President Trump announced on Tuesday that he was planning to attend next week’s debate in Miami against former Vice President Joseph R. Biden Jr. despite his continued struggle with the coronavirus and unresolved questions about the event’s rules.
“I am looking forward to the debate on the evening of Thursday, October 15th in Miami. It will be great!” the president tweeted early Tuesday, the morning after he returned to the White House from Walter Reed National Military Medical Center.
“FEELING GREAT!” he added in a separate tweet, hours before his physician reported that he was feeling well.
Mr. Biden’s campaign did not immediately respond to a request for comment. Over the weekend, Mr. Biden said he would follow the guidance of medical professionals and the nonpartisan commission overseeing the debate in making his plans.
But physicians who specialize in infectious diseases quickly warned that Mr. Trump’s optimism might be premature, and could reflect a false sense of security about his condition, reinforced by temporary improvements that could be reversed once he is removed from medications.
People with mild to moderate cases of the illness are likely to “remain infectious no longer than 10 days after symptom onset,” according to guidelines from the Centers for Disease Control and Prevention. But that period could be doubled in cases of more serious illness.
That means Mr. Trump could still be contagious, depending on the severity of his case and when his symptoms began, during the next debate, according to Dr. Krutika Kuppalli, an infectious-disease physician in South Carolina.
“We don’t even know what’s going to happen tomorrow, let alone in a few days,” she said.
Medical details that Mr. Trump’s doctors disclosed over the weekend — including his fluctuating oxygen levels and a decision to begin treatment with a steroid drug — suggested to many infectious-disease experts that he had a more severe case of Covid-19 than the physicians acknowledged.
He has been taking a steroid called dexamethasone — a drug known to buoy feelings of well-being, said Dr. Taison Bell, an emergency medicine physician at the University of Virginia, and patients typically need to demonstrate they can function without medication before being allowed to resume normal activities.
Should Mr. Trump’s condition continue to improve and should he be definitively cleared by physicians to participate in next week’s event, Dr. Bell added, masking and distancing will remain crucial. “They need to stick with the rules they’ve set,” he said.
If Mr. Trump is able to follow through on his promise, he faces a campaign transformed by an infection that has spread to his top aides, and stakes that have been heightened by a disruptive performance in the first debate that prompted the Commission on Presidential Debates to consider revising its procedures.
Mr. Trump had previously questioned whether he would participate if new rules, including the possibility that his microphone would be muted to discourage interruptions, were enacted. But his illness has upended those calculations, and Republican officials said that he now needed to show that is physically capable of carrying on his campaign.
Debate planners are also trying to keep their events from exacerbating the pandemic. On Monday, the commission decided to install a sheet of plexiglass between Kamala Harris and Mike Pence at the vice-presidential debate on Wednesday amid concerns about transmission during their back-and-forth.
It is not clear if the commission will do the same at the town-hall-style debate in Miami, but Democratic officials have pressed for rigorous safety measures including the expulsion of attendees who refuse to wear masks or decline to observe social distancing protocols.
Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff, along with several of the Pentagon’s most senior uniformed leaders, are quarantining after being exposed to the coronavirus, a Defense Department official said on Tuesday.
The official said almost the entirety of the Joint Chiefs of Staff, including Gen. James C. McConville, the Army chief of staff, are quarantining after Adm. Charles Ray, the vice commandant of the Coast Guard, tested positive for coronavirus.
“We are aware that Vice Commandant Ray has tested positive for Covid-19 and that he was at the Pentagon last week for meetings with other senior military leaders,” Jonathan Hoffman, the Pentagon spokesman, said in a statement released by his office.
“Out of an abundance of caution, all potential close contacts from these meetings are self-quarantining and have been tested this morning,” he added. “No Pentagon contacts have exhibited symptoms and we have no additional positive tests to report at this time.”
The announcement represents an alarming development — as the virus extends its reach from the highest levels of civilian government to the operational heart of the country’s national security apparatus.
A military official noted that General Milley and the other senior officers have full operational capability from where they are working — most at home — and said there is no degradation to the country’s national defense.
Admiral Ray was in the Pentagon last week, attending meetings in the secure “Tank” with General Milley and the senior Pentagon uniformed leadership. Defense Department officials said the decision to quarantine complied with Defense Department guidelines established by the Centers for Disease Control.
General Milley and a number of senior Defense Department officials have also been getting tested frequently since Sept. 27, when many of the Pentagon’s senior leadership attended a White House reception for “Gold Star” families of fallen troops. Both Mr. Trump and Melania Trump, the first lady, were at that event.
The reaction at the Pentagon to the possible exposure of senior military leaders to coronavirus stands in contrast to the White House, where Mr. Trump has flouted the same guidelines established by the C.D.C. that the Pentagon is following.
White House officials, citing national security concerns, last weekend told Defense Department officials that they should no longer inform the public or the press about the coronavirus status of senior Pentagon leaders. But Defense Department officials have questioned the directive.
General Milley, 62, was appointed to his post as the most senior member of the military on December 8, 2018, by Mr. Trump.
President Trump is reporting “no symptoms” of the coronavirus and doing “extremely well,” according to his physician, Dr. Sean P. Conley.
In a brief, three-sentence memo released by the White House, Dr. Conley — whose credibility has been questioned by some medical experts after he admitted to giving a deliberately rosy description of the president’s condition during a news briefing over the weekend — said that Mr. Trump’s team of physicians visited him in the residence this morning and that, after a “restful first night at home,” Mr. Trump “reports no symptoms.”
“Vital signs and physical exam remain stable,” he said, “with an ambulatory oxygen saturation level of 95 to 97 percent.”
“Overall he continues to do extremely well; I will provide updates as we know more,” Dr. Conley said.
Separately, Vice President Mike Pence’s physician also released an update on his condition, saying that Mr. Pence has “remained healthy, without any Covid-19 symptoms.” The physician, Dr. Jesse T. Schonau, said that Mr. Pence has been tested daily and has received negative results. He reiterated his past assertion that Mr. Pence does not qualify as a “close contact” with anyone who has tested positive for the virus, according to guidelines from the Centers for Disease Control and Prevention.
“The Vice President is encouraged to go about his normal activities and does not need to quarantine,” Dr. Schonau wrote. Mr. Pence is in Salt Lake City ahead of Wednesday night’s vice-presidential debate and plans to attend campaign rallies in Arizona and Nevada the following day.
Facebook removed a post from President Trump on Tuesday that violated its policy against sharing misinformation about the virus, one of the few times that the social network has taken down one of his posts.
In Mr. Trump’s message, he falsely claimed that the flu was responsible for more deaths than the coronavirus. More than 1 million people have died from the coronavirus, with more than 35.5 million cases reported around the world. Mr. Trump’s post is no longer available on Facebook.
“Many people every year, sometimes over 100,000, and despite the Vaccine, die from the flu,” Mr. Trump wrote in the post. “We have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!”
The president’s comments and actions over the past few days — including his Twitter message on late Monday telling Americans: “Don’t be afraid of Covid. Don’t let it dominate your life” — have drawn outrage from scientists, ethicists and doctors, as well as from some people whose relatives and friends have died.
“I am struggling for words — this is crazy,” said Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania. “It is just utterly irresponsible.”
Facebook had previously removed ads and posts by Mr. Trump’s re-election campaign for spreading coronavirus misinformation or for violating policies about hate symbols, and it took down a video Mr. Trump posted in August in which he claimed children were “virtually immune” to the coronavirus. While the Silicon Valley giant has been under intense pressure to deal with Mr. Trump’s spreading of falsehoods on its site, its chief executive, Mark Zuckerberg, has said that he is a proponent of free speech.
This year, Facebook introduced new policies to remove misinformation related to Covid-19 “that could contribute to imminent physical harm.” The company has applied the policy to remove posts that “make false claims about cures, treatments, the availability of essential services or the location and severity of the outbreak.”
“We remove incorrect information about the severity of Covid-19, and have now removed this post,” Facebook said in a statement.
Mr. Trump also tweeted the same message falsely claiming that the flu was responsible for more deaths than the coronavirus. The company added a label to the tweet that hides the message, saying that the post violated its policies by spreading misleading information about Covid-19.
A Twitter spokeswoman said that the label will mean “engagements with the tweet will be significantly limited.”
President Trump tweeted on Tuesday that he had instructed his representatives in talks with Democrats over an economic aid package “to stop negotiating until after the election when, immediately after I win, we will pass a major Stimulus Bill that focuses on hardworking Americans and Small Business.”
Stocks on Wall Street gave up their gains after the president’s tweet, which accused Speaker Nancy Pelosi of “not negotiating in good faith.” The S&P 500 dropped as much as 1 percent after Mr. Trump’s tweet. It had been up more than half a percent in the moments before.
More than 40 United States senators, along with more than a dozen congressional aides and reporters, have been tested for the coronavirus since late last week, when it became clear the White House was a hot spot for transmission, officials said on Tuesday.
In contrast to the approach taken at the West Wing — where officials are making little effort to determine the scope of the outbreak — Congress’s attending physician, Dr. Brian P. Monahan, is working with the Washington, D.C., health department to trace contacts of known cases on Capitol Hill, according to a Democratic aide familiar with the medical office’s work.
Three Republicans — Mike Lee of Utah, Thom Tillis of North Carolina, and Ron Johnson of Wisconsin — have tested positive in recent days. The other senators who have sought testing — about evenly divided between the two parties — have so far tested negative.
Aides for both Mr. Lee and Mr. Tillis have tested negative, according to spokesmen for the lawmakers.
Mr. Johnson has said that he would return to the Senate even if he were still ill when Judge Amy Coney Barrett’s nomination to the Supreme Court came to a vote, declaring that he would show up “in a moon suit” if necessary to confirm the president’s Supreme Court nominee before the election.
Senate leaders at war over the confirmation have quickly set aside differences and agreed to adjourn for two weeks beginning Monday. (The House had already been scheduled to be out of session.)
That left the cavernous Capitol — a beehive workplace for 535 legislators and thousands of staff — eerily empty on Tuesday as a frantic investigation was underway to understand the extent of the transmission.
Anxiety over the possibility of widespread infection is particularly acute on Capitol Hill, where nearly half of senators are over the age of 65; the House, on average, is not much younger, and thousands of employees have been forced to work amid the pandemic.
Even as the crisis intensifies, there remains no mandatory testing requirement or consistent set of virus precautions for the hundreds of lawmakers who have traveled routinely in and out of Washington.
Some legislators have taken multiple tests as an extra precaution after being in proximity with the infected senators, who continued to go about their regular business in the Capitol through last Thursday.
Dr. Monahan’s office has asked lawmakers who tested positive to publicly announce the results to inform those who might have interacted with them, the aide said, but the exact scope of its work has been difficult to determine, because Dr. Monahan does not comment publicly. His team administers tests on site and typically processes the results within six hours.
Those steps came as representatives from the nation’s capital region called on the White House to quickly take measures to protect its employees — who are their constituents.
“We are alarmed and dismayed by the casual disregard for the health of our community, including constituents who work at the White House as staff, agents or officers of the United States Secret Service, journalists of the White House Correspondents Association, and the general public,” wrote nine Democratic lawmakers, including Representatives Eleanor Holmes Norton, the district’s sole nonvoting representative, and Steny H. Hoyer of Maryland, the majority leader.
President Trump’s comparisons of Covid-19 and the flu stand in sharp contrast to months of data gathered by experts, who have repeatedly said that the coronavirus poses a far more serious threat than influenza viruses.
The president tweeted on Tuesday morning:
“Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu. Are we going to let it close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!”
Based on data gathered thus far, most flu viruses are less deadly and less contagious than the coronavirus. And while flu vaccines and federally approved treatments for the flu exist, no such products have been fully cleared by governing bodies for use against the coronavirus.
According to the Centers for Disease Control and Prevention, between 24,000 and 62,000 flu-related deaths occur in the United States each year — substantially fewer than Mr. Trump claimed. In February, Mr. Trump stuck closer to the facts at a White House news conference. “The flu, in our country, kills from 25,000 people to 69,000 people a year. That was shocking to me,” he said at the time. On average, seasonal flu strains kill about 0.1 percent of the people they infect.
The coronavirus, on the other hand, has killed more than 210,000 people in the United States, and more than one million worldwide, since the start of 2020. The virus’s true mortality rate remains unclear, as it is difficult to gather such data while the pandemic rages on. Inadequate testing has also made it hard to pinpoint how many people have been stricken by the virus, which can spread silently from people who never show symptoms.
Still, estimates from experts tend to put the coronavirus’s death rate higher than the flu’s. The virus’s death toll was especially high in late winter and spring, when hospitals were overwhelmed, clinically-tested treatments were scarce and masking and distancing were even more intermittent than they are now.
Frequent encounters with past flu strains, in combination with effective vaccines, can also bolster the body’s defenses against new flu viruses. The coronavirus, however, has swept through a defenseless population of unprepared hosts at a dizzying rate.
And deaths also don’t reveal the entire picture. Researchers still don’t fully understand the long-term consequences of coronavirus infections, which have saddled a growing number of people, called long-haulers, with serious and debilitating symptoms that can linger weeks or months.
Twitter appended a note to Mr. Trump’s tweet, saying that it violated the company’s rules about spreading false or misleading information about the virus, and Facebook removed the post for violating its similar policy.
The White House resembled a ghost town again on Tuesday, as officials stayed home to wait out the infectious period from an outbreak of the coronavirus within the building and among people who had been there.
President Trump was in the White House residence, convalescing, as a number of advisers and other officials stayed home, either because they had contracted the coronavirus or had been near people who did.
A culture of nervousness replaced a culture of negligence about precautions against the virus, led by Mr. Trump, that had infused the White House since March.
The White House communications and press shops were bereft of people. The White House press secretary, Kayleigh McEnany, announced on Monday that she had tested positive. Two other press office aides have also tested positive.
And a military aide who comes in contact with Mr. Trump tested positive over the weekend, a person close to the president said, confirming a report by CNN.
Mr. Trump was considering some kind of a nationwide televised address, two people familiar with the discussions said. But while there were no new reports of him needing oxygen, he was still sounding somewhat short of breath in conversations, another person said.
Since President Trump disclosed early Friday that “@FLOTUS and I tested positive for COVID-19,” he has tweeted 57 times and released four video statements posted on social media accounting for 7:09 minutes of direct-to-camera communication (as of 2:05 p.m. Eastern on Tuesday).
He has instructed Americans to not let the virus “dominate” their lives, compared the impact of the deadly disease to the seasonal flu (a post Facebook removed from its platform on Tuesday, citing its rules against spreading misinformation), lavished praise on his supporters and the medical staff who helped him, talked about how fit he was feeling, and declared he has “learned a lot about Covid” and now “gets it.”
One topic has been scarcely mentioned: the 210,000 people in the United States who have already died of the virus.
In none of the messages does Mr. Trump directly offer condolences to the families of the dead or make explicit reference to the toll that the pandemic has taken on the families of those who contracted the disease or died in the pandemic.
He has not avoided the topic entirely, referring in vague terms to the massive negative impacts of the virus — urging people “to get out there and be careful” in one video, and making passing reference to “the millions of people all over the world” affected by the disease in another.
Mr. Trump has played down the impact of the disease in the months before he came down with the virus, a pattern that has continued since his diagnosis.
Fifteen of the posts were exhortations to supporters, boasting of his accomplishments and urging them to “VOTE!”
He has defined his role as morale booster, rather than emphasizing the steps needed to ameliorate the crisis or offering new approaches based on his personal experience.
“You’re going to beat it,” he said in a message on Monday. “We’re going to be out front. As your leader, I had to do that. I knew there’s danger to it, but I had to do it. I stood out front, and led.”
Twitter appended a note to Mr. Trump’s tweet comparing the coronavirus to the flu, saying that it violated the company’s rules about spreading false or misleading information about the virus, and Facebook removed the post for violating its similar policy.
Despite almost daily disclosures of new coronavirus infections among President Trump’s close associates, the White House is making little effort to investigate the scope and source of its outbreak.
According to a White House official familiar with the plans, the administration has decided not to trace the contacts of guests and staff members at the Sept. 26 Rose Garden celebration for Judge Amy Coney Barrett, Mr. Trump’s Supreme Court nominee. At least 11 people who attended the event, including the president and the first lady, have since tested positive.
Instead, it has limited its efforts to notifying people who came in close contact with Mr. Trump in the two days before his Covid diagnosis on Thursday evening. The White House official, who declined to be identified because he was not authorized to speak about the matter, said that the administration was following guidelines from the C.D.C.
The contact tracing efforts have consisted mostly of emails notifying people of potential exposure, rather than the detailed phone conversations necessary to trace all contacts of people who have been exposed. These efforts, typically conducted by the C.D.C., are being run by the White House Medical Unit, a group of about 30 doctors, nurses and physician assistants, headed by Dr. Sean Conley, the White House physician.
“This is a total abdication of responsibility by the Trump administration,” said Dr. Joshua Barocas, a public health expert at Boston University, who has advised the city of Boston on contact tracing. “The idea that we’re not involving the C.D.C. to do contact tracing at this point seems like a massive public health threat.”
For more than a century, Secret Service agents have lived by a straightforward ethos: They will take the president where he wants to go, even if it means putting their bodies in front of a bullet.
But that guiding principle has been tested in recent days by President Trump’s desire to get back to work, play or campaigning, despite an active coronavirus infection that could pose a serious threat to those around him.
The problem came into focus on Sunday, when a masked Mr. Trump climbed into a hermetically sealed, armored Chevy Suburban with at least two Secret Service agents so the president could wave to supporters outside Walter Reed National Military Medical Center in Bethesda, Md., where he was hospitalized from Friday to Monday.
Medical experts said the move put agents at risk. Secret Service personnel have privately questioned whether additional precautions will be put in place to protect the detail from the man they have pledged to protect.
“It’s on everybody’s mind,” said W. Ralph Basham, a former director of the Secret Service and the commissioner of U.S. Customs and Border Protection in the George W. Bush administration. “The ones no longer there are happy they’re not there. These are tough decisions to have to make.”
Central to the job of Secret Service agents is a willingness to say yes to the president no matter what he asks. Now, that means subjecting an agent’s health to Mr. Trump’s whims.
Critics say the president is not repaying his protectors’ dedication with anything like care or consideration. While agents have volunteered to sacrifice themselves for those they protect, they do so knowing that there is a low chance they will need to step in between a gunman and the president.
“If they’re on the protection detail, they’ll take a bullet for their protectee,” said Janet Napolitano, President Barack Obama’s first homeland security secretary. “There’s a difference between that and being unnecessarily exposed to risk,” she added, one that extends to their families.
President Trump returned to the White House on Monday night, staging a defiant, made-for-television moment in which he ripped off his face mask and then urged the nation to put aside the risks of the deadly coronavirus that has swept through his own staff and sent him to the hospital for three days.
Just hours after his press secretary and two more aides tested positive, making the White House the leading coronavirus hot spot in the nation’s capital, Mr. Trump again dismissed the pandemic that has killed more than 210,000 people in the United States, telling Americans “don’t be afraid of it” and saying that he felt “better than 20 years ago.”
The words and visuals were only the latest ways Mr. Trump has undermined public health experts trying to persuade Americans to take the pandemic seriously. Even afflicted by the disease himself, the president who has wrongly predicted that it would simply disappear appeared unchastened as he pressed America to reopen and made no effort to promote precautions.
“We’re going back to work. We’re going to be out front,” Mr. Trump said in a video shot immediately after his return and then posted online. “As your leader, I had to do that. I knew there’s danger to it, but I had to do it. I stood out front. I led. Nobody that’s a leader would not do what I did. And I know there’s a risk, there’s a danger, but that’s OK. And now I’m better and maybe I’m immune, I don’t know. But don’t let it dominate your lives.”
Mr. Trump’s statement was meant to cast his illness as an act of courage rather than the predictable outcome of recklessness. He took no responsibility for repeatedly ignoring public health guidelines by holding campaign rallies and White House events without masks or social distancing, like the Supreme Court announcement at the White House last month that may have infected a wide array of his aides and allies.
The regret-nothing approach demonstrated that the president intended no pivot in his handling of the pandemic despite his own medical crisis and the growing number of infections among his inner circle. The White House press secretary, Kayleigh McEnany, and two of her deputies were the latest to test positive.
Mr. Trump’s message, in effect, was that Americans should live their lives and not worry about catching the virus because “we have the best medicines in the world,” never mind that he has had access to experimental treatment and high-quality health care not available to most people.
The president’s dismissal of a virus that in recent weeks has been killing another 700 people each day in the United States set off alarm bells among health specialists who worried that it would send the wrong message to the public.
Kristin Urquiza, who addressed the Democratic National Convention in August after her father died of the coronavirus, responded on Twitter to the president’s admonishment to Americans not to be afraid of Covid-19, the disease caused by the coronavirus. “At this point the only thing we should be afraid of is you,” she wrote.
Critics also noted the president’s bravado is bolstered by care that isn’t available to most people, including an experimental antibody treatment that is still being tested in clinical trials and has been given to only a few hundred people. The manufacturer, Regeneron, has said that most of those who have gotten the cocktail have done so as participants in the trials, although in a handful of cases they have received it outside of the studies, as Mr. Trump did.
Mr. Trump pressured his doctors to release him from Walter Reed National Military Medical Center in suburban Maryland, but it did not indicate that he had escaped jeopardy, only that he could be treated at the White House, where he has 24-hour medical care. Dr. Sean P. Conley, the White House physician, acknowledged that the president “may not entirely be out of the woods yet,” adding that it would be another week until doctors could feel confident that he had passed the danger point.
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