新闻简述：2020年10月5日，在川普总统出院当日，Walter Reed 医院医疗团队，包括 Conley 医生，最后举行了一次新闻发布会，介绍川普总统出院和返回白宫的具体情况，并详细回答了记者提出的各种问题。
Dr. Sean Conley: Good afternoon, everyone. Thank you for being here.
Over the past 24 hours, the president has continued to improve. He’s met or exceeded all standard hospital discharge criteria. He’ll receive another dose of remdesivir here today, and then we plan to get him home. It’s been more than 72 hours since his last fever, oxygen levels, including ambulatory saturations and his work of breathing are all normal. Though he may not entirely be out of the woods yet, the team and I agree that all our evaluations, and most importantly his clinical status, support the president’s safe return home, where he’ll be surrounded by world-class medical care 24/7.
I’d like to bring Dr. Dooley up to review some more specifics.
Dr. Sean Dooley: Good afternoon, just a brief update this morning. As Dr. Conley mentioned, the president continues to do very well. His vital signs this morning were notable for a temperature of 98.1, his blood pressure was 134 over 78, and a respiratory rate of 17 respirations per minute, and his heart rate was 68 beats per minute. His last oxyhemoglobin saturation was 97% on room air. He currently does not endorse any respiratory complaints, and aside from our evaluation with the multi-disciplinary team this morning, has maintained a full schedule, ambulating and working on the White House medical unit.
Sean Dooley医生：下午好，今天早上只是一个简单更新。正如Conley医生提到的，总统的情况持续向好。今早他的生命体征明显，体温98. 1，血压134/78，呼吸频率为每分钟17次，心率为每分钟68次。他的最新氧合血红蛋白饱和度在室内空气下为97%。他目前没有任何呼吸道的不适，除了今天上午我们与多学科团队的评估之外，他一直保持着全负荷日程，在白宫医疗单元内活动和工作。
I’ll now turn it over to Dr. Garibaldi to again discuss therapeutics. Thanks.
Dr. Brian Garibaldi: Hi, good afternoon. Again, I just wanted to echo the sentiment of what an honor it is to be part of this wonderful team here at Walter Reed. Yesterday evening the president received his third dose of remdesivir and he tolerated that infusion without difficulty and his kidney and liver function continued to be normal. Our plan is to give the fourth dose of remdesivir this evening before he goes back to the White House. We’ve made arrangements to deliver the fifth and final dose of his treatment course at the White House tomorrow evening. He continues on dexamethasone and, again, the plan for today is to continue to be up and out of bed, eat and drink, and work as he is able.
Dr. Brian Garibaldi: I’d like to turn it over to Dr. Jason Blaylock, who’s an infectious disease specialist and the chief of medicine here at Walter Reed to give some updates on infection control. Thank you.
Brian Garibaldi医生：我想请Jason Blaylock医生，他是传染病专家，也是沃尔特-里德的医学主管，给大家介绍一下感染控制的最新情况。谢谢。
Dr. Jason Blaylock: Good afternoon, everyone. First of all, I just want to say what an honor it’s been to be part of this medical team behind me and to care for the president.
Jason Blaylock医生：大家下午好。 首先，我只想说，能成为我身后这个医疗团队的一员，并照顾总统，是多么的荣幸。
Since the president’s arrival at Walter Reed, he’s received medical management that remains in line with national, clinical, societal guidelines for treatment of COVID-19 infection. In addition, both myself and Dr. Wes Campbell have worked very closely with various laboratories in the area, state-of-the-art facilities, to include USAMRAA and [RAR 00:03:10] on obtaining advanced diagnostic testing to really inform the White House medical team of both the status of the president, as well as his ability to transmit virus to others. Also, we have worked very closely with the Walter Reed team to ensure that we are looking very closely at infection control prevention strategies and the right posture so that the president can safely return to his residence.
With that, I’m going to turn it over to Dr. Conley, who will answer any final questions?
Dr. Sean Conley: Thanks, Jason.
I mentioned it Saturday, but I’d like to reiterate myself just how grateful the president and I are to the men and women of Walter Reed, our colleagues at Johns Hopkins, as well as the many federal, private institutions that we’ve received support from. So long as everything continues on the track that we’re experiencing right now, at this time, as the president already tweeted out, is to get him home later today. With that, I’ll take a couple questions.
Speaker 5: Dr. Conley, how can the president be discharged back to the White House when he was given steroids. You’ve said that he’s still on those steroids. Those are medicines, as you know, that are usually given to COVID patients who are on ventilators or with low oxygen, so did you over-treat him? If he’s still on that medication, how is it safe for him to return to the White House?
Dr. Sean Conley: We send patients home with medications all the time. In fact, yesterday afternoon, he probably met most of his discharge requirements safely from the hospital. He’s returning to a facility, the White House medical unit, that’s staffed 24/7, top-notch physicians, nurses, PAs, logisticians. The unit here, the team here behind me, is going to continue to support us in that nature.
Speaker 6: Dr. Conley. Dr. Conley, what are infection control measures are you taking and how was it safe for him to drive around in a cloth mask yesterday? How is it safe for him now to return to the White House where there’ve been so many cases? How’s any of this safe?
记者：Conley医生， Conley医生，你采取的感染控制措施是什么？ 昨天他戴着布面罩坐车兜风，怎么会安全？他现在回到有那么多感染病例的白宫又如何能安全？这些怎么能安全？
Dr. Sean Conley: The president has been surrounded by medical and security staff for days wearing full PPE. Yesterday, the US Secret Service agents were in that same level of PPE for a very short period of time. We’ve worked with our infectious disease experts to make some recommendations for how to keep everything safe down at the White House for the president and those around him. We’re looking at where he’s going to be able to carry out his duties, office space. I’ll just say that it’s in line with everything we’ve been doing upstairs for the last several days.
Speaker 7: Can you tell us please, on testing, can you tell us when he had his last negative test? Was it Thursday? Was it Wednesday? Do you remember when he had his last negative test?
Dr. Sean Conley: I don’t want to go backwards.
Speaker 7: It helps for contact tracing for people who were around him to know when he was positive.
Dr. Sean Conley: I understand. The contact tracing, as I understand it, is being done. I’m not involved in that.
Speaker 8: [crosstalk] that he leave or was this something he pushed for?
Dr. Sean Conley: No. We try to get patients home and out of the hospital as quickly as is safe and reasonable. Every day a patient stays in the hospital unnecessarily is a risk to themselves. Right now there’s nothing that’s being done upstairs here that we can’t safely conduct down home.
Sean Conley医生：不是。我们尽量让病人在安全合理的情况下尽快出院回家。病人在医院里不必要地多呆一天，对他们自己来说都是一种危险。现在，没有什么是在这楼上能做到， 我们不能安全地在家里操作的。
Speaker 9: You had said that seven to ten days was a window that you’d be concerned about. I don’t think we’re there yet. Do you have concerns about potential worsening or reversal? What are your plans for addressing that if it were to happen?
Dr. Sean Conley: You’re absolutely right. That’s why we all remain cautiously optimistic and on guard because we’re in a bit of unchartered territory when it comes to a patient that received the therapies he has so early in the course. We’re looking to this weekend. If we can get through to Monday with him remaining the same or improving, better yet, then we will all take that final deep sigh of relief. But as I said, 24/7 world-class medical care surrounding him down there. We’re not going to miss anything that we would have caught up here.
Sean Conley医生：你说的很对。 这就是为什么我们都保持谨慎乐观和警惕， 因为当涉及到一个病人接受处于治疗过程的初期阶段，我们处于有点未知的领域。我们看这个周末。如果我们顺利度过到周一，他的病情保持不变或有所改善，那就更好，那么我们都会最后深深地松一口气。但正如我说的，全天候世界级的医疗服务在他那里就位。任何我们在这里能做的事情，到那里也能。
Speaker 10: Where is he physically going to be in the White House? What does that look like? How do you keep him safely quarantined?
Dr. Sean Conley: I wish I could go into that more, but I just can’t.
Speaker 6: Doctor, why did you begin dexamethasone treatment?
Dr. Sean Conley: Yesterday, we talked about that, the several little temporary drops in his oxygen, and we had discussed that as a team and elected to start it early in case that persisted or worsened. The potential risks and side effects, we all discussed. We looked at the data and decided that we’d rather, push ahead on it then hold and risk the opposite.
Speaker 6: What about CT scans and X-rays? What have you seen on his chest X-rays?
Speaker 11: [crosstalk] resume his campaigning?
Dr. Sean Conley: As far as travel goes, we’ll see.
Speaker 12: Dr. Conley, on his mental status, can you talk about whether he has any neurological symptoms? Does he have any side effects from his medications, any fogginess from the virus?
Dr. Sean Conley: No. I think you’ve seen the videos and now the tweets and you’ll see him shortly. He’s back. Yeah.
Speaker 6: What about his chest X-rays and CT scans?
Speaker 13: Have you seen any evidence of pneumonia or any inflammation in his lungs at all?
Dr. Sean Conley: We’ve done routine standard imaging, I’m just not at liberty to discuss.
Speaker 6: Doctor you were on board Air Force One.
Speaker 14: You’re actively not telling us what those lung scans showed, just to be clear.
Dr. Sean Conley: There are HIPAA rules and regulations that restrict me in sharing certain things for his safety and his own health and reasons.
Speaker 15: You said his oxygen dropped several times. Can you share how many times he was on oxygen? You said you would check with the nursing staff yesterday.
Dr. Sean Conley: Sean Conley医生：Yeah. Yeah. Yes. Yes. Two episodes, like we talked about yesterday, and both times that he received a little bit of oxygen and recovered immediately.
Sean Conley医生：是的，是的，是的。两次发作，就像我们昨天谈到的， 这两次他都吸了一点点的氧气， 并立即恢复了。
Speaker 15: Was it required? Was that oxygen required?
Dr. Sean Conley: No, it wasn’t required. He wasn’t short of breath. He wasn’t looking ill. It was more of us trying to anticipate needs and see how he’d respond. In both cases, he came right off. He didn’t need it for very long at all.
Speaker 6: Doctor, you were on board Air Force One for multiple trips, are you at all concerned about your own exposure and exposure to the medical team?
记者：医生，你曾多次在 “空军一号 “上，你一点都不担心自己接触病毒，以及传染给医疗团队吗？
Dr. Sean Conley: I am concerned, but as the CDC says, there are caveats for essential employees that as long as you continue to test negative, you remain symptom-free and you keep a mask on when you’re out and about, which we do inside the hospital, 24/7, then you can carry on your duties.
Dr. Sean Conley: Yeah?
Speaker 10: We all know the president’s an impatient man, has he been itching to get out of here?
Dr. Sean Conley: The president has been a phenomenal patient during his stay here. He’s been working hand in glove with us and the team. Today it got to the point, he’s holding court with those of us around him, the whole team, going over all the specifics, the testing, what the future is, and we have been back and forth on what’s safe, what’s reasonable. He has never once pushed us to do anything that was beyond a safe and reasonable practice that we all first wanted.
Speaker 16: Was there anybody on this medical team, who recommended against the president leaving here and going back to the White House today?
Speaker 16: Or any White House staffers?
Dr. Sean Conley: No.
Speaker 6: The president said, “Don’t be afraid of COVID.” Do you agree with that? Should we not be afraid?
Dr. Sean Conley: I’m not going to get into what the president says.
Speaker 17: You said his heart, liver, and kidney function was normal or improving. Improving, does that mean that there were effects and is it all normal? What’s up with that?
Dr. Sean Conley: Yeah. It’s all normal right now. I would say he appeared to be a little dehydrated Friday. He was able to just drink and recover from that. Yeah, everything looks great.
Speaker 18: Doctor, what would you like to see before he starts, resumes campaigning out in the country? What sort of things do you want to see?
Dr. Sean Conley: Yeah. The big first thing that we need to do is that there is no evidence of live virus still present that he could possibly transmit to others, and that’s what the infectious disease experts and some of our partners, military, civilian entities doing some of these advanced diagnostics just to see, as soon as we can identify that routinely. We talk about a 10-day window, CDC guidelines, but we’re checking him more routinely than just waiting 10 days. There’s a possibility it’s earlier than that. There’s a chance that it’s a little bit later, but we will know as soon as possible. Then we will look at him clinically. How are you feeling? How are you doing?
Sean Conley医生：是的，我们需要做的第一件大事是，确认没有证据表明活病毒仍然存在，由此他可能会传播给其他人。 这就是传染病专家和我们的一些合作伙伴， 军队，民间实体正在做先进的诊断，就是常规尽早确认；我们谈到CDC指南的10天窗口期， 但我们给他更多的日常检查， 而不是等待10天。有可能比那早些，也有机会稍晚些， 但我们会尽快知道。然后，我们会像在诊所那样给他看病。你感觉怎么样？你的情况如何？
Speaker 19: Why have you decided not to use, administer hydroxychloroquine to the president during his time here?
Dr. Sean Conley: I’m not going to go into all of our debates about specific medicines and therapies. There are dozens of therapies that we were made aware of that we considered, that we discussed and debated and looked at the existing literature on. This is the regimen we chose.
Speaker 19: [crosstalk] hydroxychloroquine.
Dr. Sean Conley: Yeah?
Speaker 20: On the symptoms of COVID, is he’s having some of the muscle aches? Has he lost his sense of taste and smell?
Dr. Sean Conley: No. We were just talking about that, what symptoms he has left. Even the slight cough that he used to have, he doesn’t really complain of at all. He hasn’t ever complained of a muscle aches. Yeah, he’s up and back to him old self, predominantly.
Speaker 10: You talked about next Monday, just to be clear, how long will he still be actively shedding the virus?
Dr. Sean Conley: This morning, I believe there was even an accounting by Dr. Fauci referencing a five day, the first five days of illness that people are most likely to shed live virus. There’s a reason there’s the 10 days. It’s because most people, by that time, after seven days, most folks don’t have culturable live virus. They put it to 10, just to give some extra space. It’s never 100% between everybody, so we’ll see. I’m not going to put a specific number, but we look at that window is all I will say.
Sean Conley医生：今天早上，我相信曾经有一个福西博士的报告提到了五天，人生病的前五天最容易排出活病毒。说10天也是有原因的，是因为大多数人，到了那个时候，七天后大多数人没有可培养的活病毒。他们把它放到10天，只是为了给一些额外的空间。人与人之间从来没有100％一致，所以我们将拭目以待。我不会拿出一个具体的数字， 但我想说的就是这个窗口期。
Speaker 21: Doctor, will the president be confined to his residence or will he be allowed to return to the Oval Office?
Dr. Sean Conley: We’re going to do whatever it takes for the president to safely conduct business, whatever it is he needs to do within the residence and White House.
Speaker 22: Is he on blood thinners? Also, has he been using, have you been giving him Tylenol, Advil, anything to bring his fever down?
Dr. Sean Conley: Oh, that came up. I would like to say, he has not been on any fever-reducing medications for over 72 hours.
Speaker 22: But what about the blood thinners?
Dr. Sean Conley: Yeah. He’s on a routine regimen of COVID therapy. I’m not going to go into specifics as to what he is and is not on, but …
Sean Conley医生：是的，他在接受常规的COVID治疗。我不会去到具体细节 关于他是在服用什么，没服用什么 … …
Speaker 23: You said, I’m going to read this here, that the president had a mild cough, some nasal congestion and fatigue on Thursday. Now back to my colleague, John Jacobs question, the reason knowing when the president’s last negative test is important for that reason, your words, what you said, and also for the contract tracing, but would you’ve recommended that given those symptoms that he go, that the president go to that Bedminster fundraiser?
Dr. Sean Conley: It’s not up to me, necessarily, the president’s schedule, but I would say that it wasn’t until after he returned that we really sat down, then knowing the news of the day that we really dove into, how are you feeling? What’s going on?
Speaker 23: But how was that safe given that those were the symptoms he was experiencing on Thursday?
Dr. Sean Conley: I’m not going to get into operations.
Speaker 6: Doctor, one last time, when was his last negative test and what was his viral load?
Dr. Sean Conley: I know everyone wants that.
Speaker 6: We’ve been exposed. [crosstalk]
Dr. Sean Conley: Yeah. I don’t have his viral load. Those are some of the diagnostics that we’re sending out that will really tell us when it’s safe for him to get back out and around people.
Sean Conley医生：是的，我不知道他的病毒载量。 我们正在公布的某些诊断结果将会真实地告诉我们，什么时候让他回去和接触人是安全的。
Speaker 6: You’ve never had his viral load?
Speaker 24: Why is it [crosstalk] say when the last negative test was?
Speaker 25: Did he have any abnormal tests? Were any of his lab tests abnormal?
Dr. Sean Conley: Again, HIPAA kind of precludes me from going into too much depth on things that I’m not at liberty or he doesn’t wish to be discussed. At some future point, maybe. But today, I’m sorry. I think that’s it. Yeah.
Speaker 26: Thank you, guys, so much.
Dr. Sean Conley: Thank you.
Speaker 26: Thank you.