Use of Coronavirus Rapid Tests May Have Fueled White House Covid-19 Cluster, Experts Say

At least eight people who attended the White House’s recent Supreme Court nomination ceremony for Amy Coney Barrett have tested positive for the coronavirus, and public health experts say they expect more attendees to be diagnosed in coming days.

The White House says it has relied on rapid testing to help prevent the spread of Covid-19 among officials and guests. Officials don’t wear masks or socially distance because they are tested daily. The president is also tested for the coronavirus every day, as is anyone who comes in close contact with him.

The administration relied on

Abbott Laboratories

’ ID Now rapid test at the Sept. 26 event for Judge Barrett. After guests tested negative, they were ushered to the Rose Garden, where few people were wearing masks. The White House didn’t comment on whether anyone screened at the event tested positive.

Public-health experts say the White House isn’t using the test appropriately, and that such tests are not meant to be used as one-time screeners. Regardless of the type or brand of test, any strategy that relies solely on testing is insufficient for protecting the public against the virus, epidemiologists and researchers say.

President Trump’s schedule in the week before he was diagnosed with Covid-19 included a Rose Garden event, a presidential debate, and visits to three states. Photo: Getty Images

“What seems to have been fundamentally misunderstood in all this was that they were using it almost like you would implement a metal detector,” said Ashish Jha, dean of Brown University’s school of public health.

All tests, including those processed in a lab, can produce false negatives, he and other experts say. Some studies have shown that the Abbott Now ID test, which can produce a result in minutes, has around a 91% sensitivity—meaning 9% of tests can produce false negatives.

“A metal detector that misses 10% of weapons—you’d never, ever say that’s our only layer of protection for the president,” said Dr. Jha.

Such rapid tests trade some accuracy for speed, and need to be administered multiple times to a person over a period of days or weeks to be useful for screening, he said. The idea is that if the test misses the virus one day for whatever reason, it will be more likely to catch it on another.

“No test detects the virus immediately after the person becomes infected,” said an Abbott spokesperson in a statement. “Today we have lab-based and rapid tests that help reduce the risk in society and slow the spread of the virus. The goal should be to test often—or if that’s not possible, to test if you’ve been exposed or have symptoms—and find out if you have it. If so, you’ll know to isolate to prevent spread.”

A multipronged approach is vital, epidemiologists and researchers say. That includes socially distancing, masks and avoiding crowds.

Former New Jersey Gov. Chris Christie and other guests at the ceremony for Judge Barrett. Mr. Christie has tested positive for coronavirus.



Photo:

Rod Lamkey – Cnp/Zuma Press

The virus spreads via large and small droplets infected people emit when they talk, laugh, shout, and breathe. People near an infected person can breathe in those particles and become infected. The closer someone is to an infected person, the higher the likelihood they will come in contact with enough viral particles to get infected.

Some guests at the White House event were seen hugging, kissing and standing very close together without masks. The outdoor ceremony, during which people were seated in close proximity to each other and sometimes cheering loudly, lasted about 20 minutes.

The CDC generally defines prolonged contact as 15 minutes or more of unprotected interaction with another person less than 6 feet away. It could take less time with a sneeze in the face or other intimate contact.

As of Sunday, the list of attendees with positive coronavirus tests included President Donald Trump, first lady Melania Trump, former White House adviser Kellyanne Conway,  Sen. Mike Lee, (R., Utah), Sen. Thom Tillis, (R., North Carolina), University of Notre Dame President John Jenkins and former New Jersey Gov. Chris Christie. The eighth person, a journalist, hasn’t been named.

Judge Barrett tested negative for coronavirus on Friday.

Mrs. Trump and Ms. Conway have said they were going to quarantine. Mr. Trump is hospitalized at Walter Reed National Military Medical Center.

“President Trump’s top priority has been the health and safety of the American people which is why we have incorporated current CDC guidance and best practices for limiting Covid-19 exposure to the greatest extent possible,” said White House spokesman Judd Deere.

The nomination event and the spate of cases following it point to a failure in the Trump administration’s approach, epidemiologists said.

“The White House has not been the best at infection prevention measures as a holistic approach,” said Saskia Popescu, an infectious-disease epidemiologist at George Mason University. “This particular event is a good example of why that approach is not successful.”

Infectious-disease experts say it is too early to call the Sept. 26 gathering, which included the Rose Garden ceremony and a smaller gathering with Judge Barrett and her family indoors, a superspreader event, but that it had all the ingredients for one: prolonged, close contact without masks among a large group of people. An estimated 150 to 200 people were in attendance.

It could be weeks before the full effects of the event play out, researchers said.

It is unclear whether the guests caught it there, or if they were already infected before attending and tests screening attendees didn’t catch some cases.

Understanding how the body clears the new coronavirus is becoming more important as the U.S. begins to reopen. WSJ’s Daniela Hernandez explains how the body fights infection and why feeling better doesn’t equal being virus-free. Photo illustration: Laura Kammermann

Superspreader events are worrisome because they tend to seed additional rounds of infection, he and others said. For instance, someone who got infected on Saturday could go back home and spread it to others in their community before knowing they were even infected.

Such asymptomatic transmission is what has made containing the pandemic so difficult, experts say.

The risk of transmission is higher indoors because the natural mixing of air doesn’t happen as efficiently and so there is less dilution of potentially infectious particles. A building’s ventilation system may not mix the air well or equally throughout a room, creating pockets of air where viral particles can build up, said Rachael Jones, a health specialist at the University of Utah who studies how infectious diseases are transmitted in indoor environments.

The longer people are inside together, the more exposed they are to the virus. The White House declined to comment on how long the indoor portion of Saturday’s events lasted.

The ceremony itself was held outside, which lowers the risk of transmission, experts say. When people are outdoors, there is more space for potential virus-laden particles to spread out, lessening the risk of catching the virus. But being outside is not completely protective, they say.

“I know we’ve been harping on doing things outdoors, but that was not for hundreds of people for an extended period of time. Packing people together without masks defeats the purpose,” said George Mason University’s Dr. Popescu.

When Notre Dame President Rev. Jenkins arrived at the White House on Sept. 26,  he was taken to a room where he was tested using a nasal swab, a Notre Dame official said. He was then taken to another room with a few other people to await results, where everyone was wearing a mask. After his test came back negative, Rev. Jenkins was taken to the Rose Garden and told he no longer had to wear a mask.

On Friday, the school said he tested positive for the virus.

He said not wearing a mask at the event was an error in judgment and that he regretted it. “My symptoms are mild and I will continue to work from home,” he said through a school spokesman. “The positive test is a good reminder for me and perhaps for all of us how vigilant we need to be.”

Write to Sarah Toy at [email protected] and Daniela Hernandez at [email protected]

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