The Covid Pandemy in the actuality, the polemic at the White House

Some employers are relying on rapid tests to reopen. The outbreak around President Trump shows the shortcomings of that approach. In July, John Constantine posted a 14-foot-long banner outlining the government's guidance for handling Covid-19 exposure in the conference room at Arcpoint Labs, where he is the CEO. In normal times, Arcpoint oversees labs and guides employers through drug and alcohol testing laws and policies. Now, its business is a bit different:It’s testing, and advising companies on how to test for, SARS-CoV-2, the virus that causes Covid-19. The banner was meant to help Arcpoint employees guide others through proper workplace testing procedures as more companies considered returning to work. But just days after the big sign was posted in the conference room, an employee had to revise it with printer paper and Scotch tape. The testing guidelines from the Centers for Disease Control and Prevention had changed. “It’s a symbol of the fluidity of the situation,” says Constantine. “New data comes out. Guidelines are getting launched and then they're getting retracted.”

President Trump’s positive coronavirus test last week has been widely viewed as a symbol, mostly of the administration’s mismanagement of the pandemic response. But the way Trump and 40-odd others seem to have contracted the virus—by ignoring some of the government’s own recommendations against large gatherings, and for social distancing and face masks—symbolizes something else, too: the challenge for workplaces to adapt to a new pandemic normal, and keep their facilities safe for their employees. The White House is lots of things, but it’s an employer, too.

If White House officials want to find the origin of its outbreak, they could use viral genomics to identify a source and a location. But time is quickly running out.

WITH THE FLURRY of COVID-19 cases coming out of the White House, experts have been calling for classic contact tracing to identify who else might be at risk. But these investigations could go even further by adding a technique called viral genome sequencing. Popular among disease detectives, this could answer when and how President Donald Trump himself was exposed. Much of the focus has been on a September 26 event in the Rose Garden, where the president announced his nomination of Judge Amy Coney Barrett for the vacancy on the Supreme Court. The gathering has been described as a superspreader event, as at least a dozen guests have reported testing positive since. A debate has flared over whether the White House has done enough to trace; guests weren’t immediately notified, and the involvement by the Centers for Disease Control and Prevention has been restricted. Meanwhile, the cluster continues to grow, as a Federal Emergency Management Agency memo reported October 7 that so far, 34 White House staffers, housekeepers, and "other contacts" have been infected with the coronavirus, along with the president, the First Lady, a Navy admiral, and a number of campaign aides.

But Trump and his cadre may have been exposed before the Barrett ceremony, given social distancing and mask wearing aren’t always practiced at their campaign events. Using viral genome sequencing would not only help public health officials sketch the timeline of how the disease spread, but could convey whether the afflicted were exposed at various moments and places on the campaign trail, or all at once. Here’s how that would work. The virus that causes COVID-19 has a genome based on RNA, which like DNA, is made up of a sequence of chemical “letters” called nucleotides. As the coronavirus invades people’s cells and multiplies, it naturally makes mistakes when replicating its genetic code, swapping a few of those letters. “Imagine having to copy 30,000 letters by hand,” says Stephanie Spielman. “Imagine having to copy 30,000 letters by hand,” says Stephanie Spielman, assistant professor of biological sciences at Rowan University. ”You might make a mistake, and that’s what a mutation is.”

At least 11 people who attended a White House event on Sept. 26 have since tested positive for the coronavirus. Eight of them, including the first lady, sat in the first several rows of a nomination ceremony for Judge Amy Coney Barrett in the White House Rose Garden. Those diagnosed include the president himself. Few people at the outdoor ceremony wore masks or kept their social distance. But experts say the more risky time spent that day was at a reception inside the White House, where President Trump met with a smaller group of guests. There, Mr. Trump mingled with Judge Barrett, her family and prominent Republicans in the Oval Office and in the Diplomatic Room. Research has shown that transmission of the virus tends to happen indoors, and gatherings where guests are maskless and in tight quarters can be a recipe for “super spreader” events.

It is not clear when exactly the attendees who later tested positive were infected, and the White House has said all guests tested negative for the virus before the event. Still, it can take several days after exposure for the virus to be detected by a test. The indoor White House gathering was far from the only time this week that Mr. Trump was in close quarters indoors with family, aides or supporters. Ahead of the first presidential debate on Tuesday night in Cleveland, Mr. Trump held closed-door preparation sessions on Saturday, Sunday, Monday and Tuesday with a half-dozen aides and advisers, including Bill Stepien, his campaign manager; Kellyanne Conway, a former White House adviser; and Chris Christie, the former governor of New Jersey. All of them have since tested positive for the virus. Rudolph W. Giuliani, the president’s personal lawyer, also participated in debate preparation sessions but has said he tested negative. Since the event in the Rose Garden, Mr. Trump traveled in close quarters aboard Air Force One to and from the debate in Cleveland and campaign events in Pennsylvania, Minnesota and New Jersey. At least five other people on those flights later tested positive.