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What would successful contact tracing look like following the President of the United States’ COVID-19 infection?

This article was published on
April 21, 2021

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Given that the the period between exposure to COVID-19 and symptom onset can be between 2-14 days, U.S. President Donald Trump could have been infected as early as two weeks ago. He could have been contagious as early as approximately 12 days before his positive test result. Since other prominent individuals in Donald Trump’s circles have also tested positive in days following Trump’s positive result — such as Melania Trump, presidential adviser Hope Hicks, and Trump campaign manager Bill Stepien — all infected members of the White House may have overlapping chains of transmission and as a result, contact tracing efforts will be complex. As a result, the optimal, comprehensive contact tracing approach in this situation would look as follows:  1. Donald Trump and all individuals who tested positive in his close circles would provide detailed information on where they were and who they had close contact with in the 14 days prior each of their positive test results. Close contact includes anyone who has been within 6 feet (2 m) of any of them for at least 15 minutes, or indoors with any of them without a mask on within two days of any of the three diagnoses 2. A team of contact tracers would then quickly alert the identified individuals, to let them know that they may have been exposed to COVID-19 3. The individuals from the close contact group would then be assessed for symptoms and tested for COVID-19 4. The people from the close contact group who test negative for COVID-19 would then be instructed to self-quarantine for 14 days after they were exposed, keep social distance from others, self-monitor for COVID-19 symptoms, and send doctors and the state health department daily health updates 5. The people from the close contact group who don’t have symptoms, but have also not been tested, would be instructed to follow guidelines as if they tested negative 6. The people from the close contact group who test positive would be instructed to self-isolated and recover at home for minimum 10 days and then self-quarantine for 14 days after being exposed, seek medical care if they experience emergency warning signs, and monitor symptoms and avoid spreading the virus 7. The people from the list who have symptoms of COVID-19 but can’t be tested would be asked to follow the guidelines as if they tested positive 8. Each close contact would get tested again one week after initial testing 9. Contact tracing steps 1-8 would repeat for the close contacts of each individual who tests positive Though the incubation period of the virus that causes COVID-19 is 2-14 days, the incubation period of infection is most often 3-5 days, so it's most likely that Trump was infected between Saturday, 9/26/2020, and Monday, 9/28/2020. That makes him mostly likely infectious as of Tuesday, 9/29/2020. This entry was updated with new information on October 4, 2020.

Given that the the period between exposure to COVID-19 and symptom onset can be between 2-14 days, U.S. President Donald Trump could have been infected as early as two weeks ago. He could have been contagious as early as approximately 12 days before his positive test result. Since other prominent individuals in Donald Trump’s circles have also tested positive in days following Trump’s positive result — such as Melania Trump, presidential adviser Hope Hicks, and Trump campaign manager Bill Stepien — all infected members of the White House may have overlapping chains of transmission and as a result, contact tracing efforts will be complex. As a result, the optimal, comprehensive contact tracing approach in this situation would look as follows:  1. Donald Trump and all individuals who tested positive in his close circles would provide detailed information on where they were and who they had close contact with in the 14 days prior each of their positive test results. Close contact includes anyone who has been within 6 feet (2 m) of any of them for at least 15 minutes, or indoors with any of them without a mask on within two days of any of the three diagnoses 2. A team of contact tracers would then quickly alert the identified individuals, to let them know that they may have been exposed to COVID-19 3. The individuals from the close contact group would then be assessed for symptoms and tested for COVID-19 4. The people from the close contact group who test negative for COVID-19 would then be instructed to self-quarantine for 14 days after they were exposed, keep social distance from others, self-monitor for COVID-19 symptoms, and send doctors and the state health department daily health updates 5. The people from the close contact group who don’t have symptoms, but have also not been tested, would be instructed to follow guidelines as if they tested negative 6. The people from the close contact group who test positive would be instructed to self-isolated and recover at home for minimum 10 days and then self-quarantine for 14 days after being exposed, seek medical care if they experience emergency warning signs, and monitor symptoms and avoid spreading the virus 7. The people from the list who have symptoms of COVID-19 but can’t be tested would be asked to follow the guidelines as if they tested positive 8. Each close contact would get tested again one week after initial testing 9. Contact tracing steps 1-8 would repeat for the close contacts of each individual who tests positive Though the incubation period of the virus that causes COVID-19 is 2-14 days, the incubation period of infection is most often 3-5 days, so it's most likely that Trump was infected between Saturday, 9/26/2020, and Monday, 9/28/2020. That makes him mostly likely infectious as of Tuesday, 9/29/2020. This entry was updated with new information on October 4, 2020.

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What our experts say

Given that the the period between exposure to COVID-19 and symptom onset can be between 2-14 days, U.S. President Donald Trump could have been infected as early as two weeks ago. He could have been contagious as early as approximately 12 days before his positive test result.

Since other prominent individuals in Donald Trump’s circles have also tested positive in days following Trump’s positive result — such as Melania Trump, presidential adviser Hope Hicks, and Trump campaign manager Bill Stepien — all infected members of the White House may have overlapping chains of transmission and as a result, contact tracing efforts will be complex. As a result, the optimal, comprehensive contact tracing approach in this situation would look as follows: 

  1. Donald Trump and all individuals who tested positive in his close circles would provide detailed information on where they were and who they had close contact with in the 14 days prior each of their positive test results. Close contact includes anyone who has been within 6 feet (2 m) of any of them for at least 15 minutes, or indoors with any of them without a mask on within two days of any of the three diagnoses
  2. A team of contact tracers would then quickly alert the identified individuals, to let them know that they may have been exposed to COVID-19
  3. The individuals from the close contact group would then be assessed for symptoms and tested for COVID-19
  4. The people from the close contact group who test negative for COVID-19 would then be instructed to self-quarantine for 14 days after they were exposed, keep social distance from others, self-monitor for COVID-19 symptoms, and send doctors and the state health department daily health updates
  5. The people from the close contact group who don’t have symptoms, but have also not been tested, would be instructed to follow guidelines as if they tested negative
  6. The people from the close contact group who test positive would be instructed to self-isolated and recover at home for minimum 10 days and then self-quarantine for 14 days after being exposed, seek medical care if they experience emergency warning signs, and monitor symptoms and avoid spreading the virus
  7. The people from the list who have symptoms of COVID-19 but can’t be tested would be asked to follow the guidelines as if they tested positive
  8. Each close contact would get tested again one week after initial testing
  9. Contact tracing steps 1-8 would repeat for the close contacts of each individual who tests positive

Though the incubation period of the virus that causes COVID-19 is 2-14 days, the incubation period of infection is most often 3-5 days, so it's most likely that Trump was infected between Saturday, 9/26/2020, and Monday, 9/28/2020. That makes him mostly likely infectious as of Tuesday, 9/29/2020.

This entry was updated with new information on October 4, 2020.

Context and background

On Thursday, Oct. 1, U.S. President Donald Trump reported a positive diagnosis of COVID-19, meaning that he is currently infected with the virus that causes COVID-19. Knowing his status allows public health experts to track, and ideally prevent, the spread of the virus through contact tracing by following the chain of transmission — that is, who the president has been in close contact with, who those individuals have been in contact with, and so forth down the line. Contact tracing around President Trump’s status will also help clarify who President Trump contracted the virus from, who else might be at risk, and how big those risk pools are. In the case of U.S. President Trump, there is concern that these risk pools could be large given his busy public schedule, and could include senior government leaders and staff. 

Resources

  1. Contact Tracing - Coronavirus Disease 2019 (CDC)
  2. Contact tracing and COVID-19: What is it and how does it work? (Mayo Clinic)
  3. The White House should now be ground zero for a huge contact tracing operation (Vox)
  4. There should be 'enormous' contact tracing of people around Trump, says public health expert (The Hill)

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