What we all know—and don’t know—in regards to the president’s coronavirus analysis

President Donald Trump shared that he and first girl Melania Trump have examined constructive for coronavirus on early Friday morning, resulting in a slew of questions within the medical neighborhood about when, the place and the way he might have contracted the illness. 

The analysis has come as a shock to some public well being specialists, given the steps that the White Home took to maintain the president and his interior circle secure, together with common testing and entry to medical doctors. Press secretary Kayleigh McEnany beforehand described the president because the “most examined man in America.”

As former U.S. Meals and Drug Administration commissioner Dr. Scott Gottlieb famous this morning on CNBC: “They created a bubble across the president and but he nonetheless grew to become weak.” 

So how did it occur? We requested public well being specialists and medical doctors for his or her tackle the timeline of when the president might have been uncovered, how lengthy he would possibly expertise signs, and the place we go from right here. 

At this stage, it is all hypothesis. It is extraordinarily difficult, given the restricted knowledge obtainable, to make any laborious and quick conclusions. As public well being specialists clarify, it is determined by how continuously the president was examined, the kind of take a look at he obtained and the timeline round when he began experiencing signs. 

There’s additionally nonetheless some unknowns in regards to the “early time course” of the illness, mentioned Carl Bergstrom, a biologist and professor on the College of Washington. So even as soon as this data turns into clearer, it could nonetheless be a problem to map out precisely when Trump was uncovered. 

In fact, there are a couple of theories which have been thrown on the market. 

Chief amongst them, that the president received uncovered throughout the Supreme Courtroom nominee announcement on the White Home on Saturday. In response to information studies, Notre Dame President Rev. John Jenkins, who was in attendance, later examined constructive for Covid-19. Jenkins apologized earlier this week to the campus neighborhood for not sporting a masks or social distancing on the occasion. Furthermore, most of the visitors, together with prime Trump administration officers, have been photographed with out masks. 

One other potential clue is that Hope Hicks, an in depth adviser to the president who traveled with him on board Air Power One a number of instances this week, has additionally examined constructive. However Dr. Megan Ranney, an emergency medication doctor and an affiliate professor at Brown College, would not assume it is possible that there was a transmission chain by way of Hicks, on condition that she examined constructive simply hours earlier than the president. “It makes way more sense, they have been uncovered to a typical vector, however actually it is inconceivable to know.”

Once more, there are not any clear solutions at this stage, public well being specialists stress. 

“I think the president might have been contaminated anytime up to now week,” mentioned Dr. Jeremy Faust, an attending doctor within the Brigham and Ladies’s Hospital Division of Emergency Medication. “This virus is basically laborious to trace.”

The outcomes could also be affected by the timing of the take a look at. If the president was examined on the day he was contaminated, the end result would possible come again destructive. That is as a result of there may not be sufficient viral particles within the nostril or saliva. 

Oftentimes, it takes a couple of days after an individual is initially contaminated — or after they develop signs — to get a constructive end result. Each Trump and the primary girl have shared that they are now experiencing gentle signs, however it’s unclear when that began. 

“It is normally about 48 hours, though there are instances the place individuals have been uncovered to the virus and extra rapidly transformed to a constructive,” mentioned Dr. Faust. 

Within the 48 hours earlier than he examined constructive, and doubtlessly might have been contagious, the president traveled to Ohio, Minnesota and New Jersey, whereas accompanied by workers that didn’t put on masks. 

Throughout these occasions, he could have additionally been in shut contact with supporters who didn’t put on masks. 

On Wednesday, he travelled to a rally in Minnesota, the place Hicks began to first expertise signs. Because the New York Instances has reported, Trump fell asleep on Air Power One on his means again, at which level it grew to become clear that one thing is likely to be up. A number of staffers began sporting masks by Thursday. 

Democratic nominee Joe Biden has introduced that he is now examined destructive for coronavirus, after standing in shut proximity to the president for about two hours on the debates on Tuesday night time. 

Nonetheless, that does not imply Biden is within the free and clear. 

“If you happen to informed me you have been at a live performance and 12 toes away from somebody who later examined constructive for a number of hours, I might let you know to quarantine,” mentioned Dr. Ranney, the emergency doctor. Ranney mentioned Biden will possible be suggested by his medical workers to take precautions, notably if he begins experiencing any signs. 

“The rules are pretty clear,” mentioned Dr. Faust. “When you have an publicity, you need to quarantine 10 to 14 days, however it’s much less clear if after 7 to 10 days of destructive testing, for those who can name it off.”

What’s not but recognized is that if Trump might have been contaminated previous to the debates. The CDC has reported that it is doable for an individual contaminated with Covid-19 to unfold the virus for no less than a day or two earlier than experiencing any signs.

However Trump has implied that he was examined earlier than the occasion. Nonetheless, Chris Wallace, who moderated the talk, mentioned in an interview with Fox anchor Invoice Hemmer that the president arrived too late in Cleveland on Tuesday to get a Covid-19 take a look at. 

“We do not assume it is possible you could be contagious with a destructive take a look at, though it is at all times doable {that a} take a look at was inaccurate,” mentioned Dr. Faust. 

The president tweeted that he and his spouse Melania will quarantine as they recuperate. So far, each have shared that their signs are gentle, though that might change over time. 

On Friday afternoon, White Home doctor, Dr. Sean Conley, mentioned Trump was “fatigued however in good spirits,” whereas the primary girl had a light cough and headache.

Trump obtained a single 8-gram dose of Regeneron’s experimental antibody cocktail as “a precautionary measure,”  Dr. Conley mentioned.

Trump additionally left the White Home for Walter Reed hospital “out of an abundance of warning, and on the suggestion of his doctor and medical specialists. The White Home mentioned the President will likely be working from the presidential workplaces on the medical middle. 

Conley added that the primary household has examined destructive for the virus Friday. 

Even when Trump have been to check destructive in subsequent days, he ought to nonetheless proceed to isolate, public well being specialists be aware. How lengthy he isolates would possibly rely upon the severity of his signs. The 74-year-old president has a number of threat components that might enhance the probability that he’ll be hospitalized or expertise extreme sickness, together with his age, gender and weight.

The newest public well being tips counsel that individuals with gentle to average Covid-19 signs are infectious for as much as 10 days after the onset of signs. These with extra extreme sickness or those that are severely immunocompromised can stay infectious for 20 days. 

The CDC recommends those that are capable of recuperate at dwelling, ought to solely cease isolating if: 

• At the least 10 days have handed since symptom onset (except sickness is extreme)
• At the least 24 hours have handed since decision of fever with out using fever-reducing medicines and
• Different signs have improved

“So actually we’re a minimal of 10 days,” mentioned Dr. Ranney.