By ZEKE MILLER, JILL COLVIN and AAMER MADHANI

WASHINGTON (AP) — President Donald Trump staged a dramatic return to the White House after leaving the military hospital where he was receiving an unprecedented level of care for COVID-19. He immediately ignited a new controversy by declaring that despite his illness the nation should not fear the virus that has killed more than 210,000 Americans — and then he entered the White House without a protective mask.

Trump’s message alarmed infectious disease experts and suggested the president’s own illness had not caused him to rethink his often-cavalier attitude toward the disease, which has also infected the first lady and several White House aides, including new cases revealed Monday.

Landing Monday night at the White House on Marine One, Trump gingerly climbed the South Portico steps, removed his mask and declared, “I feel good.” He gave a double thumbs-up to the departing helicopter from the portico terrace, where aides had arranged American flags for the sunset occasion. He entered the White House, where aides were visible milling about the Blue Room, without wearing a face covering.

The president left Walter Reed National Military Medical Center, where his doctor, Navy Cmdr. Sean Conley, said earlier Monday that the president remains contagious and would not be fully “out of the woods” for another week but that Trump had met or exceeded standards for discharge from the hospital. Trump is expected to continue his recovery at the White House, where the reach of the outbreak that has infected the highest levels of the U.S. government is still being uncovered.

Still, just a month before the election and anxious to project strength, Trump tweeted before leaving the hospital, “Will be back on the Campaign Trail soon!!!” And in case anyone missed his don’t-worry message earlier, he rushed out a new video from the White House.

“Don’t be afraid of it,” Trump said of the virus. “You’re going to beat it. We have the best medical equipment, we have the best medicines.” His remarks were strong, but he was taking deeper breaths than usual as he delivered them.

On Tuesday, Trump went a step further, repeating his previous comparisons between COVID-19 and the seasonal flu.

“Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu,” he tweeted. “Are we going to close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!”

COVID-19 has already proven to be a more potent killer, particularly among older populations, than seasonal flu, and has shown indications of having long-term impacts on the health of even younger people it infects.

Trump’s nonchalant message about not fearing the virus comes as his own administration has encouraged Americans to be very careful and take precautions to avoid contracting and spreading the disease as cases continue to spike across the country. For more than eight months, Trump’s efforts to play down the threat of the virus in hopes of propping up the economy ahead of the election have drawn bipartisan criticism.

“We have to be realistic in this: COVID is a complete threat to the American population,” Dr. David Nace of the University of Pittsburgh Medical Center, said of Trump’s comment.

“Most of the people aren’t so lucky as the president,” with an in-house medical unit and access to experimental treatments, added Nace, an expert on infections in older adults.

“It’s an unconscionable message,” agreed Dr. Sadiya Khan of Northwestern University Feinberg School of Medicine. “I would go so far as to say that it may precipitate or worsen spread.”

Likewise, Democratic presidential nominee Joe Biden, who spent more than 90 minutes on the debate stage with Trump last week, said during an NBC town hall Monday night that he was glad Trump seemed to be recovering well, “but there’s a lot to be concerned about — 210,000 people have died. I hope no one walks away with the message that it’s not a problem.” Biden tested negative for the virus on Sunday.

There was pushback from a prominent Trump political supporter as well.

Republican Sen. John Cornyn of Texas told the Houston Chronicle editorial board that Trump had “let his guard down” in his effort to show that the country was moving beyond the virus and had created “confusion” about how to stay safe.

Conley said that because of Trump’s unusual level of treatment so early after discovery of his illness he was in “uncharted territory.” But the doctor also was upbeat at an afternoon briefing and said the president could resume his normal schedule once “there is no evidence of live virus still present.”

According to the Centers for Disease Control and Prevention, those with mild to moderate symptoms of COVID-19 can be contagious for as many as — and should isolate for at least — 10 days.

Trump’s arrival back at the White House raised new questions about how the administration was going to protect other officials from a disease that remains rampant in the president’s body. Press secretary Kayleigh McEnany announced she had tested positive for the virus Monday morning and was entering quarantine.

There were also lingering questions about potential long-term effects to the president — and even when he first came down with the virus.

Conley repeatedly declined to share results of medical scans of Trump’s lungs, saying he was not at liberty to discuss the information because Trump did not waive doctor-patient confidentiality on the subject. COVID-19 has been known to cause significant damage to the lungs of some patients. Conley also declined to share the date of Trump’s most recent negative test for the virus — a critical point for contact tracing and understanding where Trump was in the course of the disease.

Only a day earlier, Trump suggested he had finally grasped the true nature of the virus, saying in a video, “I get it.” But on Sunday afternoon, he ventured out of the hospital while contagious to salute cheering supporters by motorcade — an outing that disregarded precautions meant to contain the virus.

At the hospital, doctors revealed that his blood oxygen level had dropped suddenly twice in recent days and that they gave him a steroid typically only recommended for the very sick.

Trump’s experience with the disease has been dramatically different from most Americans, who do not have access to the same kind of monitoring and care. While most must cope with their symptoms — and fear of whether they’ll take a turn for the worse — at home and alone, Trump has been staying in the presidential suite of one of the nation’s best hospitals and has been given experimental drugs not readily available to the public. He returns to the White House, where there is a team of doctors on call with 24-hour monitoring.

Trump was leaving the hospital after receiving a fourth dose of the antiviral drug remdesivir Monday evening, Conley said. He will receive the fifth and final dose Tuesday at the White House.

Vice President Mike Pence returned to the campaign trail moments after Trump announced he would soon leave the hospital. The vice president boarded Air Force Two to fly to Salt Lake City, where he is to face off against Democratic vice presidential nominee Sen. Kamala Harris on Wednesday.

Trump, in his new video, defended his decision to repeatedly flout his own administration’s guidelines to slow the spread of the virus, including by holding rallies with thousands of mostly maskless supporters.

Apparently referring to any potential danger to himself rather than others, he said: “I stood out front. I led. Nobody that’s a leader would not do what I did.” He added: “And I know there’s a risk, there’s a danger. But that’s OK. And now I’m better. And maybe I’m immune, I don’t know.”

Even before Trump’s motorcade outing Sunday, some Secret Service agents had expressed concern about the lackadaisical attitude toward masks and social distancing inside the White House, but there isn’t much they can do, according to agents and officials who spoke to The Associated Press.

Trump’s aggressive course of treatment included the steroid dexamethasone and the single dose he was given Friday of an experimental drug from Regeneron Pharmaceuticals Inc. that supplies antibodies to help the immune system fight the virus. Trump on Friday also began a five-day course of remdesivir, a Gilead Sciences drug currently used for moderately and severely ill patients. The drugs work in different ways — the antibodies help the immune system rid the body of virus, and remdesivir curbs the virus’s ability to multiply.

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Madhani reported from Bethesda, Maryland. Associated Press writers Lauran Neergaard and Jonathan Lemire in Washington, and Bill Barrow in Wilmington, Delaware, contributed to this report.

By JILL COLVIN, STEVE PEOPLES and ZEKE MILLER

BETHESDA, Md. (AP) — President Donald Trump was hoping for a Monday discharge from the military hospital where he is being treated for COVID-19, a day after he briefly ventured out while contagious to salute cheering supporters by motorcade in a move that disregarded precautions meant to contain the deadly virus that has killed more than 209,000 Americans.

White House officials said Trump was anxious to be released after three nights at Walter Reed National Military Medical Center, where doctors revealed on Sunday that his blood oxygen level dropped suddenly twice in recent days and that they gave him a steroid typically only recommended for the very sick. Still, the doctors said Trump’s health is improving and volunteered that he could be discharged as early as Monday to continue the remainder of his treatment at the White House.

“This is an important day as the president continues to improve and is ready to get back to a normal work schedule,” White House chief of staff Mark Meadows told Fox News on Monday. He said the determination on whether Trump would leave the hospital won’t be made until later in the day after the president is evaluated by his medical team, but that Trump was “optimistic” he could be released Monday.

Less than one month until Election Day, Trump was eager to project strength despite his illness. The still-infectious president surprised supporters who had gathered outside the hospital, driving by in a black SUV with the windows rolled up. Secret Service agents inside the vehicle could be seen in masks and other protective gear.

The move capped a weekend of contradictions that fueled confusion about Trump’s health, which has imperiled the leadership of the U.S. government and upended the final stages of the presidential campaign. While Trump’s physician offered a rosy prognosis on his condition, his briefings lacked basic information, including the findings of lung scans, or were quickly muddled by more serious assessments of the president’s health by other officials.

In a short video released by the White House on Sunday, Trump insisted he understood the gravity of the moment. But his actions moments later, by leaving the hospital and sitting inside the SUV with others, suggested otherwise.

“This is insanity,” Dr. James P. Phillips, an attending physician at Walter Reed who is a critic of Trump and his handling of the pandemic. “Every single person in the vehicle during that completely unnecessary presidential ‘drive-by’ just now has to be quarantined for 14 days. They might get sick. They may die.”

White House spokesman Judd Deere said Trump’s trip outside the hospital “was cleared by the medical team as safe to do.” He added that precautions were taken, including using personal protective equipment, to protect Trump as well as White House officials and Secret Service agents.

Joe Biden’s campaign, meanwhile, said the Democratic presidential nominee again tested negative for coronavirus Sunday. The results come five days after Biden spent more than 90 minutes on the debate stage with Trump. Biden, who has taken a far more cautious approach to in-person events, had two negative tests on Friday.

The White House has refused to say when Trump last tested negative and whether he was tested before the debate, but the Cleveland Clinic, which co-hosted the event, said that Trump’s team certified the day of the debate that he and everyone who accompanied him in the debate hall had received a negative COVID-19 test.

For his part, Trump still faces questions about his health.

His doctors sidestepped questions on Sunday about exactly when Trump’s blood oxygen dropped — an episode they neglected to mention in multiple statements the day before — or whether lung scans showed any damage.

It was the second straight day of obfuscation from a White House already suffering from a credibility crisis. And it raised more doubts about whether the doctors treating the president were sharing accurate, timely information with the American public about the severity of his condition.

Pressed about conflicting information he and the White House released on Saturday, Navy Cmdr. Dr. Sean Conley acknowledged that he had tried to present a sunnier description of the president’s condition.

“I was trying to reflect the upbeat attitude that the team, the president, that his course of illness has had,” Conley said. He said he “didn’t want to give any information that might steer the course of illness in another direction. And in doing so, you know, it came off that we were trying to hide something, which wasn’t necessarily true. The fact of the matter is that he’s doing really well.”

Medical experts said Conley’s revelations were hard to square with his positive assessment and talk of a discharge.

“There’s a little bit of a disconnect,” said Dr. Steven Shapiro, chief medical and scientific officer at the University of Pittsburgh Medical Center.

It was not clear for how long Trump’s recovery would continue at the White House once he is discharged.

According to CDC guidelines, “In general, transport and movement of a patient with suspected or confirmed SARS-CoV-2 infection outside of their room should be limited to medically essential purposes.”

Even before Trump’s motorcade outing on Sunday, some Secret Service agents have expressed concern about the lackadaisical attitude toward masks and social distancing inside the White House, but there isn’t much they can do, according to agents and officials who spoke to The Associated Press. This close to the election, thousands of agents are engaged on protective duty so they can be subbed out quickly should someone test positive.

The disclosures about Trump’s oxygen levels and steroid treatment suggested the president is enduring more than a mild case of COVID-19.

Blood oxygen saturation is a key health marker for COVID-19 patients. A normal reading is between 95 and 100. Conley said the president had a “high fever” and a blood oxygen level below 94% on Friday and during “another episode” on Saturday.

He was evasive about the timing of the Trump oxygen drops. But he revealed that Trump was given a dose of the steroid dexamethasone in response. At the time of the briefing, Trump’s blood oxygen level was 98% — within normal rage, Trump’s medical team said.

Signs of pneumonia or other lung damage could be detected in scans before a patient feels short of breath, but the president’s doctors declined to say what those scans have revealed.

“There’s some expected findings, but nothing of any major clinical concern,” Conley said. He declined to outline those “expected findings.”

Asked about Conley’s lack of transparency, White House aide Alyssa Farah suggested the doctors were speaking as much to the president as to the American public: “When you’re treating a patient, you want to project confidence, you want to lift their spirits, and that was the intent.”

In all, nearly 7.4 million people have been infected in the United States, and few have access to the kind of around-the-clock attention and experimental treatments as Trump.

Trump’s treatment with the steroid dexamethasone is in addition to the single dose he was given Friday of an experimental drug from Regeneron Pharmaceuticals Inc. that supplies antibodies to help the immune system fight the virus. Trump on Friday also began a five-day course of remdesivir, a Gilead Sciences drug currently used for moderately and severely ill patients. The drugs work in different ways — the antibodies help the immune system rid the body of virus, and remdesivir curbs the virus’ ability to multiply.

Garibaldi, a specialist in pulmonary critical care, said the president was not showing any side effects of the drugs “that we can tell.”

The National Institutes of Health COVID-19 treatment guidelines recommend against using dexamethasone in patients who do not require oxygen. It has only been proven to help in more serious cases. Among the concerns with earlier use is that steroids tamp down certain immune cells, hindering the body’s own ability to fight off infection.

Trump is 74 years old and clinically obese, putting him at higher risk of serious complications. First lady Melania Trump has remained at the White House as she recovers from her own bout with the virus.

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Peoples reported from New York. Miller reported from Washington. Associated Press writers Lauran Neergaard, Jonathan Lemire and Aamer Madhani in Washington, and Bill Barrow in Wilmington, Del., and Marilynn Marchione in Milwaukee contributed to this report.