Health Concerns Loom as Trump Says He’ll Move Ahead With Campaign

President Donald Trump announced Tuesday that he was planning to attend next week’s debate in Miami against former Vice President Joe Biden 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.

Biden’s campaign did not immediately respond to a request for comment. Over the weekend, 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 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 put forth by the Centers for Disease Control and Prevention. But that period could be doubled in cases of more serious illness.

That means Trump could still be contagious, depending on the severity of disease and when his symptoms began, during the next debate, said Dr. Krutika Kuppalli, an infectious disease physician based in South Carolina.

“We don’t even know what’s going to happen tomorrow, let alone in a few days,” she said. Trump 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. Patients typically need to demonstrate they can function without medication before being allowed to resume normal activities.

Should Trump’s condition continue to improve and he is definitively cleared by physicians to participate in next week’s event — which is not guaranteed — Bell added that masking and distancing will remain crucial. “They need to stick with the rules they’ve set,” he said.

If 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 revise its procedures.

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 needs 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 Plexiglas between Kamala Harris and Mike Pence at the vice-presidential debate Wednesday amid concerns about transmission during their back-and-forth. (Aides to Pence said Tuesday that they felt the barriers were unnecessary.)

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.

On Thursday evening, senior administration officials confirmed that Stephen Miller, Trump’s top speechwriter and a policy adviser, had tested positive for the coronavirus, joining a growing list of Trump’s close aides who have the virus.

“Over the last five days I have been working remotely and self-isolating, testing negative every day through yesterday,” Miller said in a statement. “Today, I tested positive for COVID-19 and am in quarantine.”

Miller is married to Katie Miller, Vice President Mike Pence’s communications director. A senior administration official said Katie Miller, who contracted the virus this spring and returned to work in May, was tested Tuesday morning and was negative for any new infection.

On Tuesday, many White House offices were empty 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.

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.

The White House communications and press shops were bereft of people. The White House press secretary, Kayleigh McEnany, announced Monday that she had tested positive. Two other press office aides have also contracted the virus, and two more aides Tuesday were said to have tested positive, people familiar with the results said. The outbreak in the White House, which has extended to some lawmakers on Capitol Hill, has raised concerns in the city that surrounds it. Washington, D.C., which has managed to bring infection rates down in recent weeks through preventive laws and high rates of compliance, has almost no control over the federal government.

The city reported 105 new coronavirus cases Tuesday, the highest number since June 3.

The gathering at the Rose Garden would have violated the city’s mandates limiting the size of gatherings and requiring masks. But because the White House is on federal property, it is exempt from such rules.

City officials said they would be closely monitoring infection trends for several days to see if the Capitol and White House cases affected the city’s overall infection rate.

Gen. Mark Milley, 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 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, vice commandant of the Coast Guard, tested positive for the 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 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. Ray was in the Pentagon last week, attending meetings in the secure “Tank” with Milley and the senior Pentagon uniformed leadership. Defense Department officials said the decision to quarantine complied with Defense Department guidelines established by the CDC.

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 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 Trump has flouted the same guidelines established by the CDC 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.

Milley, 62, was appointed to his post as the most senior member of the military Dec. 8, 2018, by Trump.

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, 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 Trump’s team of physicians visited him in the residence this morning and that, after a “restful first night at home,” Trump “reports no symptoms.”

“Vital signs and physical exam remain stable,” he said, “with an ambulatory oxygen saturation level of 95 to 97%.

“Overall he continues to do extremely well. I will provide updates as we know more,” Conley said.

Separately, Pence’s physician also released an update on his condition, saying that Pence has “remained healthy, without any COVID-19 symptoms.”

The physician, Dr. Jesse T. Schonau, said that Pence has been tested daily and has received negative results. He reiterated his past assertion that Pence does not qualify as a “close contact” with anyone who has tested positive for the virus, according to guidelines from the CDC.

“The vice president is encouraged to go about his normal activities and does not need to quarantine,” Schonau wrote. Pence is in Salt Lake City before Wednesday night’s vice presidential debate and plans to attend campaign rallies in Arizona and Nevada the following day.