President Trump is incurring significant risks, physically and politically, by leaving the protective care of Walter Reed National Military Medical Center for a White House that is less a safe space than a hot zone.
Yet sitting still — much less resting in bed — was never really an option for a president who often equates mobility, the power to control his own movement and hence his message, with survival.
By midday Monday, Mr. Trump made it clear he would soon be moving on from Walter Reed, and moving forward with his campaign, even as medical experts warned that the course of his illness is unpredictable in a man of his age and weight.
Hours before he left the hospital, Mr. Trump’s campaign spokesman said he “intends to be ready” to appear at the presidential debate next week, a town hall-style event that demands stamina from even a healthy candidate.
And this is what he typed out on Twitter shortly before flying the short helicopter flight from Walter Reed to the South Lawn late Monday:
“Will be back on the Campaign Trail soon!!! The Fake News only shows the Fake Polls.”
But will he, really? If he does return to the trail, will he be in any kind of shape to match the relentless back-to-back barnstorming effort that he credits for pushing him over the top in the waning days of his 2016 campaign?
And who on his virus-ravaged campaign and West Wing staffs will come along for the ride?
Mr. Trump chafed at the confinement imposed on him by the pandemic even before he came down with Covid-19 himself — one of his darkest days in a beclouded 2020 came when he insisted on staging an indoor rally in Tulsa over the summer, even as the infection spread over the summer.
For months, he mocked former Vice President Joseph R. Biden Jr. (who is now very much out and about) for quarantining in his “basement,” then he balked at going to the hospital when his blood-oxygen level dropped on Friday — and when medical professionals were advising recuperative isolation, for his own good and for the safety of those around him.
For the moment, at least, Mr. Trump is planning to stay put.
“THE PRESIDENT has no public events scheduled,” read his official schedule for Tuesday.
President Trump is hardly the first president confronting a crush of last-minute pressures and obstacles in the closing weeks of a re-election campaign. Jimmy Carter was saddled with the hostages in Iran. Barack Obama had to recover from a weak first debate. George W. Bush had to overcome deep reservations about the war in Iraq.
But it seems fair to say that no president in the history of American politics has ever confronted the hurdles that Mr. Trump faces as he attempts to be at once a president seeking re-election and a coronavirus patient. Mr. Trump is charging into unchartered territory, against the advice of doctors who warned against leaving the hospital and about the random and often lethal nature of the disease.
There are all kinds of questions that will determine if Mr. Trump can make an easy, quick transition from the hospital room to the campaign trail. The most critical one is whether the disease is really in remission; Covid-19 has proved to linger and return in often debilitating ways.
Will Mr. Trump have the energy to stage the two-hour rallies on his feet that have characterized his campaign? Will voters, campaign aides, White House staff, Secret Service agents and reporters want to be close to him, particularly if he continues to flaunt not wearing a mask, as he did upon returning from Walter Reed National Military Medical Center?
Patients struggling with Covid-19 are supposed to stay isolated. But Mr. Trump seems ready to jump on airplanes, into presidential motorcades and crowded campaign settings.
Many of these questions may be resolved by the virus. It could disappear, or it could re-emerge and send Mr. Trump back to convalescence.
For now, there is one key test coming up: Mr. Trump is supposed to debate former Vice President Joseph R. Biden Jr. on Oct. 15. It is a critical debate for Mr. Trump. He hurt himself with many voters in the first debate, and he is trailing in polls. This will be one of the last chances to turn things around.
But this is a town hall debate, which if it is set up at all like past town hall debates — a big if, of course — means that Mr. Trump and Mr. Biden would be in a setting where voters, asking questions, are in fairly close proximity — not only to one another but to someone just out of the hospital, including a certain president. Mr. Trump may be game for that. The question is, will anyone else?
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.
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.
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.”