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With Trump Back at Work, Colleagues Face ‘Dangerous Moment’

President Donald Trump is protected at the White House by snipers, sensors, a new 13-foot-tall fence, and a dozens-strong force of Secret Service agents, but none of that managed to keep out the deadly and wily virus that infected him and has killed more than 211,000 Americans.

Nonetheless, the President went back to the Oval Office on Wednesday, less than 48 hours after being released from Walter Reed National Military Medical Hospital and still undergoing aggressive treatment. Medical experts warn that Trump may face a challenging, second-week phase of COVID-19 and could still be contagious.

Trump insisted on working out of the iconic office anyway, and was briefed by aides about the pandemic aid package talks with Congress — which he temporarily cut off in a tweet on Tuesday — and Hurricane Delta’s threat to the Gulf Coast, said White House Deputy Press Secretary Brian Morgenstern. To accommodate the President while he is ill, the Oval Office’s ventilation system was upgraded to change and filter the air more frequently, Chief of Staff Mark Meadows said Wednesday. Staff seeing Trump in person are asked to wear a yellow gown, mask and goggles.

Seven months into the pandemic, there’s a newfound realization among White House staff that they relied too heavily on a rapid testing regime to alert them to COVID-19 in their midst, and didn’t do enough to enforce that masks be worn and distance be kept, measures recommended by federal health officials for months and used in workplaces around the country. Over the course of the last week, it has become clear that the West Wing is part of a COVID-19 hotspot in the nation’s capital, infecting Trump and at least 10 White House officials, with more than 100 believed to have been infected in Capitol Hill offices, and leading senior military officials isolating themselves.

Trump’s decision to leave the main residence of the White House and work from his office was seen by many as another example of the President’s disregard for those around him, his willingness to put his staff at risk, and his unwillingness to be a model for responsible public health recommendations that could stem the spread of the virus. It echoed Trump’s insistence on Sunday evening that a Presidential limousine driver and two Secret Service agents risk being exposed to the virus while riding with him while he waved through the car’s bullet-proof glass to supporters outside Walter Reed hospital.

As the scale of the outbreak has come into focus, the White House leadership has now told the few still working in the cramped West Wing to space themselves apart in meetings and cover their faces, after months of actively discouraging staff from wear masks and not keeping their distance in meetings.

U.S. Service members wear masks and eye protection before President Trump's return to the White House from Walter Reed National Military Medical Center on Oct. 05

U.S. Service members wear masks and eye protection before President Trump’s return to the White House from Walter Reed National Military Medical Center on Oct. 05

Win McNamee—Getty Images

But given President Trump’s publicly stated dislike for masks and social distancing measures,

Trump enters ‘uncharted territory,’ returning to White House at fraught moment in his recovery

The president returns to the White House at a fraught moment in his recovery — before he has seemingly escaped a period when some patients are known to crash.

“The problem with covid-19 is that people’s condition can deteriorate rapidly, even after days of stability,” said Harlan Krumholz, a cardiologist and health-care researcher at Yale University and Yale New Haven Hospital. “And so we are more accustomed to be cautious with people with high risk.”

The president has received care accessible to few other Americans. He was given a brew of laboratory-made antibodies that fewer than 10 other patients have received outside of clinical trials. And for him, returning home means arriving at a place that can be adapted to cater to his needs, Krumholz and others said.

Jonathan Reiner, a George Washington University Hospital cardiologist, said that in an emergency, the White House medical unit “can do what an emergency room can do in the first 15 minutes” — someone could be resuscitated and stabilized during a heart attack, for example, and then transferred to a hospital. Still for ongoing treatment, he said, it would be wise for Trump to remain hospitalized.

“It makes zero sense to move him from Walter Reed,” Reiner said.

At a Monday news conference, White House physician Sean P. Conley said doctors were “cautiously optimistic and on guard” about Trump’s discharge. But he said the benefits of returning to the White House outweighed the risks.

“Every day a patient stays in the hospital unnecessarily is a risk to themselves,” Conley said. “And right now there’s nothing that’s being done upstairs here that we can’t safely conduct down home.”

But Conley acknowledged that the medical team is in “uncharted territory” with the mix of medications the president has been given and that the dangerous period for the infection is not over. He’s “looking to this weekend” for assurance that Trump has cleared rough waters.

“If we can get through to Monday” of next week, he said, doctors will “take that final deep sigh of relief.”

Conley declined for the third briefing in a row to answer additional questions about X-rays and other images taken of Trump’s lungs, and about other key data, such as when he last received a negative coronavirus test before falling ill. Instead, Conley emphasized symptoms the president was not experiencing: A “slight cough” was gone. There were never complaints of muscle aches. And fever-reducing drugs had not been deployed for at least 72 hours.

“He’s up and back to his old self, predominantly,” Conley said.

In the White House, Trump’s doctors will be vigilant for sudden changes, specialists predicted.

“You would want to be prepared to take care of any sudden unanticipated or very concerning event,” said Jeanne Marrazzo, an infectious-diseases expert at the University of Alabama at Birmingham. The biggest risk, she said, would be the sudden onset of acute respiratory distress syndrome, which sometimes occurs with covid-19. Patients’ lungs fill with fluid, and they can’t breathe on their own.