President Trump returned to the White House from the hospital on Monday, saying that he had recovered from the novel coronavirus and that people should not be afraid of a disease that has killed more than 209,000 Americans.

Trump’s comments a few hours before leaving Walter Reed National Military Medical Center in Bethesda, Md., again downplaying the coronavirus, came despite evidence that White House decisions to flout public health guidelines and engage in practices viewed as reckless have had dire consequences in the West Wing.

More than a dozen White House officials have tested positive for the coronavirus in recent days, a steadily increasing total that grew again Monday to include press secretary Kayleigh McEnany. How the return of an infected president to such a setting could be managed safely was one of several questions left unanswered Monday as Trump’s medical team briefed reporters about his condition.

“We’ve worked with our infectious-disease experts to make some recommendations for how to keep everything safe down at the White House,” Trump’s doctor Sean Conley said after describing the president’s condition as improving, though he said Trump was “not out of the woods yet.”

Conley declined to describe what specific steps would be made to ensure a safe environment at a building that doubles as a personal residence and a government office while the president remains contagious, which could be for several more days at least.

“I wish I could go into that more, but I just can’t,” he said.

The transformation of the White House into a vector of a deadly pathogen has done little to change the approach of an administration that has been determined to downplay the coronavirus for months. Trump used his personal experience with the disease — which twice knocked his oxygen levels down significantly and required him to be hospitalized and injected with several drugs — to again play down its severity.

“Don’t be afraid of Covid. Don’t let it dominate your life,” Trump tweeted Monday afternoon, three days after he was transported to Walter Reed for treatment. “We have developed, under the Trump Administration, some really great drugs & knowledge. I feel better than I did 20 years ago!”

His statement — seeming to again minimize the pandemic, something he has done consistently since it emerged as a threat earlier this year — immediately drew rebukes.

“ ‘Don’t be afraid’? I wish every American had access to the same health care you’re getting — but they don’t,” Sen. Robert Menendez (D-N.J.) wrote on Twitter.

But Trump has given little indication that he plans to change his behavior if or when he is told by doctors that he can resume normal activities.

When he returned to the White House on Monday evening, the contagious president climbed up the stairs rather than use the usual ground-level entrance and posed for pictures. After a few seconds, he reached up with his right hand, took off his mask, put it in his pocket and resumed flashing thumbs up. He then turned and entered the building.

Trump spent Sunday and Monday discussing his campaign, the polls, advertising in key states and what Democratic presidential nominee Joe Biden is doing, according to people who spoke to the president. He began discussing with officials Sunday when he could return to the campaign trail — and how.

“Will be back on the Campaign Trail soon!!! The Fake News only shows the Fake Polls,” he tweeted Monday afternoon shortly before leaving the hospital.

Trump is trailing Biden in national and key state polls.

Aides said the Diplomatic Reception Room and Map Room are being prepared for working spaces for Trump at the White House, where many staff members have opted to work from home in the coming days.

Even before Trump’s return, several officials have cleared out of the building amid ongoing news reports of lawmakers, aides, visitors and residence staffers who have tested positive for the coronavirus after spending time in the White House in recent days.

“The West Wing is a total ghost town,” said one official who worked at the White House on Monday. The official, like others, spoke on the condition of anonymity to discuss internal dynamics in the building.

Trump walked out of the hospital Monday evening around 6:30 p.m., boarded Marine One, flew back to Washington and then strolled into the White House about 10 minutes later.

He entered a building that has become a hot spot for the coronavirus.

On Monday, McEnany announced that she had tested positive for the virus, after taking several tests that came back negative in previous days. News reports also identified two other press aides who had contracted the virus. Altogether, at least 20 people have tested positive for the coronavirus after spending time at the White House, a list that includes senators, journalists, first lady Melania Trump and senior aides and campaign advisers to the president.

The medical team treating Trump held a news conference Monday, telling reporters that the president was breathing without difficulty and had normal vital signs.

“Though he may not be entirely 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,” Conley said, later adding, “He’s back.”

It was not clear how or how long Trump might remain isolated upon returning to the White House. Guidelines from the Centers for Disease Control and Prevention call for infected individuals to stay away from other people for at least 10 days after symptoms first appear. The guidelines say patients who experienced severe illness while infected may need to stay home for up to 20 days after symptoms first appear.

Trump had already been dismissive of many CDC guidelines, putting himself and others at higher risk of catching the virus before it began circulating in the White House. He has held crowded events, eschewed mask-wearing and ignored social distancing rules as his campaign for reelection has heated up.

His experience with the disease appeared to fall into the category of severe illness. Trump’s oxygen levels twice dropped to concerning levels on Friday and Saturday, and he suffered from symptoms including a cough, fatigue and a fever, according to his medical team.

Trump has been treated with a range of drugs and experimental therapeutics, including the steroid dexamethasone, the antiviral drug remdesivir and a cocktail of monoclonal antibodies that has not yet been approved to fight the virus by the Food and Drug Administration. He was also twice put on supplemental oxygen Friday and Saturday, Conley said, referring to “several little temporary drops” in Trump’s oxygen levels.

Doctors said Monday that Trump continued to be treated with dexamethasone, a steroid that is typically reserved for severely ill coronavirus patients. He was scheduled to receive another injection of remdesivir Monday before being released and a final dose at the White House after his return, doctors said.

Conley dodged several questions about Trump’s condition, at one point citing privacy laws that he appeared to employ selectively.

Asked about whether Trump had any lung damage or inflammation, he demurred.

“We’ve done routine standard imaging,” he said. “I’m just not at liberty to discuss.”

He also declined to answer questions about the viral load detected in Trump, or whether Trump had taken blood thinners.

“He’s on a routine regimen of covid therapy,” he said. “I’m not going into specifics of what he is and isn’t on.”

Asked when Trump last tested negative for the coronavirus, Conley again dodged — continuing a pattern from White House officials who have avoided answering the question.

“I don’t want to go backwards,” Conley said.

Understanding the date of Trump’s last negative test could help determine how long the president may have been contagious before his positive test Thursday — and how many people he may have put at risk in the interim.

McEnany also declined to directly answer questions about when Trump last tested negative.

Her own experience came to serve as a cautionary tale for a White House that has held up its rapid testing system as a kind of cure-all to protect Trump and his aides from the coronavirus. That system has failed to keep the virus out of the West Wing, resulting in the hospitalization of the president and raising questions about the Trump administration’s cavalier attitude toward public health measures for people who do not have access to on-demand rapid tests.

“After testing negative consistently, including every day since Thursday, I tested positive for the coronavirus on Monday morning while experiencing no symptoms,” McEnany said in a statement.

The day before she tested positive, McEnany declined to wear a mask while talking with reporters outside the White House, removing her face covering Sunday evening as she approached journalists. Like McEnany, White House Chief of Staff Mark Meadows also has spoken to reporters without a mask since Trump’s diagnosis. Meadows has not tested positive for the virus.

As Trump prepared to return to the White House from Walter Reed, aides were being asked to wear masks when around others.

Meadows had a call with senior staffers Monday morning to say the president was likely to return to the White House later in the day, officials said. He encouraged staffers to work remotely and suggested that some meetings could happen in the Eisenhower Executive Office Building, where there is more space.

Officials said many spaces inside the White House complex — offices used by the National Economic Council, the press staff, even the hallways — were almost entirely bereft of people. Among those who remained, mask-wearing was more prevalent than it had been previously — but not universal.

Disdain among staffers for Meadows in the West Wing is “through the roof” right now, one senior administration official said, citing the chief of staff’s contradictory messaging about Trump’s health on Saturday and a lack of communication with aides about what was going on.

Trump may be spending considerable time in the White House’s Map Room, officials said. Trump likes the room and goes there regularly to prepare for major speeches and hold tele-town-hall events. It is close to the White House medical offices.

Conley said Trump would continue to be monitored daily to determine when it is safe for him to leave isolation.

“We’re looking to this weekend,” Conley said. “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.”

In the meantime, Biden has continued to campaign, while avoiding direct attacks on Trump.

En route to campaign stops in South Florida, Biden said he would listen to experts to gauge whether it would be safe for him and Trump to participate in the second presidential debate next week.

Biden so far has tested negative but shared the stage with Trump for a prolonged period during the first presidential debate last Tuesday, when the president may have already been infected.

“I’ll do whatever the experts say,” Biden said before boarding his campaign plane Monday morning in Delaware. “I think we should be very cautious.”

While Trump has told aides he was bored at the hospital and eager to get back into the action — he briefly left the hospital Sunday to greet supporters from a vehicle — outside medical experts said he also should proceed cautiously. The CDC says seriously ill coronavirus patients may need to remain in quarantine for up to 20 days. Some of the drugs Trump has been prescribed are known to have side effects including euphoria, confusion or emotional instability.

Asked whether Trump was experiencing any fogginess or other effects from the various drugs he had been prescribed, Conley told reporters to look at the president’s tweets as a sign that he is not impaired.

But asked to comment on Trump’s claim on Twitter that people should not be afraid of the virus, Conley reverted to evasion.

“I’m not going to get into what the president says,” he said.

John Wagner contributed to this report.