Happy Scribe
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Hey there, it's the NPR Politics podcast. I'm Scott Detro. I cover the presidential campaign. I'm Mara Liasson, national political correspondent, and we are joined by Richard Harris from NPR's Science Desk to help us make sense of things again today. Hey, Richard. Hello, Scott. Hey, Mara. Hi, Richard. So it's just about two o'clock Eastern on Sunday, October 4th. We got another update from the president's doctor outside of Walter Reed National Military Medical Center this morning.

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Since we spoke last, president has continued to improve. As with any illness, there are frequent ups and downs over the course, particularly when a patient is being so closely watched 24 hours a day.

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Richard UPS and Downs feels like the key theme from today's briefing. What did we learn today about the president's treatment and the president's prognosis?

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Well, I think the most important thing we learned is something the doctors didn't say directly, but that it's now pretty clear that the president had a severe case of covid-19, that doctors now say he had a high fever on Friday and low oxygen levels.

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We don't know exactly how high the fever was or how low the oxygen, but those are both very concerning signs and the drugs that he's getting also told this story. The president is now on three different medications, two of which are not FDA approved. He was given monoclonal antibodies, which are in theory, at any rate, supposed to block infection. And those drugs are still experimental and may not actually work and they could have side effects. Yesterday, he also got the second dose of Ramdas severe, which is given to people with significant illness.

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And one study found that this drug reduce the amount of time people need to stay in the hospital. So that's good. And today we learned that the president is also getting a steroid called dexamethasone. This drug, again, is given to people with advanced illness. It's usually used to prevent their immune systems from overreacting and causing serious inflammation, which can be deadly.

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And despite all of that, the president's doctor, Sean Connelly, had a very upbeat, optimistic take on things. And he talked about the president getting out of the hospital very, very soon.

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The fact of the matter is, is that he's doing really well, that he is he is responding. And as the team said, if everything continues to go well, we're going to start discharge planning back to the White House right here.

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That discharge back to the White House. They say they could send him home or back to the White House at any rate, as soon as tomorrow. He would still need around the clock medical attention and he'd need to be isolated. And it's not really as if he's going home. You could really say the hospital is going to the White House with him.

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Sure. I want to talk a lot about the tone of today's press conference and yesterday's press conference with Mara. But but one more question about what we've learned about treatment and the drugs that the president is on and his condition. We heard today directly from the doctors what they did not seem to want to say out loud yesterday, that the president did need oxygen Friday before he left the White House. Dr. Connelly seemed to indicate, again, kind of filling in the blanks of what he didn't say, that he may have needed oxygen again yesterday.

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His oxygen levels did drop a little bit yesterday. How concerning is that?

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Yeah, it was it was confusing that he said that the oxygen levels are low, but didn't seem to know whether he was actually given supplemental oxygen yesterday as a result.

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But overall, these are serious things to happen to somebody who has covid-19 a patient who needs oxygen is showing signs that their lungs really aren't working well. And Dr. Carlos Del Rio from Emory University was on NPR this morning and he said that really pushes the definition of this disease into the severe category.

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That may be why doctors decided to move the president to Walter Reed.

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The president clearly had a severe illness when the oxygen saturation crossed below 94 percent. We talk about the person having having severe covid Samarra.

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What what is going on with these briefings? Because two days in a row now, today was a little more straightforward than yesterday. But the key information seems to come from repeated follow up questions or kind of, you know, Talmudical reading the the statements of the doctors to try to figure out what they didn't say, what's happening?

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Well, I think that the answer to that was in the last question of the briefing, the doctor was asked, Connelly was asked, why were you so reluctant to disclose that the president was administered oxygen?

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I was trying to reflect the the the upbeat attitude that the team, the president that, of course, of illness has had didn't want to give any any information that might steer the course of illness in another direction. And in doing so, you know, it came off that we were trying to hide something that wasn't really true.

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So there you have it. I mean, the president's team wanted a positive attitude. Where have we heard that before? And this is what he told Bob Woodward. And this is now personal. The president's brand, and he is a brander above all else, is of a strong, tough in. Vincible guy, and, you know, his enemies are weak and wimpy and apparently it sounds like to the president's team to take oxygen or to admit that he was taking oxygen somehow with something he didn't want to get out.

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Now, at another point in the briefing, he was asked, did the oxygen levels ever dip below 90? And he did say, we don't have any recordings here of that. That's kind of classic dissembling. But then he said something that was really interesting. He said it was below 94, but not in the low 80s or anything. Oh, does that mean it was 85? This is what you're talking about, Talmudic parsing of these things?

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Well, let's be blunt about this. Let's be blunt about this, because the initial word from the White House Friday was that everything was going well. The president was working. This was all out of an abundance of precaution that he was going to Walter Reed. I mean, obviously, you assumed he wouldn't be going to the hospital out of a total abundance of caution. And then that super positive briefing yesterday is immediately undercut by immediately after it ends. You have an anonymous background source telling reporters.

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The AP later reported that was the chief of staff, Mark Meadows, saying no, actually, the president was in really serious shape. It seems like at every possible moment, the more facts we learned, the more the official storyline here is just not on the level.

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And the reason why that is particularly problematic is this is a White House that has depleted its credibility reserves down to fumes. You know, there are many other presidential doctors that have sugar coated presidential sickness. You know, he's in good spirits. He's resting comfortably. There's all sorts of political euphemisms you use when you talk about a president who's sick.

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But I have never seen Reagan's making jokes on the surgery. Right, right. Right.

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But this goes much farther. And the fact that they have to do cleanup that each answer in is a new round of questions is just bad for them.

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So, Richard, a couple of questions for you. First of all, in this kind of reconfiguring of the facts, we learned based on what they didn't say dynamic we have here, Dr. Connelly was asked a question about whether X-rays showed any signs of pneumonia. He didn't quite have a clear answer on that. Is that is that something that you took note of? Is that something that we should be worried about?

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I did.

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Well, he said that basically that they looked the way you would expect, in other words, the way you would expect for somebody who has a pretty serious case of covid-19.

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So I think, again, he didn't really want to talk about the bad news the way he didn't like to talk about the bad news yesterday, although he did admit the high fever, he did admit oxygen, at least in one time. And he did say that, you know, the condition was going up and down. But, you know, again, the message was largely optimistic to the point that, you know, they're now talking about sending the president back to the White House.

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I think that we shouldn't lose sight of the fact that most people who are in this condition actually do survive. They do recover.

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And so, you know, we don't really understand the full dimensions of things. If we just sort of go with the numbers, it's likely the president will recover. But, yeah, I think that we do need to be very aware of the fact that that we're not getting straight answers. And we have to be quite cognizant of the fact that there's still a lot of reading between the lines we have to do. And that's troubling.

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OK, we're going to take a quick break. When we come back, more about what to look for in the coming days and also what to make of former Vice President Joe Biden, who, as we know, spent an hour and a half in pretty close proximity to President Trump this week.

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Right. Ambulante is NPR's only Spanish language podcast, listen for stories you won't hear anywhere else told by the voices that make Latin America come alive. Each week we bring you another remarkable story that will surprise and move you Ambulante new episodes every Tuesday. Listen and subscribe. And we're back and let's actually talk about Joe Biden for a second. He stood about 15 feet from the president for an hour and a half. He took to test Friday and was negative.

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His campaign said he would take a test again today.

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But as we tape, we have not heard word yet on what those results are. Richard, six feet has been drilled into our heads. But from what we know of how covid can spread indoors over extended periods, it feels like it is fair to say that Joe Biden might be at risk here.

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Right? Right.

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Well, we don't know whether the president at the time of the debate was, in fact, breathing out coronavirus, but if he were, you know, that would put the vice president at some risk. The CDC defines close contact as being within six feet of someone for more than 15 minutes. So by that definition, there wasn't close contact. But there's no magic bubble at six feet. So the risk isn't zero. And also, I will say that the tests, depending upon which test the vice president is taking, they're not exactly right either.

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As we've seen at the White House in recent days, that we have to be careful about being specific about what tests we're talking about, because some tests are much more accurate than others.

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So even even a negative test, we need to think about what test that is, is this is the gold standard test, the PCR test, or is this something less exact, the way the White House is typically used?

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And Biden did take a PCR test on Friday. We got no idea what test is happening today because we haven't got that information yet.

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Today would be five days from the Tuesday debate. At what point would we be safe to say looks like Joe Biden does not have coronavirus?

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Well, the CDC says if you've been in close contact with someone who shortly thereafter get sick with covid, you should quarantine yourself for 14 days.

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That's when the risk truly has passed. So that means another week or more of uncertainty about this particular contact.

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O'Mara, on that note, Biden is not quarantining. He's continuing to campaign. And I've honestly been surprised at how the Biden campaign has handled this. They have been the science people all year. They listen to the experts and now they are saying, no, no, no, he wasn't in close contact. He wasn't within six feet. And we are going to continue campaigning as we have before, which is to be fair to them, in a very controlled, safe way.

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But he's still out there. He's still interacting with people.

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He is. But, you know, they we have to assume they have taken great pains not just to send a message with a masked Biden that he takes this seriously because that's what the mask now says to people, communicates to people.

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But also, he's 77 years old. They're trying to protect him. So they're going forward. He's doing his social distance events. And this is a crucial time in the campaign. He has a lead. He wants to cemented. He wants to help down ballot Democrats. And, you know, I I have to assume that they are doing what their medical experts are advising them to do. There are other messages they're sending. Biden pulled his negative ads.

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The Trump campaign did not pull their negative ads, but that gets Biden a lot of free media praise. Classy move, people said on Fox News. And he doesn't need to run that negative ads at a time when the headlines are all full of the president having covered.

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And when I asked the campaign, how long will you keep your ads down for, they did not answer that question. That's unclear, right.

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They'll go right back up when he thinks they're necessary. But just you know, we've been waiting for polling on this and there really isn't any good polls, although every Republican I've talked to thinks there's no way this is good for Trump. The ads kind of make themselves he couldn't even keep himself safe. How can he keep you and your family or the country safe? But we do have a kind of snap poll, a survey monkey poll for Axios where 73 percent of Democrats, 58 percent of independents said Trump handled his diagnosis irresponsibly, assuming they're referring to the fact that he kept traveling even after Hope Hicks tested positive.

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But 88 percent of Republicans say he acted responsibly. So there you have it.

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So, Richard, let's let's end shifting back to President Trump.

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You know, like you said, the doctors say he could be discharged as soon as tomorrow.

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But like you said, that means something very different for the president of the United States compared to you or me going home from the hospital.

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What will you be listening for and looking for over the coming days as we get more updates?

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Well, covid doesn't follow a neat and predictable course. Some people get better over the course of a week or more and then they suddenly crash. That's usually due to inflammation.

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And because the president is taking a drug to reduce inflammation, he's probably at less risk of that happening. But to use the words of his doctors yesterday, he's not out of the woods. You know, typically if people are still feeling well after about 10 days and the risk of a serious setback is low, then that would be and that would be like next weekend or whatever. That's that's the time to start breathing a little bit easier. I think it's also worth saying that even if he, you know, escapes the most serious trajectory of this disease, it can still have lingering effects.

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That was brought up today on NPR by Dr. Carlos Del Rio from Emory University. Here's what he had to say about that.

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What we need to remember that many patients with covid, even after they recover, just don't feel well. They continue to feel fatigue. They continue to feel febrile. They continue to maybe have a cough. And their three organs that we worry about, particularly one is the lungs that patients may have decreased lung capacity. One is the heart that patients may have, you know, the diminished cardiac function and the other one is the brain. Some patients describe many, many weeks after having covered having this what they call a brain fog, just not being able to think, well, I'm not being able to to work appropriately.

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And I should add that, you know, even if that doesn't happen with the president, the steroid drug that he's taking, dexamethasone commonly increases irritability and it can also trigger mood changes. So that's something to be aware of as well in the coming week at least.

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All right. More on the campaign, more on the president's diagnosis, more on whatever happens next will be in your feed as it's needed. This was if you started on Monday. This was an eight podcast week for us. Richard, thank you so much for joining us. Hey, happy to be with you. I'm Scott Tetrault. Cover the presidential campaign.

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I'm Mara Liasson, national political correspondent. Thank you for listening to the NPR Politics podcast.