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Why don’t you need a negative coronavirus test to leave isolation?

President Donald Trump’s doctor on Saturday said Trump has met criteria from the US Centers for Disease Control and Prevention to leave isolation after falling sick with the coronavirus.



a man wearing a suit and tie: US President Donald Trump walks to Marine One prior to departure from the South Lawn of the White House in Washington, DC, October 2, 2020, as he heads to Walter Reed Military Medical Center, after testing positive for Covid-19. - President Donald Trump will spend the coming days in a military hospital just outside Washington to undergo treatment for the coronavirus, but will continue to work, the White House said Friday (Photo by SAUL LOEB / AFP) (Photo by SAUL LOEB/AFP via Getty Images)


© Saul Loeb/AFP/Getty Images
US President Donald Trump walks to Marine One prior to departure from the South Lawn of the White House in Washington, DC, October 2, 2020, as he heads to Walter Reed Military Medical Center, after testing positive for Covid-19. – President Donald Trump will spend the coming days in a military hospital just outside Washington to undergo treatment for the coronavirus, but will continue to work, the White House said Friday (Photo by SAUL LOEB / AFP) (Photo by SAUL LOEB/AFP via Getty Images)

The White House didn’t say Trump had actually tested negative for the virus — but according to CDC guidelines, people don’t generally need a negative test to be around people again.

Here’s why:

People can test positive even if no longer infectious

Earlier in the pandemic, health officials said people should have two negative tests for coronavirus — taken 24 hours apart — before being around people again. That forced some people into isolation for weeks on end.

But coronavirus tests can’t necessarily determine whether someone is infectious. PCR tests, for example, just look for pieces of genetic material called RNA — and that can linger long after someone has recovered.

According to the CDC, research has shown that people aren’t likely to be infectious 10 to 20 days after symptoms first began, regardless of test results.

To figure that out, scientists have taken samples from coronavirus patients and tried to infect living cells. Even though PCR tests can come back positive, people don’t tend to be infectious after that 10- to 20-day window has passed.

Think of it this way: A PCR test is looking for the blueprint of the virus — its “genome” — and not for the virus itself. In fact, the test is just looking for fragments of that blueprint.

It’s like a recipe for chocolate cake; finding the recipe in someone’s kitchen doesn’t mean you’ll find a cake.

Why might Trump not need to isolate for 20 days?

People with mild to moderate Covid-19 are thought to remain infectious “no longer than 10 days after symptom onset,” according to the CDC.

For patients with severe Covid-19, the CDC says up to 20 days of isolation “may be warranted.” But the agency’s recommendations only require 10 days. “Consider consultation with infection control experts,” the CDC’s recommendations say.

The President’s physician, Dr. Sean Conley, released a memo Saturday that referenced “advanced diagnostic tests” and stated “there is no longer evidence of actively replicating virus” from Trump.

Still, the letter didn’t fully describe those advanced diagnostic tests or their exact findings.

The President’s doctor said Trump had undetectable “subgenomic mRNA.” Those are molecules produced when viruses replicate. Their absence may suggest Trump is no longer shedding live virus.

But Conley did not detail what “advanced diagnostic tests” the President had

Trump has met CDC criteria to end isolation and is cleared to return to an active schedule by his physician

President Donald Trump has been cleared to return to an active schedule, according to a new memo from his physician, Dr. Sean Conley, released Saturday night.



Donald Trump wearing a suit and tie: President Donald Trump removes his face mask to speak from the Blue Room Balcony of the White House to a crowd of supporters, Saturday, Oct. 10, 2020, in Washington. (AP Photo/Alex Brandon)


© Alex Brandon/AP
President Donald Trump removes his face mask to speak from the Blue Room Balcony of the White House to a crowd of supporters, Saturday, Oct. 10, 2020, in Washington. (AP Photo/Alex Brandon)

The memo says Trump has met criteria from the US Centers for Disease Control and Prevention to end isolation but does not say Trump has received a negative coronavirus test since first testing positive for the virus last week. However, that is not a criteria for clearing isolation, according to the CDC.

“This evening I am happy to report that in addition to the President meeting CDC criteria for the safe discontinuation of isolation, this morning’s COVID PCR sample demonstrates, by currently recognized standards, he is no longer considered a transmission risk to others,” the memo from Conley reads in part.

Conley wrote that Trump is 10 days from the onset of symptoms, has been fever-free for “well over 24 hours” and after diagnostic tests, “there is no longer evidence of actively replicating virus.”

Conley did not fully explain what “advanced diagnostic tests” the President had received. For example, he did not disclose whether so-called viral culture was performed — the process by which scientists try to infect living cells to see whether active virus is present.

The latest disclosure from Conley comes as Trump prepares to return to the campaign trail after being sidelined amid his fight with the virus. It’s likely to raise additional questions about the health of the President as officials continue to provide carefully worded statements as the campaign enters its final stretch.

Trump on Saturday held his first public event since his diagnosis, delivering a highly political speech to a crowd of supporters packed on the White House’s South Lawn. He is currently scheduled to hold at least three in-person rallies this upcoming week, beginning Monday in Florida. Conley says he will continue to monitor Trump “as he returns to an active schedule.”

Officials — including Conley — still haven’t disclosed when the President last tested negative before his positive test last week, which would offer insight into when he was contagious and how much so.

Trump, who left the hospital earlier this week after receiving treatment for the virus, credited his quick recovery to his rapid treatment during an interview with Fox News on Friday.

“I think the secret for me was I got there very early,” he told the network’s medical contributor Dr. Marc Siegel.

Trump had received an immediate dose of an experimental monoclonal antibody therapy at the White House, then was treated with a course of the infused antiviral medication remdesivir and the steroid dexamethasone during his hospital stay. He had also been given supplemental oxygen, Conley previously said.

This story has been updated with additional background information and context.

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