President Donald Trump and first lady Melania Trump tested positive for COVID-19. Here’s a look at where he traveled the week before his diagnosis.
While the nation watches and waits to see how President Donald Trump will fare as he’s treated for COVID-19, doctors say there are lessons the American people can learn from his infection in the midst of a pandemic that has so far killed more than 200,000 Americans and infected 7.3 million.
Key among them is that no one is invulnerable to a disease that doesn’t pick and choose whom to infect based on political affiliation or status.
“I remain eternally optimistic that this will be the week that more Americans recognize the severity of this epidemic and just how many more Americans might die this fall and winter, and begin to take greater responsibility for it,” said Dr. Theodore J. Iwashyna, director of health services research and an associate professor of internal medicine, pulmonary and critical care medicine at the University of Michigan.
Dr. Theodore J. Iwashyna, director of health services research and associate professor of internal medicine, pulmonary and critical care medicine at the University of Michigan and research scientist at the VA Ann Arbor Healthcare System. (Photo: University of Michigan Health System)
“I hope that some will do so and I hope that our leaders will use this as an opportunity to remember that this is about a virus whose transmission can be reduced, not as an excuse to score political points.”
Trump announced early Friday morning that he and first lady Melania Trump had tested positive for the novel coronavirus.
Nearly a dozen others who were in close contact with the president or other White House officials also have tested positive for the virus, leaving the nation reeling just a month from Election Day.
Dr. Trini Mathew, an infectious disease specialist and epidemiologist for Beaumont Health, said the Trumps are getting the highest-quality medical care, and it’s not time to panic. But, she said, it is time for ordinary people to take a hard look at their own lives, and do what they can to prevent the spread of COVID-19.
“This news just shows that the virus can infect anyone, and therefore we need to be serious,” she said. “It’s not just protecting ourselves as an individual, but it is also protecting others around us. This is what this news headline is showing us, right? One person around the POTUS being positive, and then potentially infecting others.
Dr. Trini Mathew, (Photo: Beaumont Health)
“That’s exactly what we know with infections and viruses. … They get transmitted from one person to another person. And I hope that this is a good reminder for all of us to think about it. This pandemic is not over. This is a serious disease.”
Wear a mask, social distance
The president is being treated at Walter Reed National Military Medical Center, and his physician, Dr. Sean Conley, said Saturday that he is “doing very well.”
Trump, he said, had a mild cough, congestion and fatigue Thursday, “all of which are resolving.”
“He is receiving outstanding multidisciplinary care. … We are monitoring him very closely,” Conley said.
Mathew urged people who may have been skeptical about wearing a mask in the past to start wearing one now.
“Frequently, I do see people not wearing the mask or not wearing the mask correctly,” she said. “It can inadvertently slip down the nose and then only protect the mouth. So I think those who are wearing masks also need to be cognizant of that, how to wear the mask correctly, and also to be careful where our hands are when we are having the mask on. We may have contaminated our hands and touched contaminated objects around us, and then touch our masks.
“I think this is a good time for us to all be calm and think through the process of how we wear masks, how we wash our hands, and what we can do to protect ourselves.”
“In general, public health guidelines are incredibly important,” he said.
“I still wear a mask whenever I go out. I try to maintain social distancing. And I am working from home whenever I’m not in the hospital. When I’m in the hospital, as a physician, I use PPE (personal protective equipment) all the time. We do know that PPE works.
“We know that the rate of health care worker infection among people who have had access to PPE has been incredibly low. … PPE works if people wear it. It doesn’t work if you don’t.”
Testing isn’t a panacea
Though at least 10 people close to the president have now tested positive for the coronavirus, many — including former Vice President Joe Biden, the Democratic presidential candidate who shared a debate stage with the president Tuesday night — have gotten negative test results.
Mathew said people ought to remember that a negative test isn’t a panacea, and test results don’t always give an accurate picture of whether someone is infected.
If you’re told by public health officials that you’ve been exposed to a person with COVID-19 and must quarantine for 14 days, it’s important to follow through, even if a test comes back negative.
“There are chances for a test to be false negative, especially when patients have all the signs and symptoms of COVID,” Mathew said. “We saw that with the first COVID surge … and that is because of when the testing was done in the continuum of the disease.
“Now the flip of that is as the prevalence in the community comes down, there’s always a possibility that someone may have a false positive test.”
After a close exposure to a person with a known case of COVID-19, it makes sense to get tested, she said. But the timing of the test matters.
“A negative test does not exclude that they have been infected,” she said. “I just want to emphasize that piece that even if people decide to get themselves tested after an exposure, a negative test does not exclude an infection or exclude them from quarantine.
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The reason is because that test result depends on many factors. One factor is the continuum of the disease. Was the sample collected when the disease is really taking a foothold … and manifesting and viral replication is occurring? Another piece for people to remember is how the test is being done. It’s what they call operator dependent.
“For example, with the nasopharyngeal swab, did you … get a good swab? Did you collect it well? Because that would also influence our results.”
That’s why it’s important for doctors to look at the full picture when interpreting the results of any test.
“This concept about false negative and false positive can occur with any testing,” Mathew said. “Even if the test is initially negative, but we see that the patient is continuing to have certain signs or symptoms or maybe getting worse, we repeat those tests.”
Flu season amid a pandemic
The nation could see another crisis as fall settles in, Mathew said, because it brings with it flu season. It’s also the time of year when other respiratory viruses ramp up.
People should catch up on vaccinations that may be overdue and get the flu vaccine, she said.
That’s especially true, Mathew said, for anyone who is considered high-risk for severe illness from COVID-19, such as people who are obese or have diabetes, heart disease or kidney disease.
“These are the groups of people that we’ve always been concerned about having potentially worse outcomes once they get infected with a viral infection,” she said. “We want to keep our immunity up in case we have to also fight COVID.
“So get your flu shot. Do not be on the fence on that. We always know that there has been controversy, and that it doesn’t offer 100% protection, but some protection now is better than no protection.”
Illness is not a punishment
Since the pandemic began, Trump has repeatedly disregarded public health guidelines, such as wearing a mask and adhering to social distancing recommendations put in place to stop or slow the spread of COVID-19.
He mocked Biden during Tuesday’s presidential debate for wearing a mask and has refused to wear one himself when he’s in close contact with other people.
President Trump and former Vice President Joe Biden argue what to do about COVID-19 and the pandemic at the first 2020 presidential debate.
And yet, Iwashyna, who also is a research scientist at the VA Ann Arbor Healthcare System, said it helps no one to suggest the president deserved to get sick or blame the president for his own infection.
He tweeted Friday morning: “Illness is not a metaphor Illness is not a judgment Illness is not a test of character,” and explained that those ideas come from the late writer Susan Sontag and her book “Illness as Metaphor.”
“It references the way we used to think of tuberculosis as a sign of a fine artistic temperament and the wasting young women, all pale, as a sign of proof of their goodness.
“And then we saw AIDS as evidence of the moral wrongness of the gay community and African communities and so that it was a judgment and plague upon them.
“And then we saw with Sen. (John) McCain dying of cancer that people talked about his strength and his fighting, as if metastatic cancer was something that if he were just a strong enough person, he could fight off.
“As an ICU (intensive-care unit) doctor, I can tell you that’s not the way biology works. Indeed, it’s profoundly unhelpful for patients to think of illness as a test of character and a judgment upon them.”
That Trump has COVID-19, he said, should not be seen as anything other than what it is.
“It’s a virus that is able to get into certain kinds of cells and infect them,” Iwashyna said. “And some immune systems are able to clear it and some aren’t. That’s just true.
“As a physician, I would care for anyone who was sick, regardless of whether I agreed with them or not. And so I would hate to think of anyone using this moment to say it’s a judgment on someone they disagree with any more than the 200,000 other Americans who died of this disease had a judgment cast upon them.
“There are certainly institutional public health and political choices that could have been made to reduce the risk of transmission that were not made. But it’s a virus, and the outcome of infection with this virus for these two people are going to be the result of chance and hopefully the superb medical care that they’re able to get access to as a result of eight months of incredibly intense research.”
Personal responsibility matters
The hope, Mathew said, is the news of the president’s illness will help people see that their actions can have a ripple effect.
“I know we have gone through many months of talking about COVID and all of us are in the state of fatigue, and we may be getting less and less vigilant,” she said. “But it is our individual personal responsibility to not just protect ourselves but others around us because our actions really do influence others’ health.”
That’s true, she said whether it’s COVID-19 or other infectious diseases like the flu or measles. Just as refusing to wear a mask makes it more likely you may contract COVID-19, and spread it to other, more vulnerable people, refusing a flu vaccine may mean you contract the flu and do the same.
“We, in society, are interconnected, Mathew said. “And this is exactly what this pandemic has shown us, that individual responsibility really is important because it impacts all those around us — the social networks we have, the people we like to be with — our actions influence those other people.”
Iwashyna said Americans should look to other parts of the world that are doing a better job controlling the spread of COVID-19, and take away valuable lessons.
“We as Americans want to believe that somehow because of our great nation everything is different here,” he said. “It’s not. Viruses are still viruses. And the epidemic is not over here.
“The epidemic is not over here because we have chosen, as a group as a society, not to engage in the public health practices that have worked in every other nation that has imposed them.
“There’s a possibility that it’s going to be a very bad fall and winter and I think this just reminds us about our common humanity and that power and privilege will not necessarily protect one. … We are all at risk and we all need to do this together.”
Follow Kristen Shamus on Twitter @kristenshamus
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