For more than six months, Joe Biden’s team went to extraordinary lengths to keep their candidate safe, fastidiously following medical guidelines that enabled him to campaign while guarding him from a potentially deadly virus.
Now, the Democratic nominee is facing the prospect that the president of the United States himself might have posed the biggest Covid-19 risk to his health since the pandemic began.
It could be days before the 77-year-old Biden will be in the clear, despite recent negative tests. The virus can incubate for up to 14 days.
Donald Trump was quite likely infectious at the Tuesday debate, medical professionals say, considering the severity of the symptoms on Friday, in which he necessitated oxygen before being transported to Walter Reed Military Medical Center.
"A person is at their peak infectiousness in the 48-hour period before they start showing symptoms,” said Leana Wen, a former health commissioner for Baltimore and ER physician. ”If that timeline is correct, then [Trump] would actually be at the peak of contagion on Tuesday night.”
Democrats expressed considerable frustration at the series of events that thrust the ever-so-careful Biden into a risky, maskless environment which ultimately ended up with several Trump staffers and supporters testing positive and Trump himself hospitalized.
"The irony in my estimation is that if there is one person out of 330 million who should have the least amount of risk, it’s the president of the United States and his inner circle," said Ohio Rep. Tim Ryan, who was inside the debate hall and had to undergo a Covid-19 test after learning Trump had tested positive. "And yet, they’re executive-level super spreaders."
During the evening debate, a slew of Trump family members broke guidelines set by the Cleveland Clinic, the academic medical center that hosted the debate, by refusing to wear masks inside the debate hall. It was a far cry from the carefully cultivated events that Biden had organized and attended for months.
Among those inside the debate hall or who traveled with Trump that night who announced positive tests later in the week: former New Jersey Gov. Chris Christie, who had helped Trump with debate prep, First Lady Melania Trump, senior adviser Hope Hicks and Trump campaign manager Bill Stepien.
By contrast, Biden and his team have been vigilant about wearing masks and adhere to the strictest of rules as he travels. There have been no Covid-19 infections on the Biden team so far. Media access has been greatly limited, with only pool reporters allowed to travel with Biden. If a flight is involved, the press always travels in a separate plane. At some events, circles are drawn to mark where exactly attendees can safely sit or stand.
On Friday, after the confirmation of Trump’s diagnosis, Biden continued with his travel plans to Michigan. But he canceled an indoor fundraiser. The team did not find out from Trump or the White House but from news reports.
Asked whether Biden should be quarantining for 14 days, a Biden campaign aide said staff considered the situation and followed medical guidelines.
"Vice President Biden and the president were never within what the CDC considers to be close contact, and we are following CDC guidance. The vice president tested negative twice Friday, our traveling staff tested negative on Friday, the VP tested negative again Sunday, our campaign events are socially distanced and everyone is wearing a mask," campaign spokesman T.J. Ducklo said in a statement. "Given all of those factors, we are comfortable that the vice president can continue to campaign safely.
Overall, concerns within the Biden team that the candidate — or other staff — had been exposed have been blunted by the fact that the campaign has been so devoted to following protocols, including wearing masks inside the hall, and keeping distance from others.
On the night of the debate, the two candidates were standing more than 12-feet apart. Social-distancing guidelines call for at least six feet of space between individuals to avoid exposure to coronavirus, but medical professionals recommend a greater distance of separation for individuals spending longer periods of time next to one another indoors.
Sen. Chris Coons (D-Del.) said after Trump’s diagnosis he thought back to the debate and wondered whether Trump may have exposed Biden that night.
“Did it cross my mind afterward that he spent 90 minutes yelling in relatively close quarters with former vice president Biden and [moderator] Chris Wallace? Yes,” Coons said. “I mean, he was projecting forcefully.”
In a new statement on Sunday, the Cleveland Clinic said the candidates and those traveling with them were required to submit a negative result from a test taken within the prior 72 hours. Both campaigns adhered to the rule, said spokeswoman Angela Kiska. The Biden campaign did not specify when the former vice president was tested but said it was within the 72-hour period allowed by the Cleveland guidelines.
Trump first tested positive for Covid-19 on Thursday through a rapid test, which was later confirmed through a PCR test. Trump made the diagnosis public early Friday.
The Trump campaign referred to the White House a question about whether Trump was tested on the day of the debate. A White House spokesman said Trump was tested “regularly” but would not say if Trump was specifically tested the day of the debate.
"That’s part of the problem, you can’t get a straight answer," said Ryan.
Some inside the debate hall, a facility shared with Case Western Reserve University, noted that Trump was sweating on stage, despite it being relatively cool in the room.
“It was probably around 68 degrees. President Trump was visibly sweating. He looked unwell. He looked agitated, but frankly I hadn’t thought of it at the time. I just took it as an indication he was wound up,” Coons said.
Trump raised his voice at various points during the 90-minute session, increasing the likelihood of sending droplets into the air.
Biden has said he would release the result of every Covid-19 test he takes. On Friday, he said he received a negative result; on Saturday, he said he had not taken a test that day. The campaign has not yet released a result on Sunday.
Medical professionals cautioned that Biden is not yet out of the woods.
“If I was one of his advisers, I would tell him to stay close to home for a couple of weeks just to be sure,” said Georges Benjamin, executive director of the American Public Health Association. “It may not be 14 days, it might be 10 days, that might be rational.”
“The good news is we know that he’s wearing a mask and he's following those good public health measures,” Benjamin added. “But again, I would err on the side of caution. Age and just the political consequences, the physical consequences of him getting sick would be intolerable.”
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