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October 07, 2020
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Close monitoring ‘critical’ for Trump, White House staff

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Rajesh T. Gandhi, MD, FIDSA, said it will be important to closely monitor President Trump and other White House staffers and administration officials who recently tested positive for COVID-19.

“Clearly, close monitoring is critical — his doctors have made that abundantly clear,” Gandhi, a member of the Infectious Diseases Society of America’s expert panel on COVID-19 treatment and management guidelines and professor of medicine at Harvard Medical School, said during an IDSA press conference today.

Rajesh T. Gandhi
Rochelle P. Walensky

“We know that after someone gets COVID-19, the first week or so after they show symptoms is the critical period of time when they can get shortness of breath and worsening oxygen levels, and so it is critical to be very vigilant during this period of time, throughout the rest of this week and early into next week,” Gandhi said.

He said roughly 80% of patients with COVID-19 experience mild disease, whereas 15% experience severe disease and 5% acquire critical illness that requires ventilation. Regarding the president’s treatment, Gandhi said it “made sense” to treat him with antibodies. Trump, who was hospitalized over the weekend after announcing early Friday that he had tested positive, also received remdesivir and dexamethasone before returning to the White House.

Gandhi said equitable access to treatment is essential to prevent the spread of SARS-CoV-2, and that “prevention trumps treatment” when it comes to controlling a pandemic.

Also during the press conference, Rochelle P. Walensky, MD, MPH, chief of the division of infectious diseases at Massachusetts General Hospital and professor of medicine at Harvard Medical School, said Trump should isolate for the appropriate amount of time — 10 days after symptom onset for most patients, per CDC recommendations — before returning to the campaign trail, and that any White House staff who have been exposed to someone with COVID-19 should quarantine for 14 days.

Trump has said he will participate in the second presidential debate, which is scheduled for Oct. 15 — 14 days since his positive test.

Walensky also emphasized the importance of contact tracing to prevent further spread.

“There should be robust contact tracing efforts,” Walensky said. “What that means is that people who are diagnosed with COVID-19 receive a rapid phone call — ideally within hours, if possible.”

Walensky said anyone who has been within 6 feet of a person infected with COVID-19 for more than 15 minutes should be included as a contact for that infected person. She said intermittent information has made it difficult to determine whether proper procedures are being followed at the White House.

“We very much need the science to lead the way,” Walensky said.