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The Lead with Jake Tapper

Trump's Doctor Says President to Leave Hospital Even Though He May Not Be Entirely Out of The Woods Yet; Trump Says He Is Leaving Hospital Tonight as He Downplays COVID. Aired 3:30-4p ET

Aired October 05, 2020 - 15:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[15:30:00]

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Why the change here?

When he was asked about as you point out, Jake, If he's on blood thinners, because as you know one of the things that can happen with this is people can develop blood clots and that's why blood thinners could potentially be important. And he says I'm not going to get into the patient's COVID-19 medications.

Well, he has told us about the remdesivir and the monoclonal antibodies and the dexamethasone, so it just -- you know, it makes you fully convinced that they are still not revealing everything here.

JAKE TAPPER, CNN HOST: Yes.

GUPTA: Why is that? And because those are basic things. Someone asked a very good question about his cardiac function, lung -- I'm sorry, cardiac, kidney and liver function, and again, sort of a non-answer answer.

I noticed, for example, the medication list that they gave you is no longer receiving his statin medication. Was that because there was a concern about his liver because that can have an interaction with the liver?

This level of detail is not just, you know, for giggles, it's really important in terms of determining what would happen next. Most important thing, Jake, which you mentioned in the beginning, he's not out of the woods.

TAPPER: Yes.

GUPTA: Dr. Conley himself said before that day 7 through 10 is kind of the most critical days here, and we haven't gotten to that point, so why discharge him right as he's getting into this critical window?

TAPPER: Yes, and I have to say HIPAA regulations which Commander Conley kept invoking for those who don't know that's a health information privacy. It's why a reporter can't call a hospital to find out how the average citizen is doing. Doctors, nurses and others are not allowed to give that information.

I have never heard a president's physician -- a president's physician invokes HIPAA regulations. I've never heard that. And also, I don't know if it's like the Fifth Amendment or not but how is that he can tell us some information about the President's health --

GUPTA: Right.

TAPPER: -- that reflects well on him and that doesn't afoul of HIPAA regulations, but stuff that might suggest that the President is actually not as healthy as the President and others want him to appear. That's covered by HIPAA regulations. That doesn't make any sense.

GUPTA: No, it doesn't. It's very selective and the things they've left out they've invoked HIPAA for are really critical details. I mean, you know, again this is a respiratory virus, and we still don't have a clear idea, after the President has been in the hospital over the weekend, what the shape his lungs are in.

We do know there's concern given that he dropped his blood oxygenation, required oxygen. A lot people may think, what's the big deal about that? It's actually fairly significant to have dropped your blood oxygenation at rest needing supplemental oxygen. It shows that your lungs, you know, have been affected significantly by the virus. Not that they can't recover, but that they've been affected.

There's two points, I think, Jake, that are going to be really critical. One, you already raised the steroids. We talked about that before the press conference. I worry that that's a mask of what's going on here. I prescribed a lot of steroids for patients, in the world of neurosurgery, all doctors do prescribe this. But it's a mask. It reduces the inflammation. The inflammation is the body's response to the infection. Sometimes the inflammation can be too much. You want to reduce it to try and make the patient be able to recover.

But at the same time, it's just a mask, the viral load is still there and still needs to be treated. As you wean the steroids, the viral load may start to increase again, and that's again, why you want him in the hospital.

And the other thing is, you know, for hospitalized patients, Jake, long hauler sort of symptoms. These persistent symptoms of fatigue, of headache, shortness of breath, whatever they may be. About 90 percent, 78 percent of patients who are hospitalized for COVID do have some of these long hauler symptoms.

So how are those going to be addressed? Have they had any evidence of that? What are they going to do about it?

This just seems very short-sighted. I mean again, if he were any other patient, leave alone that he's the President, you probably would have kept him in the hospital longer just to get him through this critical window and address these really important points.

TAPPER: There are other things Commander Conley said that I found a little odd. For instance, when asked about the fact that the President is taking these very serious medications and the course is not even done with them, and they are medications that you and I have been talking about for days. You need to be in the hospital to take them, they're so serious. And he said, we send patients home with medications all the time.

Do they with medications this serious? And this experimental? Is that true?

GUPTA: No, no, no, I mean these are -- I guarantee you they're not sending patients home all the time with these medications because some of -- certainly not for COVID.

Remdesivir is a relatively new medication -- it's been around for a while, but with COVID it's a new medication. And the idea of them combining it with antibodies, combining it with the steroids, that's almost a different situation unto itself.

[15:35:00]

We don't know what all the cross interactions are going to be. Again, as I was explaining before the press conference, remdesivir helps cut down on the viral activity. The steroids actually suppress your immune system to some extent.

So now you have counteracting forces. He's getting both those medications at the same time. I'm not saying that that plan is wrong but the idea of doing it outside of a clinical setting, outside of a hospital in something that there is very little data on, we don't know the interaction with the monoclonal antibodies if any.

I mean this is new stuff do you really want to be sort of trying -- the President may now be on a regimen that very few if any people in the world have been on, you know, over the last few days. That's why you want to observe this in the hospital to make sure it doesn't lead to problems.

The steroids in particular, even though that's an existing medication we've known about, that can cloud people's judgment, that can make people aggressive, can cause all sorts of side effects, make them restless, make them hungry, unable to sleep. There's significant issues with those medications. It can also lull you into this confidence that I'm doing great.

TAPPER: Yes.

GUPTA: Those people often do feel, you know, better on steroids but that's not because they've taken care of the problem.

TAPPER: Right.

GUPTA: They've taken care of a symptom which is the inflammation.

TAPPER: Sanjay, Commander Conley said, that President Trump is not taking fever reducers. Would the steroid be a fever reducer in any way? GUPTA: Yes, it could. That steroids can reduce fever and I think he's

also on an aspirin, I believe. At least it was in his medication list from before which can also reduce fever. So, I think he was referring to things like Tylenol which is -- it's good that he's not on medications that are designed to specifically reduce fever.

But again, I think it's good information but it's not complete, because we don't have the complete picture of still, how high did his fever go? What did it bring the fever down? How low did his oxygenations go? Was that in conjunction with the fever? Do we have evidence of just how significant the inflammation is in his body?

I'm not asking questions -- the questions I'm bringing up are ones that have easy answers --

TAPPER: Right.

GUPTA: -- and probably they know. Hopefully, they know. I'm sure he got good care, but they're definitely not sharing. And once you get into this pattern of not sharing it makes me question everything. You've got to question everything at that point.

TAPPER: Yes, and they've been hiding a lot of facts about this since last week. Sanjay, stick around, I want to go right now, of course, to CNN's Kaitlan Collins at the White House.

And Kaitlan, sources have told CNN that the President has been anxious to leave Walter Reed Medical Center for political reasons. He wants to project strength to the country with a month left before the election.

The medical team today, they didn't say a lot of things, they also didn't say, whether the President will be confined once he's back at the White House. Or what that kind of quarantine would look like?

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: No, they didn't. and so, they were specifically asked, will he have to stay in the residence, or can the President go to the Oval Office into the West Wing. Of course, they are on two opposite sides of campus. And the doctor did not answer that question. Instead he just said they're going to work to the best of their ability to allow the President to be able to carry out his everyday duties.

And, of course, Jake, if the President is going into the West Wing or if he's having aides come into the residence, it raises questions of what they're going to have to do. Are they going to have to be dressed in full PPE like you say those Secret Service agents wearing face masks and shields and gowns over their clothing yesterday when they were in the car with the President?

Because of course they said -- the doctor said he will not breathe a deep sigh of relief until next Monday, that's a week away from today. And so, if the President has been angling to get out of his hotel room, it's hard to see if he's going to want to stay in the residence for next seven days.

But we did not get a lot of answers there and that answer, the non- answer about when the President's last negative test was, really makes you question what

the White House has been claiming for months, which is that the President is tested every single day. Because Jake, if he was, they would easily be able to say, well, he was last tested on Thursday and it was a negative result. Four hours later, he tested positive.

And another thing that Dr. Conley said that raised eyebrows was he admitted they did not sit down with the President to ask if he had symptoms related to COVID-19 until after he got back from New Jersey on Thursday. Jake, that was about six hours I believe that's a generous number there after they learned that Hope Hicks had tested positive. And yet his own physician admits they did not think to test the President right away, and instead waited hours later to ask the President, how he was feeling.

That is not the doctor's job, and it's got to raise questions about that, because anyone else who comes into contact with someone would immediately start taking those precautions, yet they did not do that.

And finally, I saw you note that the doctor cited HIPAA when trying to avoid answering certain questions, of course, that comes from the President himself. Because if they were so confident in their evaluation and their decision to send the President home, you have to wonder why the President wouldn't just let the doctor go out there and tell reporters everything he knew about the President's condition including when he last tested negative.

[15:40:04]

Including what his lung scan showed but those are details that he would not provide because he said, the President was not allowing him to provide them. So now the President is going back to the White House with a lot of questions still unanswered about his condition.

TAPPER: And as we've discussed, he is a 74-year-old man who is clinically obese and has lots of comorbidities and preexisting conditions that could make this virus even worse. Kaitlan Collins, thanks so much.

Joining me, CNN's Gloria Borger, Dana Bash, Abby Phillip. Gloria, an important point that I want to underline again. These are not just the President's physicians, they are members of the United States Navy. He is not just a patient, he is their commander in chief. They have to obey his orders.

Dr. Conley, Commander Conley said the President never pushed his doctors, quote, beyond safe and reasonable practices. But it seems rather inescapable that these physicians have been pressured to do all sorts of things that normally they wouldn't do if any of the four of us were their patients.

GLORIA BORGER, CNN CHIEF POLITICAL ANALYST: Absolutely, and look that and look at the President's tweet in the context of that. The President tweets, don't be afraid of COVID. Don't let it dominate your life. And so, what he's telling these doctors, obviously is, I need to get

out of here. I need to show that I am strong. I need to show that I can beat COVID. That I'm not going to let it dominate my life.

I spoke with somebody who spoke with the President this morning who said the President needs to show that he's a warrior and that's how what he sounded like. So, he wants to be the warrior. Except these doctors know that he's not just returning home like you'd return home, or I'd return home, he's returning to the White House where he gets 24/7 medical care.

Where if he's not going to go to the Oval Office -- and the doctor wouldn't answer that question particularly -- but if he's going to work from the Presidential quarters upstairs, he can easily do that.

His returning home, his not letting COVID dominate his life is very different from most of us should we get COVID. And more importantly, for those over 200,000 Americans who have died, they didn't want COVID to dominate their lives, either. But unfortunately, it did, and they did not get the kind of experimental treatment that the President is on. As Sanjay was saying, you know, he may be the only person in the world who's getting this kind of treatment that we know of.

TAPPER: Yes, not a lot of Americans have helicopters and entire floors of government hospitals dedicated and devoted to them as Kaitlan Collins pointed out.

But Dana, don't be afraid of COVID, don't let it dominate your life. The President has the best medical care in the world. And a bunch of doctors who will do anything he says. I can't even count how many obituaries I've read of individuals who believed President Trump and Fox and the MAGA deniers of the severity of this crisis who ending up succumbing to it and tragically died.

DANA BASH, CNN CHIEF POLITICAL CORRESPONDENT: What the President said, especially given the fact that he is currently suffering from COVID, is evenly more dangerous, than those kinds of things he said about it before he had it.

Because now the people who want to believe him, believe that he has even more credibility because has the personal experience with it. And that is why, when he tweeted out, don't be afraid of COVID, don't let it ruin your life, it's almost impossible to believe given the fact as you all have been discussing that he's not only gotten the best medical care -- which by the way, he is President of the United States, he should --

TAPPER: Sure.

BASH: -- get the best medical care, and experimental treatments and all of that. But keep that into context, Mr. President, when you say things, what you said. But, you know, Gloria is speaking to sources. I spoke to a source familiar with the President's calls this morning who also said -- this is a quote from the source I spoke to, I need to get out of here. He's obviously been itching to do so. And the recommendation that he has been getting on the politics of this, Jake, not the medicine, but the politics of this is, don't rush it, Mr. President.

What would be worse not only for your health but for you reelection viability is if you push to get out and then you have a relapse or if things go south in a way that, you know, you don't expect right now. So that is what he was getting told when he was pushing to get out on the politics of it, but he wasn't going to listen to that.

TAPPER: Abby, this whole thing has been a debacle, not just the President's handling of this crisis, and we could talk about that, but just on the discreet section of when President Trump was infected. The fact that after Hope Hicks was infected, he still went to Bedminster even though he had been exposed to somebody who had tested positive and was showing symptoms.

[15:45:00]

And this continued refusal to give the American people basic information about the healthcare and the health condition of the President of the United States. Again, if you don't want to share information with the public, don't run for President, because the American people are entitled to know how healthy their President is.

They're not even sharing when the last negative coronavirus test was. Why not?

ABBY PHILLIP, CNN POLITICAL CORRESPONDENT: Yes, well, let's just be clear about it. They are hiding that information. They do not want us to know when he had his last negative test. They won't even tell us when he was last tested before he received a positive result.

Remember, they've been talking, White House Chief of Staff Mark Meadows has been talking for days about the protocol that they have had in place at this White House to prevent the President from getting infected to prevent the spread of the coronavirus in that organization.

That protocol failed. Obviously, it failed because not only did the President get infected, but they can't even tell us with any kind of certainty -- or maybe they do know but they simply just won't say -- when he tested negative last and why he isn't being tested more frequently if it is not every day?

So, it raises some serious questions about why they are withholding this information. And more broadly, to the question of what will change if anything. Not just politically about how the President deals with this virus but also about how it's handled from a practical matter within this White House.

I think we know now, nothing is going to change, the President has made it clear with his tweet today that he is going to give the message to the American people that this virus is nothing to worry about.

You had the White House Press Secretary yesterday briefing reporters, taking off her mask to brief reporters and then testing positive today. Lessons have not been learned, and I think that that should be very clear to the American people at this point.

BORGER: Jake.

TAPPER: The White House's team led by the President are now -- they can be faulted not only for how they dealt with this crisis but for literally spreading the virus to others. As the President is being released to the White House, the outbreak among the West Wing staffers is growing. That's a horrific detail and we're going to discuss that next, stay with us.

(COMMERCIAL BREAK)

[15:50:00]

TAPPER: We are following the shocking breaking news. The President will be released from Walter Reed this evening at his own insistence. But President Trump's physician says he is, quote, not entirely out of the woods yet.

The President's release comes as the outbreak among those in Trump's orbit continues to expand. Earlier today, White House Press Secretary Kayleigh McEnany and two of her deputies have become the latest to test positive and announce it.

This particular cluster of people in President Trump's orbit now totals at least 14 infected people that we know of. Most of them are in the highest levels of American government.

McEnany has recently as last evening was briefing reporters without wearing a mask continuing to defy not only health guidelines but basic common sense and consideration in fighting this pandemic and keeping it from spreading to others.

Despite the evidence that the White House seems to have been a potential virus hot zone, astoundingly, Vice President Pence, a heartbeat away from the presidency, is not quarantining. Pence seen here surrounded by multiple people who have since announced that they are infected, is traveling across the country today, forging ahead with the plan to debate Senator Kamala Harris on Wednesday.

It is frankly, a stunning move given that there are questions over whether the President may have to turn over power temporarily to Pence if his infection worsens. Vice President Pence has tested negative so far but so had Kayleigh McEnany until she tested positive.

The White House, Supreme Court announcement ceremony, which was held indoors and out, seems to have been a super spreader event marked by recklessness. No masks required, no distancing, constantly crowded events, downplaying of the virus from the very top.

In February, Kayleigh McEnany said, quote, we will not see diseases like the coronavirus come here because of President Trump. It turns out that lying about the virus is not an effective protection from it.

Joining me now to discuss all of this, Dr. Jeanne Marrazzo, Director of the Infectious Disease Division at the University of Alabama at Birmingham, as well as CNN medical analyst and former CDC disease detective Dr. Seema Yasmin.

Dr. Yasmin, let me start with you. The Trump medical team said that there is some contact tracing being done but they gave no other information. What should the White House be doing right now? We've heard of so many people from journalists who were infected on Air Force One to the Governor of Ohio. He said nobody reached out to him to do contact tracing, even though President Trump and his team were in Ohio on Tuesday for the debate. What should they be doing right now?

DR. SEEMA YASMIN, CNN MEDICAL ANALYST: They should be communicating with full openness, honesty and transparency, Jake. There is an epidemiologist from the CDC who's been detailed to the White House.

My concern is, how can that individual do their job in an environment where the truth is not being told, where we're even learning from "New York Times" reporters just earlier today, that their housekeeping staff in the White House who clean on the third floor who don't have contact with the first family who are testing positive today.

And not only that, but they've been told to exert discretion in terms of who they discuss their positive diagnosis with. Does that include not revealing very basic information to public health investigators?

[15:55:00]

As someone who's done a ton of contact tracing, your job becomes impossible when people don't share the truth with you, when they decide to be honest with you a few days later because then you're just not able to reach out to every single person who was exposed.

As you mentioned, there are all of these now what look like super spreading events including at the White House, at fundraisers and rallies in New Jersey and other places, where there were people there who were close to the President who are now telling us that they're shocked that no one has contacted them. That they were really surprised that someone hasn't followed up because of the level of exposure they had.

I also did some sleuthing and had a look at floor plans for the White House at least for the first floor. And took a look at some of the air-conditioning plans that were available. It's a much more intimate and cramped place than many would realize.

Especially in terms of people who work closely together and now it seems like we weren't given the full truth. When we were being told, well, everyone who works in the White House, everyone in the President's circle is of course getting these quick turnaround daily tests.

Are they? Are they choosing to have those tests? Why are we learning so late about these diagnoses? These press conferences were useless to me, to be honest. Such little information. They raise more questions than they answer. And I worry how that translates into contact tracing. Because what you think might be a small cluster end up spiraling out of control when you can't do your job as a public health investigator early on.

TAPPER: Dr. Marrazzo, I want to get your take on the press conference from Commander Conley in a second, but I want to look forward for one minute because we have a vice presidential debate coming up on Wednesday. Vice President Pence is not quarantining, despite the fact that he was clearly around and close with multiple people who have since tested positive. If you were advising Senator Harris, Senator Kamala Harris, is it safe for her to even debate Pence indoors in the same room on Wednesday?

DR. JEANNE MARRAZZO, DIRECTOR, INFECTIOUS DISEASE DIVISION, UNIVERSITY OF ALABAMA AT BIRMINGHAM: Yes, Jake, it's the right question to ask and technically, if you follow the rules, he should be quarantined and should not be around anyone including Kamala Harris. So absolutely, I would tell her no.

I think his failure to follow the most basic public health guidance is just one angle of the debacle that this very disheartening event has put to those of who feel like we've been yelling into the void now for literally six months. When you look at the footage from the event for the Supreme Court nominee, I don't think I've ever watched anything that made me feel more disheartened than that as a physician and somebody who's been trying so hard with so many of my colleagues to beg people to do the right thing.

And also, having seen so many people do the right thing, and knowing that this group of privileged people just completely continued to defy all that we've been saying.

TAPPER: Well, the rules are for the little people, I guess, not for the likes of us, doctor. Doctor Marrazzo, I know you wanted to weigh in on what you heard or did not hear from Commander Conley who said things that I've never heard a physician say, like I prefer to look forward, not backward.

Is that even something that doctors say? He was asked about when the President last tested negative and he said I'd like to look forward. They don't teach that in medical school. That's spin doctoring. That's not emergency medicine.

MAZZARRO: Yes, let's say that that (INAUDIBLE) video, none of these press conferences are videos that I would use to role model for medical students or medical communicators for that matter.

There were a couple of things that I think are worth noting. First of all, Sanjay did a great job of covering that in the discussion with you previously. But this selective use of HIPAA is really unethical, frankly, when you're talking about communications around the President's health.

Yes, every single patient deserves quality and confidential care. There is a right to privacy, but we are talking about someone who has just been put on not only an experimental medication, but also a strong anti-viral medication and also steroids. Which as Dr. Gupta noted, you cause significant side effects in a very high number of people. And that does include loss of sleep, it includes mania, it includes

irritation. It includes an increased appetite. So, if he was just put on steroids very recently in the setting of all of this concern, I think you would really want to be able to tell us a lot more.

The other thing that the Dr. Conley noted was he wouldn't tell us about his lab results. And he mentioned that he was dehydrated on Friday which made me wonder if he had had some kidney dysfunction on Friday and they were just explaining it away because he was dehydrated because of the virus.

The last thing I'll mention is that they didn't come out and say he wasn't being anti-coagulated, meaning he wasn't put on blood thinner. And that's a very critical thing because if he was sick enough to be put on blood thinners, then that is definitely not somebody you want to be managing outside of a true tertiary care setting.

TAPPER: Yes, I mean it's just stunning. Dr. Jeanne Marrazzo and Dr. Seema Yasmin, always good to have you on. Thank you so much.

MARRAZZO: Thanks, Jake, take care.

ANNOUNCER: This is CNN breaking news.

TAPPER: And welcome to our second hour of THE LEAD. I'm Jake Tapper.