BETHESDA, Md. -- After spending three nights at the Walter Reed National Military Medical Center, President Donald Trump returned Monday evening to the White House, where he will continue to receive treatment for covid-19.
Stepping gingerly, Trump walked out of the military hospital and boarded a black SUV that drove him to his presidential helicopter, Marine One, for the short flight to the White House.
Back at the White House, he climbed the South Portico steps, removed his mask and declared, "I feel good."
Trump's doctor, Navy Cmdr. Sean Conley, said the president would not be fully "out of the woods" for another week but that Trump had met or exceeded standards for discharge from the hospital. Trump is expected to continue his recovery at the White House, where the reach of the outbreak that has infected the highest levels of the U.S. government is still being uncovered.
Trump made a point of sounding confident. Earlier, the president tweeted, "I will be leaving the great Walter Reed Medical Center today at 6:30 P.M. Feeling really good! Don't be afraid of Covid. Don't let it dominate your life. ... I feel better than I did 20 years ago!"
However, that message alarmed infectious-disease experts.
"We have to be realistic in this: COVID is a complete threat to the American population," said Dr. David Nace of the University of Pittsburgh Medical Center, an expert on infections in older adults.
"Most of the people aren't so lucky as the president," with an in-house medical unit and access to experimental treatments, Nace added.
"It's an unconscionable message," agreed Dr. Sadiya Khan of Northwestern University Feinberg School of Medicine. "I would go so far as to say that it may precipitate or worsen spread."
Conley said that because of Trump's unusual level of treatment so early after discovery of his illness he was in "uncharted territory." But the doctor also was upbeat at an afternoon briefing and said the president could resume his normal schedule once "there is no evidence of live virus still present."
According to the Centers for Disease Control and Prevention, those with mild to moderate symptoms of covid-19 can be contagious for as many -- and should isolate for at least -- 10 days.
Trump's discharge raised new questions about how the administration was going to protect other officials from a the disease as the president remains contagious.
Both Nace and Khan expressed fear Trump won't properly stay isolated at the White House -- and that he hasn't learned his lesson about wearing a mask.
"We know he hates the mask, we know he hates to be restricted, we know he's unpredictable," Nace said. "The rest of the American people are held accountable to a 10-day isolation period."
Some Secret Service agents had expressed concern about the lackadaisical attitude toward masks and social distancing inside the White House, but there isn't much they can do, according to agents and officials who spoke to The Associated Press. This close to the election, thousands of agents are engaged in protective duty so they can be subbed out quickly should someone test positive.
There were also lingering questions about potential long-term effects to the president -- and even when he first came down with the virus.
Conley repeatedly declined to share results of medical scans of Trump's lungs, saying he was not at liberty to discuss the information because Trump did not waive doctor-patient confidentiality on the subject. Covid-19 has been known to cause significant damage to the lungs of some patients. Conley also declined to share the date of Trump's most recent negative test for the virus -- a critical point for contact tracing and understanding where Trump was in the course of the disease.
Trump's nonchalant message about not fearing the virus comes as his own administration has encouraged Americans to be very careful and take precautions to avoid contracting and spreading the disease as cases continue to spike across the country. For more than eight months, Trump's efforts to play down the threat of the virus in hopes of propping up the economy ahead of the election have drawn bipartisan criticism.
On Sunday, Trump suggested he had finally grasped the true nature of the virus, saying in a video, "I get it." But then on Sunday afternoon, Trump briefly ventured out of the hospital while contagious to salute cheering supporters by motorcade -- an outing that disregarded precautions meant to contain the virus.
White House officials said Trump was anxious to be released after three nights at Walter Reed National Military Medical Center, where doctors revealed that his blood oxygen level had dropped suddenly twice in recent days and that they gave him a steroid typically only recommended for the very sick.
Trump's experience with the disease has been dramatically different from most Americans, who do not have access to the same kind of monitoring and care. While most must cope with their symptoms -- and fear of whether they'll take a turn for the worse -- at home and alone, Trump has been staying in the presidential suite of one of the nation's best hospitals and has been given experimental drugs not readily available to the public. He returns to the White House where there is a team of doctors on call with 24-hour monitoring.
Trump was leaving the hospital after receiving a fourth dose of the antiviral drug remdesivir Monday evening, Conley said. He will receive the fifth and final dose today at the White House.
Trump's aggressive course of treatment included the steroid dexamethasone and the single dose he was given Friday of an experimental drug from Regeneron Pharmaceuticals Inc. that supplies antibodies to help the immune system fight the virus. Trump on Friday also began a five-day course of remdesivir, a Gilead Sciences drug currently used for moderately and severely ill patients. The drugs work in different ways -- the antibodies help the immune system rid the body of virus, and remdesivir curbs the virus' ability to multiply.
'LIVES AT RISK'
Less than one month before Election Day, Trump was eager to project strength despite his illness and to press his campaign effort across the country.
Trump indicated he won't be kept from campaigning for long, tweeting before leaving the hospital, "Will be back on the Campaign Trail soon!!!"
Vice President Mike Pence returned to the campaign trail moments after Trump announced he would leave the hospital. The vice president boarded Air Force Two to fly to Salt Lake City, where he is to face off against Democratic vice presidential nominee Sen. Kamala Harris on Wednesday.
Joe Biden's campaign, meanwhile, said the Democratic presidential nominee again tested negative for coronavirus Sunday. The results came five days after Biden spent more than 90 minutes on the debate stage with Trump.
There was political pushback to Trump's attitude toward the virus.
Sen. John Cornyn, R-Texas, told the Houston Chronicle editorial board that Trump had "let his guard down" in his effort to show that the country was moving beyond the virus and had created "confusion" about how to stay safe.
New Jersey Gov. Phil Murphy, a Democrat, said Monday that Trump's fundraiser at his Bedminster golf club hours before he announced he had contracted the coronavirus was wrong and "put lives at risk."
Murphy called the trip the "wrong decision at every level" and said it should have been canceled. He said the state is trying to keep tabs on the 206 attendees and 19 workers in an effort to thwart a potential outbreak stemming from the gathering Thursday.
Guests at that event said it included a photo opportunity with Trump and an indoor roundtable with him that one attendee said lasted 45 minutes or more.
"The actions leading up to and following this event have put lives at risk," Murphy said at an afternoon news conference. "This is very much a race against the clock."
Murphy made several television appearances Monday, saying state and federal officials were still working on contact tracing and had reached most of the guests. He urged anyone at the club while the president was there to quarantine for two weeks.
McENANY TESTS POSITIVE
Additionally, White House press secretary Kayleigh McEnany announced Monday on Twitter that she tested positive for covid-19.
McEnany said she isn't experiencing symptoms of the virus.
"With my recent positive test, I will begin the quarantine process and will continue working on behalf of the American people remotely," she said.
The top White House spokesperson is the latest person in the president's orbit to test positive for covid-19. Two of McEnany's deputies, Karoline Leavitt and Chad Gilmartin, have also contracted the virus, according to people familiar with the matter.
McEnany was present for many of the White House events over the past week that have been followed by positive tests among attendees. She was in the Rose Garden, maskless, for the announcement of Amy Coney Barrett's nomination to the Supreme Court on Sept. 26, in close proximity to guests including Sen. Mike Lee, R-Utah, who has also tested positive for the virus.
She also traveled with the president to Cleveland last Tuesday for the presidential debate -- a flight that included White House aide Hope Hicks and campaign manager Bill Stepien, who have both tested positive -- and again during campaign travel Wednesday to Minnesota, when Hicks first experienced symptoms.
On Thursday, McEnany briefed reporters at the White House while not wearing a mask. She later said she was not aware that Hicks had tested positive before the news conference.
"I definitively had no knowledge of Hope Hicks' diagnosis prior to holding a White House briefing," she said in her statement Monday, repeating an earlier denial.
Information for this article was contributed by Zeke Miller, Jill Colvin, Aamer Madhani, Lauran Neergaard, Jonathan Lemire, Bill Barrow, Mike Catalini and Maryclaire Dale of The Associated Press; by Katie Thomas and Denise Grady of The New York Times; and by Josh Wingrove and Justin Sink of Bloomberg News.