In Nation’s Health
Staffers are checked regularly for coronavirus
Additional administration employees test positive for COVID-19.
The disclosure by President Donald Trump and first lady Melania Trump that they have COVID-19 highlights the role of rapid tests that some say are key to slowing the spread of the disease.
The White House has employed rapid coronavirus tests since March, when Abbott Laboratories gained Food and Drug Administration emergency-use authorization for its product. More rapid tests using different technologies have emerged since spring, giving the White House’s medical team a menu of options for quickly testing close contacts of infected people.
White House officials on Friday would not disclose the type of test the president used to initially detect COVID-19. His diagnosis was confirmed with a PCR test, officials said.
“They would have access to the full force of whatever testing platform they desire,” said Dr. Geoffrey Baird, interim chair of the University of Washington’s Department of Laboratory Medicine.
Mark Meadows, the White House chief of staff, said he fully expects more people in the White House will test positive. White House staffers are tested regularly for SARS-CoV-2, the coronavirus that causes COVID-19.
Press Secretary Kayleigh McEnany in July described Trump as the “most tested man in America,” undergoing multiple tests a day. McEnany announced Monday she also has tested positive for the coronavirus.
The Centers for Disease Control and Prevention recommends tracing and testing all close contacts of people who get a lab-confirmed or probable case of COVID-19. Close contacts are any person within 6 feet of an infected person for at least 15 minutes.
Earlier this year, when lab testing was hard to secure, Trump touted Abbott Laboratories ID Now as an example of a testing machine that could deliver results in 15 minutes. The White House has used the toaster-sized device to test people in the White House. A preliminary study initially posted on a nonpeer-reviewed site and later in the peerreviewed Journal of Clinical Microbiology by researchers at New York University Langone Health concluded the instrument missed a high number of infections, a finding the company disputed.
Baird said there are several portable testing machines that produce accurate and rapid results. The Cepheid’s Xpert Xpress SARS-CoV-2 test uses PCR technology on par with testing machines found in large labs, he said. PCR tests can detect the virus’s genetic material and are the most accurate to detect low levels of the virus.
Baird said Cepheid is a “random access” instrument that can run a single test with results in about 45 minutes.
Antigen tests, which detect proteins, are less expensive, plentiful and deliver results in minutes. Quidel, Becton, Dickinson and LumiraDx gained FDA authorization to sell antigen testing instruments to labs or clinics, and the U.S. Department of Health and Human Services purchased and widely deployed these testing machines to nursing homes where residents are particularly vulnerable.
On Sept. 28, Trump held a news conference at the White House announcing a plan to distribute 150 million rapid antigen tests that can be performed outside a lab. The BinaxNOW test, also made by Abbott, won approval as a $5 rapid, credit-card-sized test, which must be administered by a health care professional. Admiral Brett Giroir, who oversees the nation’s testing efforts, demonstrated the test during the news conference.
Experts who are not part of the White House medical team say there is likely an intensive effort to track and test all of the president’s close contacts in recent days.
Trump announced Thursday night that his adviser Hope Hicks, who recently traveled with Trump, had COVID-19. Just before 1 a.m. Friday, the
president disclosed that he and Melania Trump also contracted the virus.
Hicks and Trump shared a flight on Air Force One and Marine One during that past week.
“Almost everyone who was on an airplane is going to meet that criteria” as a close contact who needs to be tested, said Dr. Yukari Manabe, a Johns Hopkins University professor of medicine. Hicks “would be within 6 feet of everybody. Plus you would have the danger of recirculated air on an air flight.”
A person can be infected with the virus but show no symptoms from two to 14 days. That is why testing close contacts of Hicks and the president is critical.
“Ms. Hicks probably gave people the virus right before she became symptomatic,” Manabe said. “That is really the superpower of SARS-CoV-2. Probably half of the transmission occurs before people realize they have the infection.”
While widespread, frequent testing can detect more people with the virus and prevent spread if people take precautions. But experts rely on people taking public health measures of distancing, wearing masks and frequent handwashing.
William Schaffner, a professor and infectious disease expert at the Vanderbilt University School of Medicine, said testing is an effective tool to identify the virus. But even testing has limits in the fight against COVID-19.
“You can’t rely on testing to keep the COVID virus outside the door,” Schaffner said. “The White House has been notorious in not performing the routines that public health has been recommending. If there is a silver lining in all of this, it is perhaps some of those messages will have a greater effect all across the country.”