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Saturday, October 3, 2020

Why Trump’s testing strategy failed him


President Donald Trump’s Covid-19 diagnosis exposed the folly of the White House’s dependence on coronavirus testing to protect against the deadly pathogen and shake off remaining restrictions on American life.

News of Trump’s infection comes weeks before the election and amid constant calls from the White House to broadly reopen the economy, send children back to school and essentially return to normal. Central to this vision was a deployment of rapid coronavirus tests, with little emphasis on other public health measures that experts long identified as critical to keeping the virus in check.

But the tests, which were supposed to deliver results in 15 minutes, couldn’t protect the most fortified compound in the country at perhaps the most critical moment in Trump’s presidency, leaving him and a growing share of his inner circle stricken and the government in chaos.

“They had this false belief that testing would suffice — and it was clearly just wrong,” said New York University bioethicist Arthur Caplan.

Just this Monday, Trump in a Rose Garden announcement touted his administration’s plans to distribute 100 million rapid coronavirus tests to states by the end of the year, claiming they would help schools and economies open “immediately and as fast as they can” as he took a swipe at state restrictions.

"Lockdowns can be very harmful, and we have too many states that are locked down right now," Trump said at the time. "The governors are — nobody knows what the governors are doing, actually."

Trump has often bragged about the scope of the country’s testing regime. More than 900,000 coronavirus tests are now administered nationwide each day, which is more than this summer but still short of where experts say the country needs to safely reopen. Daily new cases are hovering around 40,000, and a rapidly approaching flu season could vastly complicate the health crisis in the months ahead, infectious disease experts have warned.

The president has also sent mixed signals on testing, at times blaming them, inaccurately, for an alarming spike in cases. He infamously told a rally in Tulsa, Okla., this summer that he ordered his administration to slow down testing, although health officials later said they never received those instructions.

Testing only provides a snapshot of a person’s infection status, and it may not even detect cases in which patients aren’t showing symptoms. That’s why public health experts preach social distancing, mask wearing, hand washing and disinfecting as effective tools to curb the virus spread.

“There are a few problems with relying on testing as an exclusive strategy,” said Holly Fernandez-Lynch, a medical ethics professor at the Perelman School of Medicine at the University of Pennsylvania. There is a gap between testing and receiving results, leaving a window to infect others if a person does not isolate. It’s also possible for an infected person to not have enough viral material to trigger a positive result while still having the ability to spread the disease to others.

“These delays are why people are encouraged to quarantine if they think they may have been exposed, rather than waiting for confirmation of infection,” Fernandez-Lynch said. “It’s also why social distancing and mask wearing are so important.”

On these measures, Trump’s record is spotty. Trump himself has rarely worn a mask, often questioned their utility and mocked his opponent, Democratic presidential nominee Joe Biden, for his regular mask wearing.

Trump has also flouted social distancing guidelines in campaign rallies, a jam-packed Rose Garden address to the Republican National Convention this summer, and most recently, last Saturday’s announcement of his nominee to the Supreme Court, Amy Coney Barrett, which is seen as a potential source for an outbreak among Republican officials. Masks have been scarce at these events, and White House aides aren’t required to wear face coverings.


Trump and his aides have defended these events by pointing out people in close proximity to Trump are tested. But the White House relied on rapid tests that aren’t as reliable at detecting infections in asymptomatic people as those conducted in labs, which take longer to process.

A spokesperson for Trump’s campaign did not respond to a request for comment. White house spokesperson Judd Deere said the White House has taken precautions to protect against the coronavirus.

“In addition to encouraging social distancing, readily available hand sanitizer, regular deep cleaning of all work spaces, and recommended facial coverings, those in close proximity to the president continue to be tested for COVID-19 to ensure exposure is limited to the greatest extent possible,” he said.

Trump in recent weeks has repeatedly suggested a vaccine could soon be approved and quickly distributed, insisting that the pandemic’s end is just around the corner. But that timeline defies expectations from government scientists, who say it could take until mid-2021 before every American can get inoculated. And that’s in a best-case scenario. The most promising vaccine candidates may not be ready for months.

“It’s important to recognize that there is not going to be a single strategy that helps defeat this virus once and for all, we need to use all the arrows in our quiver,” Fernandez-Lynch said. “Even if we do get a safe and effective vaccine, it won’t be 100 percent effective and other precautions will still be important.”

Federal health officials, including infectious disease expert Anthony Fauci and Surgeon General Jerome Adams, have pleaded with the public to limit social contact and wear masks outside their homes.

But that’s not often the message coming out of the White House.

Asked whether the White House would start requiring employees to wear masks after Trump’s diagnosis, Deere replied: “No.”



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