5 takeaways from Dr. Sean Conley Sunday update

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President Trump’s doctor said Trump is not currently on oxygen, but would not say whether he ever received oxygen since his COVID-19 diagnosis.

USA TODAY

Doctors appeared before reporters outside Walter Reed National Military Medical Center on Sunday morning to update the public on the status of President Donald Trump’s health after testing positive for COVID-19.  

White House physician Sean Conley said the president is improving and, later in the day, Trump showed his progress by waving to supporters from the back seat of an SUV as it drove by a demonstration. 

But even as Trump and his doctors say he may be discharged as early as Monday, some health experts are troubled by details of his condition and treatment. 

Here are five takeaways from Sunday’s news conference. 

Donald Trump, on dexamethasone, may be discharged ‘as early as tomorrow’

Dr. Brian Garibaldi: We did initiate dexamethasone therapy and he received his first dose of that yesterday … If he continues to look and feel as well as he does today, our hope is that we can plan for a discharge as early as (Monday) to the White House where he can continue his treatment course.

Dexamethasone has only been shown to benefit extremely ill COVID-19 patients. Russell Buhr, a professor of pulmonary and critical care medicine at the University of California-Los Angeles, said patients are recommended the steroid if they require supplemental oxygen or require mechanical ventilation. It is not given as a pre-emptive prophylactic, he said.

Dexamethasone also is not typically advised for patients with mild symptoms, as steroids can sometimes “hinder your body’s ability to fight the virus,” Yale Medicine’s Dr. Onyema Ogbuagu told USA TODAY in June.

A further issue: Researchers found that dexamethasone can interfere with the benefits of remesdivir, another medication Trump is currently taking. “Clinicians need to be cautious regarding this interaction,” they wrote in an study published in August in the journal SN Comprehensive Clinical Medicine.

What complications could remdesivir lead to?

Dr. Brian Garibaldi: The president yesterday evening completed a second dose of remdesivir. He’s tolerated that infusion while we’ve been monitoring for any potential side effects and he has had none that we can tell.

Remdesivir is taken intravenously over the course of five days. It is generally given to patients who need oxygen but do not require ventilation. In August, the FDA approved the drug for widespread use — to some concern from experts.

Side effects of remdesivir, per University of Minnesota’s Center for Infectious Disease Research and Policy, include nausea, possible liver damage and worsening respiratory failure. 

What do ‘transient drops’ in Donald Trump’s oxygen saturation refer to?

Dr. Sean Conley: There was that momentary episode of the high fever and that temporary drop in the saturation, which prompted us to act expediently to move him up here. Fortunately, that was really a very transient limited episode…Yesterday there was another episode where he dropped down about 93%. He (didn’t) ever feel short of breath, we watched it and

Trump’s doctor says president is ‘upbeat.’ Is that all Conley can say?

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Dr. Sean Conley clarifies his statements on President Trump’s condition at Walter Reed

Wochit

A day after evading direct questions about President Donald Trump’s medical treatment, Dr. Sean Conley said Sunday outside Walter Reed National Military Medical Center he was “not necessarily” intending to mislead the public.

Conley a Navy commander and the president’s physician, said he was , the 

Dr. Conley, on Saturday, kept dodging questions on whether the president had ever been on supplemental oxygen, only stating that he was (at the time) not on it. The White House later confirmed, anonymously, that Trump was given oxygen at the White House on Friday before going to Walter Reed National Military Medical Center.

When asked about the contradicting reports from himself and the White House, Conley said Sunday Trump had been on oxygen, and that he was “not necessarily” intending to mislead the public and “trying to reflect the upbeat attitude that the team, the president, the course of his illness has had. (I) didn’t want to give any information that might steer the course of the illness in another direction.”

‘Ups and downs’: Doctors say Donald Trump is improving while hospitalized; aides project image of calm

Conley adds doubt the the veracity of the reports being given by the White House and the president’s medical staff. He admitted that “it came off as if we were trying to hide something, which wasn’t necessarily true.”

When asked on CNN’s “Reliable Sources,” Dr. Sanjay Gupta, chief medical correspondent, said that this isn’t what a physician is supposed to do.

“He’s coming out ot debrief the public about the president … if you’re going to do that then you have to be absolutely honest. It wasn’t just sort of conveying an ‘upbeat attitude.’ It was purposefully misleading yesterday about a very basic issue, which is whether or not the president had been on supplemental oxygen,” Gupta said.

What can be shared, according to HIPAA law?

The Health Insurance Portability and Accountability Act (HIPAA) is set to “assure that individuals’ health information is properly protected, while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well being.”

As with any civilian, the law protects the president’s health records from being divulged to the public without his consent.

“The doctors are not going to get on television and contravene the narrative. It’s the president’s privacy. If he doesn’t want to share information with the public, they can’t,” said Dr. Russell Buhr, a pulmonologist and critical care professor at UCLA.

Dr. Sean Conley, physician to President Donald Trump, briefs reporters at Walter Reed National Military Medical Center in Bethesda, Md., Sunday, Oct. 4, 2020. Trump was admitted to the hospital after contracting the coronavirus. (AP Photo/Jacquelyn Martin) (Photo: Jacquelyn Martin, AP)

Under the Health Insurance Portability and Accountability Act of 1996, known as HIPAA, health care workers are not legally allowed to release information about a  patient’s conditions unless

What to Know About Sean Conley, the White House Physician

As President Trump remains hospitalized at Walter Reed National Military Medical Center after testing positive for the coronavirus, one doctor is at the center of his treatment: Sean P. Conley, the White House physician.

Stepping out of the hospital with a team of doctors behind him on Saturday, Dr. Conley gave an optimistic update on Mr. Trump’s condition at a news conference. He said the president was “doing very well” and in “exceptionally good spirits” after spending Friday night at the hospital.

The news conference put a national spotlight on Dr. Conley, who offered a distinctly different outlook from what Mark Meadows, the White House chief of staff, told reporters later.

Here’s what we know about Dr. Conley.

Dr. Conley took on the role of White House physician in 2018 after Dr. Ronny L. Jackson was nominated to be secretary of the Department of Veterans Affairs. Dr. Jackson had to withdraw his name from consideration for that post amid accusations of inappropriate workplace behavior and was subsequently promoted by Mr. Trump to the position of assistant to the president and chief White House medical adviser. He is now running for a House seat in Texas.

In March 2018, Dr. Conley was named acting White House physician, and he was officially appointed to the position by Mr. Trump in May 2018.

Dr. Conley graduated from the Philadelphia College of Osteopathic Medicine in 2006, according to records from the Virginia Board of Medicine. Doctors of osteopathic medicine tend to emphasize community medicine and preventive care, take a more holistic approach to medicine and rely heavily on physical diagnosis compared with traditional doctors of medicine.

Dr. Conley, who received his bachelor of science degree from the University of Notre Dame, has served as an emergency doctor for the U.S. Navy since 2006.

A native of Pennsylvania, Dr. Conley completed his residency at the Naval Medical Center in Portsmouth, Va., in 2013. After his residency, Dr. Conley served as chief of trauma for the NATO Role 3 Multinational Medical Unit in Afghanistan.

He served as director of the medical center’s Combat Trauma Research Group for a little over two years.

In May, Dr. Conley gained attention after revealing that Mr. Trump had started taking hydroxychloroquine, an anti-malaria drug, while under his care.

Many experts have questioned the drug’s effectiveness in treating, preventing or curing Covid-19 despite claims from Mr. Trump.

The Food and Drug Administration warned in April that it should be used only in clinical trials or in hospitals. The agency also said the drug could cause dangerous heart rhythm problems.

In a letter in May discussing Mr. Trump’s use of hydroxychloroquine, Dr. Conley said he and the president had “concluded the potential benefit from treatment outweighed the relative risks.”

At the news conference on Saturday, Dr. Conley told reporters that Mr. Trump was not taking hydroxychloroquine.

“We discussed it,” Dr. Conley said. “He