On Saturday, Trump and his doctors acknowledged the importance of the coming days as the illness enters what White House physician Dr. Sean Conley called “phase 2.”
In a video statement released Saturday evening from Walter Reed National Military Medical Center, Trump echoed the concern: “I’m starting to feel good. You don’t know over the next period of a few days, I guess that’s the real test, so we’ll be seeing what happens over those next couple of days.”
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The course of COVID-19 can be highly variable, but the next three to five days are likely to be crucial, physicians who have treated hundreds of coronavirus patients told USA TODAY.
Several days after symptoms of COVID-19 appear, the body’s immune system must make an important switch to fight the virus with precision — or possibly face life-threatening consequences.
Watch: Dr. Sean Conley did not answer several questions regarding Trump receiving oxygen
COVID-19 patients can “look pretty good for a few days, then they go south,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University.
That rapid deterioration can occur when the body’s immune system, unable to successfully target the virus, causes widespread collateral damage as it “brings in the troops,” Schaffner said.
A typical timeframe for patents’ decline is about five to 10 days after the person starts getting sick, said Dr. J. Randall Curtis, a professor of pulmonary and critical care at the University of Washington school of medicine in Seattle.
Conley on Saturday said Trump is in his third day of fighting the virus.
During the early part of a patient’s COVID-19 illness, the body uses an “agnostic” immune response, said Dr. Greg Poland, director and founder of Mayo Clinic Vaccine Research Group. It doesn’t know what it’s fighting, but realizes something potentially dangerous is occurring. That’s called the innate immune system.
Key to a successful recovery is an immune response that targets the coronavirus itself. That’s called the adaptive immune system.
To avoid serious illness, a patient’s innate and adaptive immune systems must stay in balance, and the virus itself must not cause serious complications along the way.
Age is a risk factor. Older patients tend to be less successful in activating the adaptive response, according to Melissa Nolan, an infectious disease expert and professor at the University of South Carolina.
Trump turned 74 in June, putting him at 90-times higher risk of death than someone in their 20s, according to data from the U.S. Centers for Disease Control and Prevention.
But the course of COVID-19 can be highly variable. The president’s VIP medical treatment and access to cutting-edge therapies make the trajectory of the illness even tougher to predict.
Related: Supporters outside hospital where Trump is staying
Patients tend to see short-term fluctuations in their symptoms throughout their illness, so doctors often evaluate a COVID-19 patient’s progress over the course of days, said Dr. David Eisenman, a professor at UCLA Fielding School of Public Health. As of Saturday evening, the information released by the White House was not enough for him to evaluate Trump’s progress thus far.
Curtis said the fact that the president’s fever is improving is a good sign but doesn’t necessarily indicate he’s out of trouble.
“We’re just going to wait and see.”
Contributing: Karen Weintraub
President Donald Trump walks to Marine One prior to departure from the South Lawn of the White House in Washington, DC, October 2, 2020, as he heads to Walter Reed Military Medical Center, after testing positive for Covid-19.
White House press secretary Kayleigh McEnany, third from left, waits with others as President Donald Trump prepares to leave the White House to go to Walter Reed National Military Medical Center after he tested positive for COVID-19, Friday, Oct. 2, 2020, in Washington.
US President Donald Trump walks to Marine One prior to departure from the South Lawn of the White House in Washington, DC, October 2, 2020, as he heads to Walter Reed Military Medical Center, after testing positive for Covid-19.
People look toward The White House as Marine One waits on the South Lawn to carry President Donald Trump to Walter Reed National Military Medical Center, Friday, Oct. 2, 2020 in Washington.
The pilot of Marine One wears a face mask as President Donald Trump prepares to leave the White House to go to Walter Reed National Military Medical Center after he tested positive for COVID-19, Friday, Oct. 2, 2020, in Washington.
US President Donald Trump boards Marine One prior to departure from the South Lawn of the White House in Washington, DC, October 2, 2020, as he heads to Walter Reed Military Medical Center, after testing positive for Covid-19.
Marine One lifts off from the White House to carry President Donald Trump to Walter Reed National Military Medical Center in Bethesda, Md., Friday, Oct. 2, 2020 in Washington.
A young man salutes as Marine One, the presidential helicopter, carries U.S. President Donald Trump from the White House to Walter Reed National Military Medical Center October 2, 2020 in Washington, DC. Trump announced earlier today via Twitter that he and U.S. first lady Melania Trump have tested positive for coronavirus.
Supporters of President Donald Trump hold banners as Marine One carries him to Walter Reed Medical Center after leaving the White House. Trump will be receiving treatment for Covid-19 at Walter Reed. Photo by Ken Alltucker/USA TODAY. (Via OlyDrop)
A US Navy security and medical personnels stand by the emergency entrance of Walter Reed National Military Medical Center on October 2, 2020, in Bethesda, Maryland. – President Donald Trump will spend the coming days in a military hospital just outside Washington to undergo treatment for the coronavirus, but will continue to work, the White House said October 2nd.
Marine One carrying President Donald Trump to Walter Reed National Military Medical Center in Bethesda, Md., flies past the Trump International Hotel in Washington, Friday, Oct. 2, 2020. The White House announced Trump will spend a few days at the hospital after contracting COVID-19.
Marine One, carrying President Donald Trump, lands at Walter Reed Medical Center after being transferred from the White House.
People watch as US President Donald Trump arrives at Walter Reed National Military Medical Center on October 2, 2020, in Bethesda, Maryland.
The Walter Reed National Military Medical Center is seen on October 2, 2020 in Bethesda, Md.
President Donald Trump arrives at Walter Reed National Military Medical Center, in Bethesda, Md., Friday, Oct. 2, 2020, on Marine One after he tested positive for COVID-19.
US President Donald Trump waves as he travels in an armor vehicle with masked members of the Secret Service after arriving at Walter Reed Medical Center October 2, 2020, in Bethesda, Maryland, after testing positive for COVID-19.
President Donald Trump rides in a vehicle after arriving at Walter Reed National Military Medical Center, in Bethesda, Md., Friday, Oct. 2, 2020, after he tested positive for COVID-19.
Walter Reed National Military Medical Center is shown in Bethesda, Md., Saturday, Oct. 3, 2020. Trump was admitted to the hospital after contracting the coronavirus.
White House Chief of Staff Mark Meadows arrives at Walter Reed Medical Center in Bethesda, Maryland, on October 3, 2020. – Trump was hospitalized at Walter Reed on October 2 due to a Covid-19 diagnosis.
Dr. Sean Conley, physician to President Donald Trump, briefs reporters at Walter Reed National Military Medical Center in Bethesda, Md., Saturday, Oct. 3, 2020. Trump was admitted to the hospital after contracting the coronavirus.
Supporters of U.S. President Donald Trump rally outside Walter Reed National Military Medical Center on October 3, 2020 in Bethesda, Maryland.
Supporters of U.S. President Donald Trump rally outside Walter Reed National Military Medical Center on October 3, 2020 in Bethesda, Maryland.
22/22 SLIDES
This article originally appeared on USA TODAY: Trump reports feeling better, but here’s why the next few days are ‘the real test’ in his COVID-19 battle
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