President Donald Trump’s covid-19 diagnosis is raising fresh questions about the White House’s strategy for testing and containing the virus for a president whose cavalier attitude about the coronavirus has persisted since it landed on American shores.
The president has said others are tested before getting close to him, appearing to hold it as an iron shield of safety. He has largely eschewed mask-wearing and social distancing in meetings, travel and public events, while holding rallies for thousands of often maskless supporters.
The Trump administration has increasingly pinned its coronavirus testing strategy for the nation on antigen tests, which do not need a traditional lab for processing and quickly return results to patients. But the results are less accurate than those of the slower PCR tests.
Testing “isn’t a ‘get out of jail free card,’” said Dr. Alan Wells, medical director of clinical labs at the University of Pittsburgh Medical Center and creator of its test for the novel coronavirus. In general, antigen tests can miss up to half the cases that are detected by polymerase chain reaction tests, depending on the population of patients tested, he said.
The White House said the president’s diagnosis was confirmed with a PCR test but declined to say which test delivered his initial result. The White House has been using a new antigen test from Abbott Laboratories to screen its staff for Covid-19, according to two administration officials.
The test, known as BinaxNOW, received an emergency use authorization from the Food and Drug Administration in August. It produces results in 15 minutes. Yet little is independently known about how effective it is. According to the company, the test is 97% accurate in detecting positives and 98.5% accurate in identifying those without disease. Abbott’s stated performance of its antigen test was based on examining people within seven days of Covid symptoms appearing.
The president and first lady have both had symptoms, according to White House chief of staff Mark Meadows and the first lady’s Twitter account. The president was admitted to Walter Reed National Military Medical Center on Friday evening “out of an abundance of caution,” White House press secretary Kayleigh McEnany said in a statement.
Vice President Mike Pence is also tested daily for the virus and tested negative, spokesperson Devin O’Malley said Friday, but he did not respond to a follow-up question about which test was used.
Trump heavily promoted another Abbott rapid testing device, the ID NOW, earlier this year. But that test relies on different technology than the newer Abbott antigen test.
“I have not seen any independent evaluation of the Binax assay in the literature or in the blogs,” Wells said. “It is an unknown.”
The Department of Health and Human Services announced in August that it had signed a $760 million contract with Abbott for 150 million BinaxNOW antigen tests, which are now being distributed to nursing homes and historically black colleges and universities, as well as to governors to help inform decisions about opening and closing schools. The Big Ten football conference has also pinned playing hopes on the deployment of antigen tests following Trump’s political pressure.
However, even senior federal officials concede that a test alone isn’t likely to stop the spread of a virus that has sickened more than 7 million Americans.
“Testing does not substitute for avoiding crowded indoor spaces, washing hands, or wearing a mask when you can’t physically distance; further, a negative test today does not mean that you won’t be positive tomorrow,” Adm. Brett Giroir, the senior HHS official helming the administration’s testing effort, said in a statement at the time.
Trump could be part of a “super-spreading event,” said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Given the timing of Trump’s positive test — which he announced on Twitter early Friday — his infection “likely happened five or more days ago,” Osterholm said. “If so, then he was widely infectious as early as Tuesday,” the day of the first presidential debate in Cleveland.
At least seven people who attended a Rose Garden announcement last Saturday, when Trump announced his nomination of Judge Amy Coney Barrett to the Supreme Court, have since tested positive for the coronavirus. They include Trump’s former adviser Kellyanne Conway, Republican Sens. Mike Lee and Thom Tillis, and the president of the University of Notre Dame, the Rev. John Jenkins.
“Having that many infected people there all at one time, we’re still going to see transmission coming off that event for a couple days,” Osterholm said.
Osterholm notes that about 20% of infected people lead to 80% of Covid-19 cases, because “super spreaders” can infect so many people at once.
He notes that participants and audience members at Tuesday’s debate were separated by at least six feet. But six feet isn’t always enough to prevent infection, he said.
While many Covid-19 infections appear to be spread by respiratory droplets, which usually fall to the ground within six feet, people who are singing or speaking loudly can project virus much further. Evidence also suggests that the novel coronavirus can spread through aerosols, floating in the air like a speck of dust.
“I wonder how much virus was floating in that room that night,” Osterholm said.
Other experts say it’s too soon to say whether Trump was infected in a super-spreader event. “The president and his wife have had many exposures to many people in enclosed venues without protection,” so they could have been infected at any number of places, said Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University School of Medicine.
Although Democratic presidential candidate and former Vice President Joe Biden tested negative for the virus with a PCR test Friday, experts note that false-negative results are common in the first few days after infection. Test results over the next several days will yield more useful information.
It can take more than a week for the virus to reproduce enough to be detected, Wells said: “You are probably not detectable for three, five, seven, even 10 days after you’re exposed.”
In Minnesota, where Trump held an outdoor campaign rally in Duluth with hundreds of attendees Wednesday, health officials warned that a 14-day quarantine is necessary, regardless of test results.
“Anyone who was a direct contact of President Trump or known Covid-19 cases needs to quarantine and should get tested,” the Minnesota Department of Health said.
Ongoing lapses in test result reporting could hamper efforts to track and isolate sick people. As of Sept. 10, 21 states and the District of Columbia were not reporting all antigen test results, according to a KHN investigation, a lapse in reporting that officials say leaves them blind to disease spread. Since then, public health departments in Arizona, North Carolina and South Dakota all have announced plans to add antigen testing to their case reporting.
Requests for comment to the D.C. Department of Health were referred to Mayor Muriel Bowser’s office, which did not respond. District health officials told KHN in early September that the White House does not report antigen test results to them — a potential violation of federal law under the CARES Act, which says any institution performing tests to diagnose Covid-19 must report all results to local or state public health departments.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, said it’s not surprising that Trump tested positive, given that so many of his close associates — including his national security adviser and Secret Service officers — have also been infected by the virus.
“When you look at the number of social contacts and travel schedules, it’s not surprising,” Adalja said.
Sheila Zinkerman says
“We need better testing.” Bloomberg Businessweek 10/05/2020
If one were out to deliberately catch the C19 Virus couldnt have done a better job. of it. Defy deny no masks mingle groups whatever.
Testing scheme? How did the testing scheme in Seattle go months ago? Never heard anything else about the people who got a 3 series shot. LMAO
Not a Unicorn says
A key point to make here is that trump doesn’t care. He doesn’t care that he has caused thousands of cases of COVID due to his inexplicable endangerment of others by telling people not to wear masks. His followers waving flags mask-less outside the hospital where trump is inpatient due to the severity of his illness. These people in Darwin’s waiting room, cannot seem to make the association between not masking up and catching the plague. I have to think they’re totally devoid of intelligence or reason.
Trumps care will be the best available and free for him. How about them? If they have insurance they’ll have co-pays, Co insurance, deductibles. Better hurry and get COVID before Trump takes away your healthcare as he plans to do. He has no plan at all for anything to replace the ACA.
He demands to be driven around the block like a 2 year old waving like he’s in a parade. He is again endangering the people around him. That vehicle is sealed so no biochemical agents can penetrate it. The air he is breathing out is being recirculated and secret service agents (who I’m sure don’t get paid enough for this crap), are breathing in his COVID. N95 masks need to be fit tested to work well. We’re theirs? Trump was not wearing an N95 mask because they’re thick and if his O2 is satting low…While they’re in a small enclosed space with this guy?
I truly feel that his followers do not realize this is not a game. It’s some kind of sick, twisted reality show to them and trump, whereby they feed of each other for Narcissistic supply. What they don’t know is that trump is all smoke and mirrors and psychopathy rolled into one big, fat lying demon. What we’re watching is a horror flick at the circus.
Anyone who wants to try and say a word to me about how I ought to have empathy for trump can shut up and watch the videos where Hillary Clinton has pneumonia and nearly passed out and he had nothing but contempt and hatred spewing from his evil mouth. Oh, and all the other hundreds of examples where trump has shown zero empathy.
I’m an Empath but nowhere in the Bible does it say I have to like, placate, or respect the devil and if your hearts in the right place, your gut tells you trump is one.
The only thing Trump’s base cares about is “triggering” or “owning” the “Libs.” If a few of their own family and friends die from a pandemic in the process, so be it.
John Stove says
Where do you start to describe the absolute level of stupidity this administration has? They have known about it for months and yet they still think that daily testing will protect them?
If you want to infect yourself, go for it but you are spreading it to everyone who works in the White House; House staff, secret service agents, capitol policemen, Marines who guard and fly you etc etc
Nice touch from the Trump cultists outside Walter Reed – 3 days of horn-blowing, shouts, etc. No thought of the effect on the hundreds of other patients and their families – just like their leader. Selfish, rude, uncaring.
As a wise counselor once said….”The characteristics of the kingdom emanate from the character of the king”.
May The Truth Be Told says
It is quite obvious
The president DOES NOT GET TESTED as often as you have been led to believe.
Do you seriously think he gets a swab shoved up his nose daily?
Don’t get me wrong here.
EVERYONE around him is tested,
Unfortunately, one of those trusted individuals who came into contact with this “holier-than-thou” asshat had received a “false negative” test result.
That is all it takes!
I saw yesterday….
on live TV:
Senior campaign adviser Jason Miller,
TRY and convince the public that:
“There is so much we do not know” about this virus.”
Trying to infer that the president had become infected by some new, unheard of way.
The fact is
1 – He didn’t wear a mask while in close contact with others
2 – Those “others,” in fact had received a false positive test result.
Who is running this White House?
Maybe he should ask the Queen on how the procedure above works?
She would no doubt use the word “testing” but I bet she would use the word “ISOLATION” first!
(you know, hiding in the basement)
Would the idiot then listen?
You know the answer,
As he has said:
ONLY HE can save the USA,
HE is the “CHOSEN ONE”
HE knows all,
and if your governor is a republican, he will support you.
Can’t wait till the VP debate.
Pence has YET to “directly” answer any question asked of him in over 4 years.
He’ll go off on some strange, obtuse, tangent, but will never answer ANY question asked “straight up”
He needs to practice his “deflection” skills.
Kamala is going to eat his cake.
Testing positive to a Leftist Hoax. Classic.
Who ya gonna blame now Fat boy? How many lives do you have to ruin?
If you’re still supporting Trump, you are complicit. Please look at the facts, look in the mirror, and wake up…For the sake of our Country.
White Bronco says
Merriam Webster should change the official definition of irony to a simple picture of this man. Just saying.
PSA: If you are one of those people who wears a mask when driving alone, there is no need to place a BIDEN sticker on your car.
We already know.
Way to deflect Teddy. If you want to defend your Orange Moron somehow, do it. But, finding fault in folks who are overly cautious is just deflection from TRUMP’S ABSOLUTE FAILURE. He didn’t create the Virus, but he’s dumb enough to think he can control it. Your turn. Come back at me with something Traitor Hannity told you to say. Or, you can use your own thoughts. Tough choice, eh?
So, the President was in the hospital Saturday, basically for not wearing a mask. You’d think his supporters would understand the risk of going mask-less? I go into Winn-Dixie and the Dollar Store and run into people shopping unmasked. One woman with two kids in tow told me I was being “non-Christianlike” for asking her “did she forget your mask?” The other guy was strolling along in the supermarket, hands in pockets. He must have been there to protect his wife because he showed no interest in the food, but was able to flip me the bird when I told him, “you can have the whole aisle because you don’t want to share community space with people by just masking up”. People who ignore community values get upset when they are singled out. My point is, we cannot arrest this virus without the cooperation of all the people. You don’t want to wear a mask? Have the food delivered to you, stay out of public spaces. If Trump can catch it you can too. Worse than that, I can catch it from YOU. Be a citizen in a society and participate in the effort.
Concerned Citizen says
Even though I wear my mask it’s self appointed mask police like you that make this hard. Sounds like to me you were intentionally looking for a confrontation. I’ve seen my share.
I’m pretty sure you weren’t nice about it when you approached these folks. And if you approached my wife I would have something to say as well. What authority do you have to approach someone and harrass them about a mask?
It’s up to the busniess to enforce mask wearing and it’s up to us individually to do our part to wear one. And if someone isn’t leave them alone.
If you feel you need to address the issue go ask for a manager and let them handle it. Or call law enforcement and file a complaint with the Sheriffs office if you feel that strongly.
Everyone on both sides needs to be a little nicer.
Donald Trump has showed our country and the world he has no regard for anyones health or well being not even his own party or staff. He only cares about his photo ops, he is irresponsible, and is now on mind altering drugs that now can cause erratic behaviors and has put our country in severe danger.
Our country is in serious danger right now and the Republican party is enabling this and it is a disgrace to our nation and its people.
Just how is it your business if a person wears a mask in their own car? How does that person affect you or your life at all? Just why should you try and ridicule and judge them? Especially when NOT wearing a mask is medically proven to put us all as higher risk of illness and death!!!
This is precisely an example of the kind of hate and divisiveness that is being sown by trump and the Republican party. Why do you not understand how dividing us from each other plays right into the hands of the Putin Communists trump kowtows to?
“United We Stand . . . Divided We Fall”!!! Do try and see the bigger picture of your words and actions.
Gary R says
There have been accidents by people wearing a mask inside the car. CDC: Drivers Should Not Wear Masks While Driving.
Rich Santomassino says
While many times I have been tempted to speak to someone not wearing a mask, I have resisted the urge. I spent 30 years in healthcare, so I do understand the importance of “masking up”. But, I do not have the desire to engage in the stupidity of others. It is sad that in America with all of the freedoms we are granted that one of those freedoms is “the freedom to let my lack of common sense endanger others”