What to watch for in the aftermath of Trump’s positive coronavirus test
We only have limited information thus far. The New York Times reported Friday that the president was experiencing a cough, low-level fever and nasal congestion. He was transferred to Walter Reed National Military Medical Center on Friday afternoon for what the White House said were precautionary reasons. Even for his age and with his known preexisting conditions of obesity and heart disease, the odds are in favor of a good outcome. Still, we must keep a close eye on Trump’s health over the course of not just days but weeks to come.
Contact tracing will be very complex. “Close contact” is defined by the CDC as anyone who has spent at least 15 minutes within six feet of individuals with covid-19. In a White House where few wear masks or follow physical-distancing guidelines, many will be identified as close contacts.
The time frame is important. The incubation period — the time between when someone contracts the virus and when they show symptoms — is between two and 14 days. Studies show that people with the coronavirus are maximally infectious in the 48 hours just before they develop symptoms. White House senior aide Hope Hicks was reported to have tested positive and to have developed symptoms on Wednesday. She could well have been transmitting the virus for a few days before then. All individuals she came into contact with during that period should be traced, tested, monitored for symptoms and told to self-quarantine for the entire incubation period of 14 days.
Tracing must extend beyond the White House staff. Hicks accompanied Trump to rallies and to the presidential debate at a time when she was potentially infectious. She could have had close contact with dozens of people. Their footsteps must also be traced and all their contacts identified. If any of these people develop symptoms or test positive, the contact tracing process begins all over again.
We don’t know whether Hicks was the first person in the White House to test positive. While it’s possible that she contracted the virus elsewhere, it’s just as possible that someone else among the White House staff had the coronavirus before she did, which further lengthens the timeline and widens the net of potential exposure.
Negative tests are not enough; self-quarantine and isolation are key. The protocol for exposure is that individuals who have been in close contact with an infected person must self-quarantine for 14 days. A negative test isn’t enough to break quarantine; it’s possible that it’s still too early in the illness to pick up the virus.
Vice President Pence and other officials with known exposure are reported to have tested negative thus far. They need to self-quarantine and not interact with others for 14 days. If anyone develops symptoms, the timeline resets again, and the individual must stay isolated for at least 10 days following the onset of symptoms.
This brings up another point about the limitations of testing. Trump has touted the daily testing he and his aides receive as the reason they don’t need to follow other safety precautions. While daily testing is an important tool and allows for early detection of the coronavirus, it isn’t prevention. Wearing masks, physical distancing and avoiding crowds are still the best defenses against contracting the virus in the first place.
There are many unanswered questions. What will Trump tell the public about his illness, starting with what’s already occurred? It was reported Friday that Trump felt under the weather on Wednesday, the same day he held a rally in Minnesota, and that he had mild, cold-like symptoms Thursday. On average, a patient with the coronavirus will show symptoms five to seven days after exposure. A sensitive test would generally pick up the virus before then. Because the president was getting tested daily, it’s likely the test came back positive before he would develop noticeable symptoms.
The public should know: When was his first positive test?
How many more people will test positive as a result of this cluster of infections, and will the American people be informed?
As the country wishes the president, first lady, Hicks and everyone involved well, I hope we can be reminded of just how contagious this virus is. No one is safe from it. Our loved ones and those closest to us could be carrying it and not know it. We must all take precautions and protect one another.
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