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President Donald Trump returned to the White House after three days at Walter Reed. He removed his mask on the steps of the balcony.

USA TODAY

President Donald Trump rolled out of Walter Reed hospital confidently urging the nation not to fear the coronavirus despite experts warning the U.S. death toll, at more than 210,000, could almost double by year’s end.

Experts also warn that the commander-in-chief himself may not have seen the worst of the virus just yet.

“Don’t be afraid of Covid,” Trump tweeted hours before his release Monday following a three-day hospital stay. “Don’t let it dominate your life.”

Dr. Anthony Fauci, the infectious disease expert who for months has exhorted the nation to wear masks and social distance, told CNN that, while not likely, Trump could still face “a reversal – meaning, going in the wrong direction and get into trouble.”

Those $100 “Trump Beat COVID” commemorative coins being offered by a White House-themed online gift shop could be too soon. The danger window can easily stretch to 10 days, said Dr. Mangala Narasimhan, an intensive care physician in New Hyde Park, N.Y. 

“Saying that he beat COVID now is extremely premature, especially for someone his age,” Narasimhan told USA TODAY on Tuesday. “He is not out of the woods yet.”

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Trump, 74, tweeted that the U.S., under his administration, has developed “some really great drugs & knowledge.” 

Dr. Lucy McBride, an internal medicine physician at Foxhall Internists in Washington, D.C., says professionals do know a lot more about the coronavirus today than they did in March but still don’t have drugs to prevent hospitalization and severe illness.

“We have a long way to go on therapeutics – drugs,” she said. “The best defense against the virus is our own behavior – masks, distancing, avoiding crowded spaces, and handwashing – as we buy time for drug development.”

White House physician Sean Conley said Trump would continue taking the antiviral drug remdesivir and the steroid dexamethasone at the White House, where he will receive “24/7 world-class medical care.” The president tweeted that he feels better than “I did 20 years ago!”

That, Narasimhan said, could be the steroids talking.

“I am very worried that people will take this to mean that ‘If he can beat COVID I can beat COVID,'” said Narasimhan, senior vice president for critical care services at Northwell Health. “I don’t think that we can take any real lessons (from Trump’s illness) except that he did get sick. Pretending this is not real disease will not help.”

Much of the nation does not have “world-class” medical care. That is particularly true among lower-income Americans and people of color – those most at risk for poor outcomes from the virus.

Many underinsured Americans get sick but will never seek professional treatment, Narasimhan said. She said Trump had at least six doctors focusing on his care – and access to medications not available to the public yet.

“What he got was treatment that nobody gets,” she said. “Nobody.”

The vulnerable populations also are at an increased risk for mental health challenges – “a parallel pandemic that directly inform our physical health,” McBride said.

More than 210,000 people in the U.S. have died from COVID-19 as of Tuesday, according to data from Johns Hopkins University. There have been almost 7.5 million confirmed cases.

The Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington, forecasts that the U.S. death toll will exceed 363,000 by year’s end alone. That number would be drastically reduced if everyone wore masks, according to the forecast. But major easing of restrictions could push the U.S. death toll beyond 500,000, IHME warned.

Dennis Carroll, who led the pandemic unit at the federal Agency for International Development for nearly 15 years, is urging leaders not to lower the nation’s guard.

“If we keep failing to take this pandemic seriously, 200,000 more lives will be lost by the end of this year,” Carroll said. “Fact-denying rhetoric from the president … only ensures these deaths will come. Even with better treatments.”

There has been bits of encouraging data. IHME has lowered its death toll projections from more than 400,000 a month ago. COVID-19 hospitalizations nationwide have leveled off in the last month at about 30,000, according to the COVID Tracking Project at The Atlantic, still alarming but about half the number seen during the peak in July.

In South Dakota, the relatively low hospitalization rate prompted Gov. Kristi Noem to assert that her resistance to statewide stay-at-home orders has paid off – even as the state has struggled with the second-highest number of new coronavirus cases per capita over the last two weeks. A USA TODAY analysis of Johns Hopkins data through late Monday shows a record numbers of deaths were reported over the last seven days in three states – including South Dakota.

The nation must collectively overcomes the public health crisis due to the threat of infection resurgence, said Ogbonnaya Omenka, an associate professor and public health specialist at Butler University.

“Until we can boldly say … that we have measures in place to finally contain the disease in terms of its threat to the general population, we should not rest on our oars,” Omenka said.

Contributing: Michael Stucka

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