ill with Covid-19 when he attended a presidential debate on September 29, just two days before the public announcement that he was diagnosed with the disease and three days before his deteriorating condition forced him to go to Walter Reed.
Trump’s doctor, Dr. Sean P. Conley, repeatedly downplayed concerns about Mr. Trump’s condition during his illness. At a briefing, Dr. Conley that Mr. Trump received X-rays and CT scans. When asked if there were signs of pneumonia or tissue damage, however, he said only that “the findings are expected but there are no major clinical concerns.”
Dr. Conley also told reporters that while Mr. Trump’s oxygen levels had dropped to 93 percent, it never dropped to the “low 80s”.
Mr. Trump had difficulty breathing in the White House. He was given oxygen twice before being taken to Walter Reed as Dr. Conley confirmed after this was reported by the New York Times.
Updated
Apr. 11, 2021, 3:40 p.m. ET
While still in the White House, Mr. Trump received a drug that was developed by the biotechnology company Regeneron Pharmaceuticals. The antibody cocktail, which is currently not widely used, helps people who are infected with the virus fight it off.
After Mr Trump was hospitalized, he began treatment with a steroid, dexamethasone, which is usually only recommended for Covid-19 patients with severe or critical forms of the disease, often for those who need mechanical ventilation or supplemental oxygen .
And he received a five-day course on the antiviral drug remdesivir. At the time, medical experts believed his medication course was a clear signal of significant lung problems related to his lungs.
In press conferences outside the hospital this weekend, Dr. Conley presented data that suggested his patient was recovering quickly. He noted that Mr. Trump had done well on a spirometry test that measures lung capacity. “He’s everything,” said Dr. Conley. “He’s fine.”
Medical experts say a spirometry test is practically meaningless in Covid-19 patients.
When Mark Meadows, the White House chief of staff, tried to secretly tell reporters that the situation was worse, Mr Trump went mad, according to people who spoke to him.
On Sunday October 4th, Dr. Conley admits he’d given a rosy version of Mr. Trump’s condition.
“I tried to reflect the optimistic attitude of the team, the president and his disease progression,” he said. “I didn’t want to give any information that could steer the course of the disease in any other direction, and it turned out that we were trying to hide something that wasn’t necessarily true.”
Mr Trump’s medical team said he had a “high fever” that Friday and that his oxygen levels had dropped, requiring him to be given oxygen. Mr. Trump’s oxygen levels dropped again on Saturday.
Mr. Trump still appeared to be struggling with the disease when he returned to the White House, where he stood on a balcony in a choreographed scene, tearing off his mask and saluting his helicopter. Doctors at the time noticed how Mr. Trump used his neck muscles to breathe in those moments, a classic sign that someone’s lungs were not getting enough oxygen.
On the night of his diagnosis, October 1, White House officials sought to get the Regeneron antibody cocktail – which was not yet approved for treatment by the Food and Drug Administration at the time – to Mr Trump.
Patrick F. Philbin, a senior attorney with the White House law firm, called then FDA Commissioner Dr. Stephen M. Hahn came in to discuss how the agency could approve the use of the drug for two senior administrators whom he did not want to identify, according to someone who heard about the call.
Mr. Philbin investigated how normal FDA procedures could give the President quick access to the drug. Regeneron has already approved the use of the cans, Philbin told Dr. Rooster.
Dr. Hahn and other FDA officials including Dr. Patrizia Cavazzoni, the federal supreme drug agency, worked to eliminate the drug through a standard procedure known as an emergency use for new drugs, often used on very sick patients who agree to conduct an experiment that the drug is still in clinical Studies tested. The agency is reviewing these patients’ medical histories to determine if treatment could pose serious risks.
Regeneron provided a pack of cans containing extras “in case of administrative problems,” said a company spokeswoman.
The extras were never returned. Dr. Conley once told staff that they sat in a refrigerator in the White House doctor’s office.
It wasn’t until the days after the application was approved that White House officials recognized that the doses were for Mr Trump and First Lady Melania Trump, who also tested positive for the coronavirus but turned down the drug, which took about an hour long intravenous infusion. The person close to the former president also denied that Ms. Trump had turned down the drug.
Around this time, when other people close to Mr. Trump were getting sick, his son-in-law and senior advisor Jared Kushner offered to facilitate Regeneron treatment for them, two people with knowledge of the discussions said. An aide to Mr. Kushner denied that he had made such an offer at the time.
In the weeks following his hospital stay, Mr. Trump was convinced that Regeneron treatment had saved his life and told the helpers, “I am proof that it works.”
That line became a hoax among leading health officials, who asked each other if anyone would tell Mr Trump that he was, in fact, a failed clinical trial result for Regeneron, as the goal is to prevent people from being hospitalized After receiving it, a former senior administration official said.
Noah Weiland, Mark Mazzetti and Annie Karni reported from Washington and Maggie Haberman from New York. Katie Thomas reported from Chicago and Denise Grady from New York.
