President Donald Trump’s doctors delivered an update of his condition on Sunday that suggested he might have more than just a mild case of COVID-19.

Based on the doctors’ accounts, Trump’s symptoms quickly escalated after he announced early Friday morning that he had tested positive for the coronavirus, The New York Times reported. He was taken to Walter Reed National Military Medical Center Friday evening.

Trump experienced a “high fever” on Friday, and there were two occasions when his blood oxygen levels dropped, on Friday and again on Saturday, the Times reported. Trump’s oxygen saturation level was 93% at one point, his doctors said. Ninety-five percent is considered the lower limit of the normal range.

Many medical experts consider patients to have severe COVID-19 if their oxygen levels drop below 94%, the Times reported. The president’s physicians said he was given supplemental oxygen at the White House on Friday; they were not clear about whether it was administered again on Saturday, or whether his blood oxygen levels had fallen below 90% at some point, the Times reported.

In addition to being given an experimental antibody cocktail on Friday, Dr. Sean Conley said Trump was also given the steroid dexamethasone on Saturday and is being treated with remdesivir, an antiviral drug. Dexamethasone has been shown to help patients who are severely ill with COVID-19, but it is typically not used in mild or moderate cases, the Times reported.

Confusion about the seriousness of Trump’s illness continued Sunday when he emerged from Walter Reed in a motorcade that drove around the hospital as Trump waved to supporters while wearing a mask. He then returned to the hospital, the Times reported. His medical team also suggested that he might be released as early as Monday if his condition continues to improve.

Hence, it was not clear whether the doctors had given Trump dexamethasone too quickly, or whether the president was far sicker than has been publicly acknowledged, experts in infectious disease and emergency medicine said on Sunday.

“The dexamethasone is the most mystifying of the drugs we’re seeing him being given at this point,” Dr. Thomas McGinn, the physician-in-chief at Northwell Health, the largest health care provider in New York state, told the Times. The drug is normally not used unless the patient’s condition seems to be deteriorating, he added.

“Suddenly, they’re throwing the kitchen sink at him,” McGinn said. “It raises the question: Is he sicker than we’re hearing, or are they being overly aggressive because he is the president, in a way that could be potentially harmful?”

On Friday, Vice President Mike Pence and his wife, Karen, along with Secretary of State Mike Pompeo, all announced that they had tested negative for the new coronavirus. Democratic presidential candidate Joe Biden, who debated Trump on Tuesday, has also said that he has continued to test negative for the virus. During that debate, the two never got within six feet of each other, the Times reported.

While Trump’s age, weight and gender automatically put him in a high-risk category, he will have the best medical care available, the Times said.

Infections surge in Midwest

Meanwhile, coronavirus infections are surging in the American heartland, with Wisconsin bearing the brunt of COVID-19’s relentless spread.

Many Midwestern states are seeing some of the nation’s highest per capita rates of infection, and while federal health officials have again urged some governors in the region to require masks statewide, some Republican governors have resisted, the Associated Press reported.

Wisconsin appeared to be in the worst shape: A record number of people with COVID-19 have been hospitalized in that state, the AP reported.

“Over the course of the past two to three weeks we have noticed a marked rise in COVID patients coming into our hospitals in Green Bay,” said Dr. Paul Casey, medical director of the emergency department at Bellin Hospital in Wisconsin, told CNN. “And this comes in the wake of what we thought we were doing well.”

“For the first time in 17 years that I’ve been here, we’ve had to put patients in hallway beds,” Casey told CNN. “I never envisioned having to do that in a small community like Green Bay.”

In North Dakota, hospitals are adding extra space amid worries about capacity, the AP reported. About 700 COVID-19 infections per 100,000 people have been diagnosed over the past two weeks, leading the country for new cases per capita, according to the COVID Tracking Project.

The surge has been seen throughout the Midwest. Iowa also reported a spike in people hospitalized with the virus, the AP reported. Last week, the state had the nation’s sixth-highest rate of coronavirus infections per 100,000 people, according to a recent White House coronavirus task force report. It again recommended Iowa require masks statewide, which Republican Gov. Kim Reynolds has said is unnecessary.

Similarly, Oklahoma Gov. Kevin Stitt, a Republican, has said he won’t impose such a requirement. The task force report found his state is among the worst in the United States for positive coronavirus tests per 100,000 people, up 15% from a week ago.

The Midwest has now overtaken the South for the country’s highest seven-day average of new daily cases per 1 million residents, CNN reported.

Global COVID death toll passes 1 million

The global coronavirus pandemic reached a grim new milestone last week: One million dead.

Americans made up more than 200,000 of those deaths, or one in every five, according to a running tally comprised by Johns Hopkins University.

“It’s not just a number. It’s human beings. It’s people we love,” Dr. Howard Markel, a professor of medical history at the University of Michigan, told the AP. He’s an adviser to government officials on how best to handle the pandemic — and he lost his 84-year-old mother to COVID-19 in February.

By Monday, the U.S. coronavirus case count passed 7.4 million while the death toll passed 209,600, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Monday were: California with over 834,600; Texas with more than 801,600; Florida with more than 716,000; New York with over 469,000; and Georgia with nearly 307,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

By Monday, India’s coronavirus case count passed 6.6 million, just over one month after hitting the 3 million mark, the Times reported.

More than 102,600 coronavirus patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India’s younger and leaner population.

Still, the country’s public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil passed 4.9 million cases and over 146,000 deaths as of Monday, the Hopkins tally showed.

Cases are also spiking in Russia: The country’s coronavirus case count has passed 1.2 million. As of Monday, the reported death toll in Russia was over 21,000, the Hopkins tally showed.

Worldwide, the number of reported infections passed 35.2 million on Monday, with over 1 million deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.