The flags are so red they might as well be wailing like sirens.
As more people in and around the White House test positive for the virus that causes Covid-19, no event is being more scrutinized than the Rose Garden event last Saturday, where President Trump announced the nomination of Amy Coney Barrett to the Supreme Court. That gathering, as videos and photos of it make clear, violated so many of the recommendations that everyone else has been told to adopt this year.
There’s Mike Lee, the Republican senator from Utah, hugging people. There’s former White House aide Kellyanne Conway having close conversations with others. There are more than 150 people, most maskless, sitting crowded in together and glad-handing. Some of them, like University of Notre Dame president Rev. John Jenkins, traveled there from other places and would return back to their communities.
Five to six days later, those three, along with the president, first lady Melania Trump, and Republican Sen. Thom Tillis of North Carolina, were attendees all diagnosed with Covid-19 — a time frame that fits with how long it takes for the virus to build up enough in someone’s system to the point that it can cause symptoms and be detected by tests.
As public health sleuths investigate how and when the pathogen infiltrated the inner circle of U.S. leadership, the Barrett event offers a case study in what experts say has been the administration’s recklessness over the months in creating settings that could abet the spread of SARS-CoV-2, including other White House events and campaign rallies. It underscores the limitations of the White House’s strategy of largely relying on testing to create a sense of security around the president without embracing other safety measures. In a way, experts said, the fact that a president who has dismissed the seriousness of the pandemic and mocked certain precautions contracted the coronavirus felt like it was his administration’s laxness catching up to him.
“Why are we having SCOTUS nominations in person?” said Michael Mina, an epidemiologist at Harvard’s T.H. Chan School of Public Health. “These in-person, especially indoor events, but even outdoor events, should not be taking place, especially not from our leaders who are trying to set good examples for this, or who should be trying to set good examples.”
He added: “This is just befuddling and dumbfounding how they are not taking this seriously and being the leaders that they should be.”
The actual announcement of Barrett took place outside in the Rose Garden, but there were also gatherings inside the White House that day. It’s not clear who was inside with whom and for how long. And while experts say that staying outdoors or at least in well-ventilated areas is safer than packing into stuffy rooms, other precautions — like masks and distancing and limiting the size of gatherings — are emphasized as ways to reduce the risk of transmission.
“If you’re outdoors and you’re sitting next to people for an hour, and you’re hugging people and kissing people — like we saw video of Mike Lee, one of our senators, hugging people — the fact that you’re outdoors is not like you have some magical powers,” said Stephen Goldstein, a virologist at the University of Utah.
— southpaw (@nycsouthpaw) October 2, 2020
It can be extraordinarily difficult to pinpoint the exact source of someone’s infection, particularly for someone like the president who interacts with hundreds of people at different events over many days. As of now, there’s no certainty that anyone was infected or that there was a superspreading event at the Barrett announcement.
There were plenty of other chances for Trump to contract the virus, or spread it to others, in the past week as well. Chris Christie, the former New Jersey governor, said on “Good Morning America” Friday that “no one was wearing a mask in the room” during the president’s preparations Tuesday ahead of the debate against former Vice President Joe Biden. On Saturday, Christie, who had also been at the Barrett event, said he had tested positive for Covid-19.
Trump on Friday evening was taken to Walter Reed National Military Medical Center as a precaution, his doctor said. He was treated earlier that day with an experimental cocktail of two monoclonal antibodies in development for Covid-19 by Regeneron Pharmaceuticals. And once at the hospital, he was started on remdesivir, an antiviral from Gilead Sciences that in clinical trials helped speed the recovery of hospitalized patients.
Researchers are increasingly learning that superspreading events drive a substantial amount of SARS-2 transmission, which is why they’ve stressed the importance of avoiding settings that are ripe for such an occurrence. Scientists have found that many people with Covid-19 do not lead to other cases, but that some 10% to 20% of people with the virus cause the vast majority of transmission. Superspreading situations have occurred at places like nightclubs, choir practices, and funerals.
In a letter this week to students and staff — issued before his diagnosis — Notre Dame’s Jenkins wrote to “regret my error of judgment” in not wearing a mask at the Barrett event and for shaking hands with others. He said that guests “were told that it was safe to remove our masks” after everyone tested negative.
The White House has been testing staff and visitors for Covid-19, but experts note that no test is perfect. The rapid tests the White House uses are more likely to return a false negative than other, lab-based tests, and they aren’t cleared by regulators for screening people who don’t have symptoms.
“They’re probably catching most cases, but not all of them,” said Zoë McLaren, a health policy expert at the University of Maryland, Baltimore County. “It doesn’t mean the tests aren’t working. It means that they’re working as we expect them to.”
If someone with the virus tested negative, it’s possible that the machine made an error in that case. It’s also possible that the person did not have enough virus in their system for the test to detect it yet; that can take a few days after a person contracts the virus. If that’s the case, it’s possible the person was expelling less virus than someone who would test positive — they simply don’t have as much in their noses and throats — but that still wouldn’t preclude the possibility of transmission. It’s why experts say everyone needs to wear masks and maintain distance from others, even after a negative test.
The Barrett event was not the only time this week that administration officials and the Trump family came under criticism for flouting health officials’ recommendations. At the debate Tuesday in Cleveland, members of the president’s contingent, including his family, were seen not wearing masks.
Norm Ornstein, a resident scholar at the American Enterprise Institute, a conservative think tank, who was at the debate, said that soon after members of the president’s family sat down at the event, they removed their masks. And when a Cleveland Clinic physician offered to give them new masks, he said, they declined to put them on.
They “were sort of in your face about it: we’re going to do what we want whether you like it or not,” he said.
A spokeswoman for the Cleveland Clinic, which was in charge of Covid-19 precautions at the event, confirmed that some audience members did not adhere to the mask requirement despite prompting from a physician, but did not identify the violators.
At a House hearing Friday, health Secretary Alex Azar, when asked about the first family not wearing masks at the debate, sought to differentiate between them and the general public.
“Our recommendations are always to wash your hands, watch your distance, wear a face covering when you can’t engage in social distance, and avoid settings where you can’t do those three things,” Azar said. “Now, the first family and the protective aspect around the president is a different situation than the rest of us because of the protocols around the first family.”
His answer did not satisfy Democratic Rep. Nydia Velázquez of New York, who said that because the first family did not follow the Cleveland Clinic’s rules, “You’ve sent the wrong message to the American people.”
Some people reacted to the president’s diagnosis Friday by expressing astonishment that the most important person in the world contracted the virus — seeing it as a sign of the virus’ rapaciousness. But experts pointed out that Trump is just another person for the virus to infect, and that if he wasn’t taking the precautions that others are, he was subjecting himself to more risk.
“People have said he’s the most protected person in the world,” Goldstein said. “Well, maybe he’s the most tested? But testing alone won’t protect you.” (It’s not clear how frequently Trump was actually tested, but White House staff and visitors have been tested as they entered the grounds.)
Indeed, if everyone was tested around Trump, it still didn’t prevent him from getting infected.
Even if it’s not possible to know when the president contracted SARS-2, “it seems pretty clear that probably somebody was infectious, tested negative, was allowed to go about their business, wasn’t wearing a mask, and therefore was able to spread the virus to Trump and others,” said epidemiologist Eleanor Murray of Boston University.
If health authorities uncover that, say, four people with Covid-19 were all at the same bar on the same night, they can deduce that a superspreading event might have occurred, publicize that information, and advise others who were there to quarantine themselves. Experts are now similarly urging people who were at the Barrett event, or at other events with the president in the past week or so, to quarantine, or at least take extra precautions.
“We know that President Trump and his staff were at a number of events with a lot of people” over the past week, Murray said. But given that Trump’s the president, anyone who was at one of those events “remembers that and is aware of that.”
Casey Ross contributed reporting from Cleveland.