The Health 202: Trump returns to White House as CDC says infection possible with social distance

The CDC officially said the virus can spread through aerosols — underscoring how easily it can be transmitted. 

A CDC Web page now acknowledges sometimes people can still get infected with the virus — even when they’re at least six feet apart.

“There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than six feet away,” the updated page states. “These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.

“Under these circumstances,” it says, “scientists believe that the amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people. The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left.” 

The latest guidance underscores the risks as Trump returns home – and residence staff tends to two active coronavirus patients. 

Around 6:30 p.m., the president appeared at the doors of the Walter Reed National Military Medical Center after a three-night stay to be treated for his own case of covid-19, clad in a suit and mask as he waved and gave a thumbs-up signal. Shortly after arriving at the White House, Trump tweeted a short video depicting himself exiting the helicopter and climbing up the stairs to pose for pictures. 

A few hours earlier, the president told Americans “dont be afraid” of covid-19:

“Trump’s comments… again downplaying the coronavirus came despite evidence that White House decisions to flout public health guidelines and engage in practices viewed as reckless have had dire consequences in the West Wing,” The Post’s Toluse Olorunnipa and Josh Dawsey write.

More than a dozen White House officials have tested positive in recent days. Trump’s doctor Sean Conley, who said Trump was “not out of the woods yet” said the medical team made “some recommendations for how to keep everything safe down at the White House.” 

“Conley declined to describe what specific steps would be made to ensure a safe environment at a building that doubles as a personal residence and a government office while the president remains contagious, which could be for several more days at least,” Toluse and Josh write. 

White House staff have abandoned the West Wing, but some are already infected.

Press secretary Kayleigh McEnany and two of her deputies reported testing positive for the virus yesterday, prompting a flurry of criticism for briefly removing her mask Sunday while briefing the press. McEnany wrote that she wasn’t in contact long enough with anyone to be considered a “close contact” by the White House Medical Unit. 

CBS News correspondent Weijia Jiang:

Other prominent figures who tested positive include former Trump counselor Kellyanne Conway and Sens. Thom Tillis (R-N.C.) and Mike Lee (R-Utah), all of whom attended a Rose Garden ceremony announcing the nomination of Amy Coney Barrett to the Supreme Court 10 days ago. Former New Jersey Gov. Chris Christie, who helped Trump with debate prep, also tested positive and checked himself into the hospital.

A White House official told the New York Times it has decided not to trace the contacts of guests and staff members at the event, instead limiting efforts to notifying people who came in close contact with Trump in the two days before he was diagnosed with covid-19. Nor will the Centers for Disease Control and Prevention be engaging in any contact tracing efforts around the celebration, Apoorva Mandavilli and Tracey Tully report.

The CDC news resolves heated debate around the tiny droplets that can move distances farther than six feet. 

Scientists have urged public health authorities to acknowledge airborne transmission by these tiny particles, which can hand out in the air for minutes or hours, is possible. But agencies including the CDC and the World Health Organization were slow to do so — perhaps because the possibility could mean the virus is even harder to keep in check than originally imagined.

The CDC still notes that larger respiratory droplets emitted when someone coughs, sneezes, sings, talks or breathes are the main routes of viral spread. And the distance people are standing apart, along with the length of time, are still key factors in determining someone’s risk of being infected.

“The update follows an embarrassing incident last month when the agency removed a draft that had not gone through proper review and was posted in error,” Lena H. Sun and Ben Guarino report. “The draft’s wording included a reference to aerosols … Officials said the draft was removed because they feared the language could be misinterpreted as suggesting that airborne transmission is the main way the virus spreads.”

Ahh, oof and ouch

AHH: There are a lot of details we still don’t know about Trump’s state of health. 

Some doctors and health experts indicated that the treatments he received suggested a more severe course of the disease than the White House let on. The Trump administration has refused to release certain details of Trump’s symptoms, including whether he has any evidence of pneumonia or lung damage. 

The Post’s national campaign editor: 

The administration has also been tight-lipped about the last date that Trump received a negative coronavirus test. It’s a data point that could be crucial for tracing contacts who may have been exposed to the virus.

“I don’t want to go backwards,” Conley said when asked about the date at the press conference.

White House press secretary McEnany said in July that Trump’s testing regimen included multiple screenings for the virus each day, but some have speculated that the administration’s reticence in releasing the date of his last test could be an indication that he was tested less frequently.

CNN White House correspondent John Hardwood:

Trump will return to a White House complex with two medical clinics and access to helicopters that can rush him to a hospital in case of an emergency. 

Joshua Topolsky, editor-in-chief of Input:

OOF: The White House is blocking the FDA’s new, tougher vaccine guidance.

Top officials told the New York Times that the White House is blocking the FDA’s proposal for stricter vaccine guidelines, which would have made it extremely difficult to approve a vaccine before the Nov. 3 election. 

“The Food and Drug Administration submitted the guidelines to the Office of Management and Budget for approval more than two weeks ago, but they stalled in the office of Mark Meadows, the White House chief of staff. Their approval is now seen as highly unlikely,” the New York Times’s Sharon LaFraniere and Noah Weiland report.

The guidelines, which were seen as a way of reassuring a wary public about the safety of any vaccine, would require that volunteers in any Phase 3 clinical trial be followed for two months after their final shot in order to ensure that there are no serious side effects and that the vaccine’s protections are not short-lived. Officials told the Times this requirement was a sticking point for the White House.

“The struggle over the guidelines is part of a monthslong tug of war between the White House and federal agencies on the front lines of the pandemic response,” LaFraniere and Weiland write.

The FDA has been seeking other avenues to ensure that the vaccines meet strict standards, including potentially sharing the guidelines with an outside advisory committee of experts that will meet publicly to review data from the vaccine trials before any approval.

OUCH: Trump’s battle with covid-19 hasn’t stopped politicians from flouting public health guidelines.

Republican senator Ron Johnson attended an event in his home state of Wisconsin on Friday night while awaiting a virus test result. The next day he announced that he tested positive for the virus.

“Three Republican congressmen who traveled with the president on Air Force One last week — on the flight during which Trump senior adviser Hope Hicks was ill — flew back to Minnesota on a commercial flight on Friday, despite having been in contact with the president,” Branswell writes.

While there are seemingly more instances of Republican lawmakers ignoring public health guidance, some public health experts have suggested that Biden should take part in in-person campaigning given his recent debate against Trump who may have been contagious with the virus at the time.

Meanwhile, Senate Republicans are still moving forward with the confirmation of Amy Coney Barrett to the Supreme Court, despite calls for delay from Democrats after three Senate Republicans announced they had tested positive in a span of 24-hours.

“If we have to go in and vote, I’ve already told leadership I’ll go in a moon suit,” said Johnson.

Senators will have the option of attending the hearing virtually.

The upcoming debates

Wednesday’s vice-presidential debate will feature plexiglass barriers.

The Commission on Presidential Debates agreed to a request from the Biden campaign to install the barriers as a precaution against the coronavirus, after Trump tested positive and was hospitalized just days after his debate with Biden. The Trump team agreed to the new precaution but said they did not want Vice President Pence to be boxed in by plexiglass in his debate against. Sen. Kamala D. Harris (D-Calif.).

“The decision follows a furor over last Tuesday’s debate between President Trump and former vice president Joe Biden, at which several people in Trump’s entourage did not wear masks,” The Post’s Chelsea Janes, Josh Dawsey and Matt Viser report. “At least 11 people involved in the setup and staging of last week’s presidential debate have tested positive for the virus.”

Some public health experts have questioned whether debates should be held in-person at all, pointing out public health guidelines that call for a 14-day quarantine for anyone exposed to the virus. Pence interacted with Trump and other people who have since tested positive at a recent Supreme Court nomination ceremony in the White House Rose Garden.

The questions over debate protocols come as the Trump administration is under pressure for flouting agreed upon public health precautions during Tuesday’s presidential debate. Fox News anchor Chris Wallace, the moderator of that debate, excoriated the Trump team over the weekend on “Fox News Sunday.”

“The rules from the Cleveland Clinic could not have been more clear. Everyone, everyone in the audience was to wear a mask,” Wallace said. “After the first family came in, they all took off their masks. So did the White House chief of staff Mark Meadows. Do they think that the health and safety rules for everybody else do not apply to them?”

Coronavirus latest

  • Top health officials met with a group of doctors who have promoted a strategy of herd immunity in response to the coronavirus. Health and Human Services Secretary Alex Azar and Trump adviser Scott Atlas met with three epidemiologists – Martin Kulldorff, a professor at Harvard; Sunetra Gupta, a professor at Oxford; and Jay Bhattacharya – who have advocated for allowing the virus to spread relatively uncontrolled through younger populations while protecting the elderly and other high risk groups. It’s a strategy many experts say could lead to additional deaths, The Hill’s Jessie Hellman reports.
  • New York Gov. Andrew M. Cuomo rejected a plan to from New York City Mayor Bill de Blasio to roll back the opening of nonessential businesses in virus hot spots in Brooklyn and Queens. The move is one in a long series of clashes between the two political figures. Several aides to Cuomo suggested that the governor may roll out his own plan this week, the New York Times reports.
  • D.C. Mayor Muriel E. Bowser and Council Chairman Phil Mendelson control a combined $355,000 in charitable funds that they oversee for the aid of constituents, but neither has made a single donation during the course of the pandemic, The Post’s Fenit Nirappil reports.

It’s not all bad

The Nobel Prize in Medicine was awarded for work on hepatitis C.

“The Nobel Prize in physiology or medicine was awarded Monday to researchers from the United States and Britain whose discoveries helped save millions of lives from the ravages of blood-borne hepatitis, a major global health problem that causes cirrhosis and liver cancer,” The Post’s Sarah Kaplan reports.

While working as a clinical scientist at the National Institutes of Health, Harvey J. Alter showed that hepatitis C was bloodborne and likely caused by a virus. Years later, British-born virologist Michael Houghton cloned the virus and identified antibodies against it, while Charles M. Rice, at the time a researcher at Washington University in St. Louis, used genetic analysis to set scientists on a path for a cure.

“Their research helped almost eliminate the risk of getting hepatitis C through blood transfusions and led to the development of antiviral medications that can clear the virus from the bodies of infected patients,” Kaplan writes.

Hepatitis C is still the most common blood-borne illness in the United States and kills tens of thousands of Americans each year. Even though the disease is curable, many Americans don’t get treatment because of stigma and the high cost of treatment.

Sugar rush

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