“Any foreign intel service worth its salt is going to want to have assets on the ground (spies and sources) who can report on POTUS’ health,” said Steve Hall, former CIA station chief in Moscow. “It’s a key requirement that gets to what we usually call ‘plans and intentions’ of a foreign government.”

Marc Polymeropoulos, a former CIA senior intelligence service officer who retired in 2019, said it would be part of “routine tasking” by foreign intelligence services to gather information during such a crisis – and that as an intelligence officer himself, such tasking on the US side was normal in every country he served in.

“It was often feasible to collect information on the health of our adversaries’ leadership, as the targets for recruitment were not the other country’s intelligence service or even government personnel, but rather hospital or administrative staff – targets that would not have the counter-intelligence antenna up,” he said.

While Hall expressed scepticism that adversaries like Russia and China could have spies inside Walter Reed Medical Center, where the president was receiving treatment over the weekend and into Monday, he argued that it was more likely they would use established sources in the White House.

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Trump returned to the White House on Monday evening, just days after he first checked in to the hospital.

“Press reports indicate Trump was on the phone with foreign leaders. If one of those calls was with Putin, and I was Putin's intel chief, I’d have a Russian doc in the line to listen in,” Hall said. “Was he short of breath? Did Trump seem confused?”

This information could easily be exploited by foreign adversaries – particularly in an environment where confusion about the president’s health is already rampant, said Mick Mulroy, an ABC News analyst and retired CIA officer who served as a deputy in the Pentagon until last year.

The misleading briefings from the White House medical team “are creating a crisis of confidence in the chain of command”, Mulroy said. This could easily be exploited by a foreign adversary such as China, Russia or Iran, launching disinformation campaigns “designed to reduce the confidence of Americans in our government and the election process,” he noted.

03:12

Conflicting reports about Donald Trump’s Covid-19 infection as he greets supporters near hospital

Conflicting reports about Donald Trump’s Covid-19 infection as he greets supporters near hospital

Mulroy called on Defence Secretary Mark Esper, who just returned from a week abroad, and other national security leaders to be present in Washington to “ensure the continuity of government and send a message to any adversary that may want to exploit the situation”.

Administration officials continue to insist that the situation is under control and that they are not unduly concerned by the potential for foreign adversaries to exploit the crisis.

“Our adversaries know that the United States government is steady at the tiller and that we're – we're protecting the American people,” national security adviser Robert O’Brien said on CBS on Sunday.

Still, concern over adversary exploitation is one reason releasing the medical information of US leaders is typically handled so carefully. Most presidents, for instance, have their doctors put out detailed letters about their vitals, any medications, and past or current illnesses.

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But although Trump was the oldest person ever elected to a first term as president in 2016, he has refused to release his full medical records. Instead, his former doctor put out a glowing statement in December 2015 stating, “If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.”

Later, he revealed that Trump had dictated the letter himself.

True to form, the White House’s handling of the president’s Covid-19 diagnosis has added to a sense of confusion and chaos in the upper echelons of the US government in recent days. Officials on Sunday acknowledged that Trump had experienced concerning drops in his oxygen saturation levels since his positive test, while also insisting that he could be discharged as early as Monday.

Later, the president himself made a surprise appearance in public, masked up and waving to crowds of supporters from inside the presidential limo before returning to Walter Reed Medical Center.

Meanwhile, White House press secretary Kayleigh McEnany became the latest in a string of staff and senior Republican officials to fall victim to Covid-19, announcing on Monday that she had tested positive for the virus.

But the administration has continued to play down the president’s illness, and argue that neither the national security apparatus nor the world needs to know Trump’s precise medical condition.

“I don’t think we need a handle on the exact medical situation because we are not doctors, but its clear that the president is doing his job, he’s not incapacitated, and the entire machinery of government is following under him,” said Elliott Abrams, the State Department’s Special Representative for Iran, on CNN, notiing that adversaries would be “ill-advised” to exploit the situation.

But given the White House’s obfuscation on the president’s coronavirus diagnosis, it would not be unreasonable to suggest “that foreign governments like Russia and China with active and effective collection programmes would have better info” on Trump’s medical condition than even the American public, said Hall.

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Foreign intelligence shops would likely have sources with access to what White House insiders are hearing about the president’s treatment – and intelligence about whether staff are being sloppier than usual with communications security given the crisis, said former acting CIA director John McLaughlin.

“Given that foreign intelligence services, particularly hostile ones, have no higher priority than understanding events in a president’s inner circle, it’s reasonable to assume that they have sources somewhere seeking access to reliable information on his diagnosis,” said McLaughlin. “Hard to say whether this would amount to something more transparent than the American public is getting, but they would certainly try to factor out the spin.”

As of Monday morning, the intelligence community had not yet provided the congressional intelligence committees with information about foreign mischief or disinformation efforts surrounding Trump's diagnosis, said one congressional source, who cautioned that this should not be taken to mean that no such intelligence exists.

But for now, said Polymeropoulos, “we can rightly assume that foreign services are actively collecting, and likely successfully so, in finding out more about the president's health status than the US media and the American people”.