The Centers for Disease Control and Prevention say that a person infected with the coronavirus can be with other people 10 days after symptoms first appear if the patient has gone 24 hours free of fever without the use of medication that reduces temperatures and if other symptoms are improving.
The onset of the president’s symptoms remains murky; if he started feeling sick on Oct. 1, the day he reported testing positive, then a Saturday return would be premature by C.D.C. guidelines. If he had his first symptoms the day before, then Saturday would meet the 10-day mark. Mr. Trump’s doctors have said he has not experienced fever in days, but the dexamethasone steroid he is taking is known to hide a fever.
Experts said resuming a public schedule might worsen Mr. Trump’s condition, which could still rapidly deteriorate in the next several days. Covid-19, an unpredictable disease, can suddenly and unexpectedly worsen during a patient’s second week of illness. Based on the information provided, “No, I would not clear him to start public engagements on Saturday,” said Dr. Phyllis Tien, an infectious disease physician at the University of California, San Francisco, where she conducts and advises on Covid-19 clinical trials.
White House aides privately expressed concern about whether the president’s animated mood in recent days stemmed from the dexamethasone. Doctors not involved with the president’s care said it could have a significant effect on a patient’s behavior.
Dr. Negin Hajizadeh, a pulmonary/critical care physician at Northwell Health, noted that the majority of Covid patients receiving dexamethasone are on mechanical ventilation and in a state of induced coma, so they do not exhibit any behavioral side effects. But, she said, large studies show that generally 28 to 30 percent of patients will exhibit mild to moderate psychiatric side effects like anxiety, insomnia, mania or delirium after receiving steroid treatments, and about 6 percent may develop psychosis.
“When we prescribe steroids we warn our patients: ‘This may cause you to feel jittery, might cause you to feel irritable,’” Dr. Hajizadeh said. “We will tell family members, especially for our older patients, ‘This may cause insomnia, this may cause changes in eating habits and, in extreme cases, mania and impaired decision making.’”
Watching the news coverage and angry at the state of the race, Mr. Trump has been imploring aides to let him resume campaign rallies as soon as this weekend. He showed up again in the Oval Office on Thursday despite efforts to get him to remain in the residence until he was more fully recovered. In addition to the attempt to hold a rally in Florida on Saturday, he said he would try to stage one the following day in Pennsylvania.