As he was being discharged from hospital on Wednesday (NZ time), US President Donald Trump said he felt "better" than he did "20 years ago".
It was a bold claim for a 74-year-old man undergoing treatment for a disease that's left more than a million people dead this year, which overwhelmingly targets the elderly and obese.
While Trump's known for lying about anything and everything to make himself look good, in this case it might actually be true - but also an illusion.
"You feel better than you did 20 years ago? That's because of your dexamethasone high that resembles mania," tweeted Eugune Gu, a prominent US surgeon and social media personality.
UK and Kiwi researchers in recent months have found dexamethasone, a common anti-inflammatory steroid, can dramatically reduce the likelihood of death in severe cases of COVID-19 where patients need respiratory help. It's a risky treatment, recommended only for use when the patient's oxygen levels drop as Trump's did at the weekend.
It's otherwise largely useless, hampering the body's ability to fight off infection (especially early in the infection), and isn't a cure.
But like most medications, it comes with side-effects.
"I remember feeling just like Trump for the first few days," one person wrote on Facebook, in a post shared widely on Twitter. "The stupid decisions I made during my steroid mania involved things like eating five bowls of cereal... at 3am. Nothing that would affect the fate of the country or the world."
A musician who was taking the steroid after suffering a brain tumour told Rolling Stone he felt like he'd "mainlined a potent mixture of espresso beans and psychotropics. I could feel my heartbeat in my eyeballs. I was euphoric... To borrow a phrase I heard somewhere recently, I felt better than I did 20 years ago."
Another former user went four days without sleep and ate "everything in the refrigerator" before they crashed. "It wasn't pretty."
New Zealand's MedSafe warns "potentially severe psychiatric reactions may occur" after taking dexamethasone.
"Psychic derangements range from euphoria, insomnia, mood swings, personality changes and severe depression to frank psychotic manifestations."
"Existing emotional instability or psychotic tendencies may be aggravated," adds the US Federal Drug Administration.
The Mayo Clinic says it can cause aggression and irritability.
In the hours after being treated with dexamethasone, Trump wrote 15 consecutive tweets in all-caps and greeted supporters outside the hospital from his car, critics saying he put Secret Service staff at risk.
After being discharged he was caught on camera appearing looking short of breath, and whipped off his facemask on setting foot back in the White House - which has 36 active cases of COVID-19 at the time of writing, just one fewer than the entire country of New Zealand.
"It can cause psychosis. It can cause delirium. It can cause mania," Brown University doctor Megan Ranney told CNN. "I would never want to say the President is experiencing steroid-induced psychosis, but it is certainly concerning to see some of his actions today in the wake of this potentially deadly diagnosis and infectious disease."
Dexamethasone patients also experience a comedown. One social media user described their experience as initially giving them a "miraculous improvement in symptoms" and a "superhuman jump in energy levels", followed by a "crushing all-encompassing comedown".
MedSafe warns "anorexia, nausea, vomiting, lethargy, headache, fever, weight loss, and/or hypotension" are possible during dexamethasone withdrawal, though they're more likely after a "prolonged treatment".
"Week one is a honeymoon," tweeted Australian doctor and broadcaster Norman Swan. "Week two is when you fall off the cliff."
Even if Trump truly is feeling better, with or without the steroids, he's not out of the woods.
"I've seen a lot of patients linger in this plateau and then after seven days they fall off a cliff and crash," professor of medicine at the University of California San Francisco Peter Chin-Hong told the Wall Street Journal.
"We've sent patients home and then they come back gasping for air in the emergency room."
In addition to dexamethasone, the President is known to have been treated with remdesiver, which can slow the virus' replication, and antibody therapy, an unproven treatment said to make it easier for the immune system to spot invaders. Neither have been proven to improve the chances of survival.
He's also said to be taking vitamin D, zinc and melatonin supplements, famotidine and aspirin - none have been shown to help against COVID-19 specifically.
