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| Boilerpipe Text | Editor’s Note: We will continue to update this story as needed.
On Oct. 2, President Donald Trump
revealed
that he and First Lady Melania Trump had tested positive for COVID-19. Here we answer common questions about the risks of the disease, treatments available and the shortcomings of testing.
What do we know about Trump’s risk of developing serious COVID-19?
Without knowing all of Trump’s medical history, it is difficult to know how dangerous his SARS-CoV-2 infection might be. On the morning of Oct. 2, news
outlets
reported
— and White House Chief of Staff Mark Meadows
confirmed
— that the president was experiencing only mild symptoms.Â
White House Press Secretary Kayleigh McEnanyÂ
reiterated
 the symptoms were “mild” in the afternoon, though Trump was taken to Walter Reed National Military Medical Center and would be “working from the presidential offices at Walter Reed for the next few days,” McEnany said.Â
On Oct. 3, a source familiar with the president’s health, who wasÂ
later revealed to be Meadows
, suggested that Trump’s condition was more serious. “The president’s vitals over the last 24 hours were very concerning and the next 48 hours will be critical in terms of his care,” Meadows told a White House pool reporter in a pool report issued at about noon. “We’re still not on a clear path to a full recovery.”
The president’s doctor, Navy physician Sean P. Conley, gave a more upbeat assessment at a
press conference
Oct. 3, describing the president as being fever-free and “doing great.”
During aÂ
press conference
 on Oct. 4, Trump’s physicians emphasized that he continued “to improve” but said that the president had been given the steroid dexamethasone, which
is not recommended
 unless patients require supplemental oxygen. Trump also had experienced two bouts of low oxygen levels, they said, and had been given oxygen at least once, on Oct. 2.
Trump
tweeted
on Oct. 5 that he would leave Walter Reed hospital that evening at 6:30.
At 74 years old, Trump is at higher risk of developing a more severe case of COVID-19 than younger people. Figures from the Centers for Disease Control and Prevention, based on data available through Aug. 6, show that people ages 65 to 74 are
five times
as likely as 18- to 29-year-olds to be hospitalized and 90 times more likely to die.
Other CDC
data
show
that for the month of August, 6.5% of people between the ages of 70 and 79 who were diagnosed with COVID-19 died, and 18% were hospitalized, although some data on death or hospitalization is missing or unknown.
Trump is also a man — and males
have consistently
had worse outcomes, on average, than females — and his last
physical
showed he was mildly obese, with a
body mass index
of 30.5 (30 is considered obese).Â
According to the CDC, obesity
increases the risk
of a severe illness from COVID-19 and may triple the risk of hospitalization. It’s not entirely understood why this is, but carrying too much extra weight has been linked to impaired immune function and fat tissue can also
push up on the diaphragm
, making it more difficult to breathe.
Most people, however — even those with risk factors — do not get seriously ill, so the president’s chances for a mild infection may still be good. He is also not known to have many of the
other risk factors
for serious disease, such as diabetes or kidney disease, and is likely to receive the best possible medical care.Â
Scientists are just beginning to understand why certain people fare so poorly with a SARS-CoV-2 infection while others never develop symptoms or only get mildly ill.
Recent
research
suggests that one difference, which may apply to
about 14%
of severe cases, is that some people don’t produce enough type I interferons early in infection. The proteins are key players in
fighting off viruses
and help kick off a robust immune response, although
too much of them later on
could be detrimental.
In some cases, a poor interferon response may result from people having antibodies that inappropriately target and cripple the interferon, whereas others may be due to faulty genes. The offending antibodies are much
more common
in males. Older people
may also
have defects in how their bodies mount this type of early, or innate, immune response.
Other
research
also
indicates that older people are less likely to produce a sufficient T cell response to SARS-CoV-2. T cells are part of the body’s later, more specific immune response, and assist with producing antibodies and also kill off infected cells. With fewer of these cells, older patients
don’t create a coordinated response
to fight off the virus and are more likely to have poor outcomes.
What do we know about the president’s health?
The president’s doctor
provided the latest update
on Trump’s health on June 3. He said the president “remains healthy.” Trump was 6’3″ and weighed 244 pounds; his cholesterol was 167,
lower than
the previous physical. (A reading below 200
is considered desirable
.) His blood pressure was normal: 121/79.
About six months prior to that report, in November 2019, Trump
made
an unannounced visit to Walter Reed National Military Medical Center, which he and his staff later said was to conduct part of his annual physical. Conley’s memo said his summary included information both from November and an April exam Conley conducted.
The president was taking
rosuvastatin
, a medicine for cholesterol,
finasteride
, used to treat an enlarged prostate or hair loss, and aspirin daily.
In 2018, then-White House physician Dr. Ronny Jackson revealed Trump underwent a coronary calcium CT scan that showed the presence of plaque. Dr. Rachel Bond of Lenox Hill Hospital in New York
told CNN
the score of 133 on the test indicates “he certainly has coronary artery disease because calcium is present. But this is also common for someone his gender, race and age.”
Who in the White House has tested positive over the course of the pandemic?
Before Trump and First Lady Melania Trump revealed they had tested positive for COVID-19,
Hope Hicks
, counselor to the president, tested positive, as of Oct. 1.
CNN
reported
that three journalists who work at the White House, as well as a White House staffer in the press area of the West Wing, had tested positive on Oct. 2.
Nick Luna, a personal assistant to the president,Â
tested positive
, according to Oct. 3 press reports. White House Press Secretary Kayleigh McEnanyÂ
tested positive
 on Oct. 5, she said on Twitter. CNNÂ
reported
 that day that two deputies of McEnany — Chad Gilmartin and Karoline Leavitt — also tested positive.
Stephen Miller, a senior adviser to Trump,Â
tested positive
 on Oct. 6.
Before these cases, National Security Adviser
Robert O’Brien
tested positive in late July; campaign fundraiser
Kimberly Guilfoyle
, the girlfriend of Donald Trump Jr., tested positive the July 4 weekend; and
Katie Miller
, Pence’s spokesperson, tested positive in early May.
Others testing positive for COVID-19 include an
unidentified White House staffer
,
unidentified member of Pence’s staff
, a
White House valet
, former acting chair of the White House Council of Economic Advisers
Tomas Philipson
, a
Marine
with the unit operating Marine One, and a
cafeteria worker
in the Eisenhower Executive Office Building.
Who has tested positive after attending presidential or campaign events?
In early October, others have tested positive for COVID-19 who don’t work in the White House complex, but have had contact with Trump and administration staffers through their work for his campaign or by attending events, such as a
Â
Sept. 26 Rose Garden event
Â
introducing Trump’s Supreme Court nominee, Amy Coney Barrett.
Kellyanne Conway
, a former White House counselor, and former New Jersey Gov.
Â
Chris Christie
Â
— both of whom
Â
assisted
Â
the president in debate preparations and
Â
attended
Â
the Sept. 26 event — announced on Twitter they had tested positive.
Â
Four others who attended the Sept. 26 event have COVID-19:Â
Sens.Â
Mike Lee
Â
andÂ
Thom Tillis,
Rev. John Jenkins
, president of the University of Notre Dame, and Pastor
Greg Laurie
.
Trump Campaign ManagerÂ
Bill Stepien
 tested positive.
Sen.
Â
Ron Johnson
Â
also tested positive, he announced on Oct. 3, though he did not attend the Sept. 26 event at the White House. Republican National Committee Chairwoman
Â
Ronna McDaniel
Â
also has COVID-19; she last was around the president at a Sept. 25 event,
Â
according to the
Â
New York Times
.
The city of Cleveland
Â
announced
Â
that it knew of 11 positive cases “stemming from pre-debate planning and set-up” for the Sept. 29 presidential debate. The city didn’t identify those individuals, only saying “the majority” were “out of state residents.”
Before the recent spate of infections,
Â
six members
Â
of the Trump campaign advance team tested positive prior to a Trump campaign rally on June 20, and
Â
two more staffers
Â
tested positive afterward.
What COVID-19 treatments are available and how effective are they?
Despite Trump’s
repeated insistence
that great progress has been made on COVID-19 treatment, there are
no Food and Drug Administration-approved drugs
for COVID-19 and only one medication has been shown in a clinical trial to improve mortality.
As we explained
before
, when Trump attributed an 85% decline in the
case fatality rate
since April to “pioneering therapies,” most treatment consists of supportive care. And as University of Pennsylvania infectious disease fellow Dr. Aaron Richterman told us in an email, “We have a long way to go in our treatment.”
In a clinical trial, the antiviral drug remdesivir
shortened the time to recovery
among hospitalized patients to a median of 11 days from 15 days. The medication received an emergency use authorization, or EUA, from the FDA, but that is
limited
to use among hospitalized patients.
Convalescent plasma may be effective, but the jury is still out on that — and for now, the National Institutes of Health
treatment guidelines
do not consider it a standard of care and neither recommend for nor against its use. Like remdesivir, it too is only available under
its
EUA
to those who are hospitalized with COVID-19.
The steroid dexamethasone is the only medication to have
demonstrated a survival benefit
in COVID-19 patients. As a drug previously approved for other uses, dexamethasone can be given to any patient off-label, but data indicate the drug is only effective for those who need supplemental oxygen — and
may harm
those with less severe cases. Accordingly, the NIH guidelines
do not recommend
dexamethasone in patients who do not require supplemental oxygen.
There is hope that a new line of drugs known as
monoclonal antibodies
will prove to be effective and could serve as a “
bridge
” until the arrival of a vaccine. These drugs are similar in concept to convalescent plasma, but are made of optimized synthetic antibodies that may be safer and more potent than the antibodies isolated from human plasma.
Although still being tested in clinical trials,
at least
two companies have announced positive preliminary findings.Â
On Sept. 16, pharma company Eli Lilly
released
initial data from a phase 2 trial of its SARS-CoV-2 neutralizing antibody that reported the therapy reduced the amount of virus in outpatients and also cut the rate of hospitalization.
On Sept. 29, biotech company Regeneron similarly
announced
that its antibody cocktail reduced viral levels and reduced symptoms among non-hospitalized COVID-19 patients.
Neither
company, however, has published its data yet and the results should not be viewed as definitive.
Trump’s physician
said
in the afternoon of Oct. 2 that the president had received an 8 gram dose of Regeneron’s antibody cocktail “as a precautionary measure.” According to Regeneron’s
press release
, that is the “high” dose the company is currently testing.
On the evening of Oct. 2, Trump
started on a five-day course of remdesivir
 and on Oct. 3 was given his
first dose of dexamethasone
.
What are the testing procedures at the White House?
On April 3, the White House
announced
that anyone in “close proximity” to Trump and Vice President Mike Pence would be tested.
On July 21, White House Press Secretary Kayleigh McEnany
said
the president himself is tested “multiple times a day,” but Trump contradicted that
hours later
. He
said
: “I do take probably, on average, a test every two days, three days. And I don’t know of any time I’ve taken two tests in one day, but I could see that happening.”
On Aug. 3, Politico
reported
that executive branch employees were told they would be subject to random testing. A White House spokesperson told Politico: “As part of our ongoing efforts to protect the health and safety of the entire White House Complex, randomized testing of Executive Office of the President staff, which has been ongoing for several months, will become mandatory rather than voluntary.”
News
reports
and Trump’s former campaign manager Corey Lewandowski have indicated the White House uses an
Abbott labs test
, which can provide results in 15 minutes. Lewandowski
said
in an interview on the “Today” show on Oct. 2 that he received such a quick-results test twice this week when seeing Trump.
Why didn’t the White House’s testing regimen prevent the president from becoming infected?
Rigorous testing procedures can help identify cases and reduce the risk of an outbreak, but can’t ensure that no one will get infected.
As Harvard epidemiologist
Michael Mina
explained
on Twitter, frequent testing worked in the sense that the transmission chain “is severed.” But, he added, tests are “not prophylactics.”
“They alone cannot stop the test taker from getting infected. But can serve to stop onward spread from the tester,” he wrote. “To stop from getting infected, masks/social distancing are needed.”
It’s also important to recognize the inherent limitations in diagnostic tests. Even if someone tests negative, that doesn’t necessarily mean that a person isn’t infected — only that the test didn’t detect the presence of the virus at that specific time.
Given that it can take
a few days
or even longer for the virus to become detectable, a negative result means someone still could be infectious and other public health measures should still be taken.
The White House was reportedly using Abbot’s
ID NOW test
as a rapid test for screening staff. The test is a molecular test that
looks for the viral genome
in a nasal swab sample, but is faster and less sensitive than the standard PCR tests.
Mina said in an Oct. 2 press call that the test was very good — perhaps the best rapid test available. But no test is perfect, and the test is not actually designed to be used the way the White House deployed it.Â
The FDA’s EUA was
revised
in mid-September to specify that testing is intended to be “from individuals who are suspected of COVID-19 by their health care provider within the first seven days of the onset of symptoms.” In other words, the test is meant for those who have symptoms, not for surveillance.
What is the status of a COVID-19 vaccine?
There are currently four companies running phase 3 trials of a
coronavirus vaccine
in the U.S. One or more vaccines may be available by the end of the year or by early 2021 to select groups, assuming the trials go well and the shots are found to be safe and effective. Members of the general population who are not prioritized for vaccination, however, are
not expected
to be able to receive a vaccine until later in 2021.
The leading company, in terms of timing, is Pfizer/BioNTech, which has enrolled 35,469 participants in its trial and given 24,298 volunteers both doses of its mRNA vaccine
as of
Sept. 28. It is the only company that still claims to be able to have an answer on whether its vaccine is safe and effective prior to Nov. 3.
Moderna’s phase 3 trial of its mRNA vaccine has
enrolled
27,232 participants as of Sept. 25, 15,454 of whom have received two doses. Moderna’s CEO
said
on Sept. 30 that the earliest he expected the company to
be able to file an EUA with the FDA is Nov. 25, with a wider approval coming perhaps in March 2021.Â
Oxford-AstraZeneca’s viral vector vaccine trial is
still on pause
in the U.S. pending an investigation into a possible severe side effect in a volunteer in the U.K.Â
Johnson & Johnson’s vaccine, which also uses a viral vector, albeit a different one,
began
phase 3 testing on Sept. 23. It is the only candidate of the four to require only one dose and
not to need
subzero temperatures.
Editor’s Note: Please consider a donation to FactCheck.org. We do not accept advertising. We rely on grants and individual donations from people like you. Credit card donations may be made throughÂ
our “Donate” page
. If you prefer to give by check, send to: FactCheck.org, Annenberg Public Policy Center, 202 S. 36th St., Philadelphia, PA 19104.
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# Updated: Q\&A on Trump’s COVID-19 Diagnosis
By [Jessica McDonald](https://www.factcheck.org/author/jessica-mcdonald/ "Posts by Jessica McDonald") and [Lori Robertson](https://www.factcheck.org/author/lori-robertson/ "Posts by Lori Robertson")
Posted on October 2, 2020 \| Updated on October 7, 2020
***
*Editor’s Note: We will continue to update this story as needed.*
On Oct. 2, President Donald Trump [revealed](https://twitter.com/realDonaldTrump/status/1311892190680014849) that he and First Lady Melania Trump had tested positive for COVID-19. Here we answer common questions about the risks of the disease, treatments available and the shortcomings of testing.
**What do we know about Trump’s risk of developing serious COVID-19?**
Without knowing all of Trump’s medical history, it is difficult to know how dangerous his SARS-CoV-2 infection might be. On the morning of Oct. 2, news [outlets](https://www.cnbc.com/2020/10/02/trump-experiencing-mild-symptoms-after-coronavirus-diagnosis.html) [reported](https://www.nytimes.com/live/2020/10/02/us/trump-vs-biden/trumps-virus-case-is-mild-so-far-with-cold-like-symptoms) — and White House Chief of Staff Mark Meadows [confirmed](https://www.rev.com/blog/transcripts/mark-meadows-says-trump-has-mild-covid-19-symptoms-transcript-october-2) — that the president was experiencing only mild symptoms.
White House Press Secretary Kayleigh McEnany [reiterated](https://www.usatoday.com/story/news/politics/elections/2020/10/02/trump-heads-walter-reed-hospital-after-positive-covid-19-test/5894256002/ "https://www.usatoday.com/story/news/politics/elections/2020/10/02/trump-heads-walter-reed-hospital-after-positive-covid-19-test/5894256002/") the symptoms were “mild” in the afternoon, though Trump was taken to Walter Reed National Military Medical Center and would be “working from the presidential offices at Walter Reed for the next few days,” McEnany said.
On Oct. 3, a source familiar with the president’s health, who was [later revealed to be Meadows](https://www.cnbc.com/2020/10/05/trump-and-medical-team-will-decide-later-monday-whether-hes-discharged-chief-of-staff-says.html), suggested that Trump’s condition was more serious. “The president’s vitals over the last 24 hours were very concerning and the next 48 hours will be critical in terms of his care,” Meadows told a White House pool reporter in a pool report issued at about noon. “We’re still not on a clear path to a full recovery.”
The president’s doctor, Navy physician Sean P. Conley, gave a more upbeat assessment at a [press conference](https://www.c-span.org/video/?476593-1/white-house-physician-president-doing-well) Oct. 3, describing the president as being fever-free and “doing great.”
During a [press conference](https://www.rev.com/blog/transcripts/dr-conley-donald-trumps-doctor-press-conference-transcript-from-walter-reed-on-trumps-condition-october-4) on Oct. 4, Trump’s physicians emphasized that he continued “to improve” but said that the president had been given the steroid dexamethasone, which [is not recommended](https://www.covid19treatmentguidelines.nih.gov/immune-based-therapy/immunomodulators/corticosteroids/) unless patients require supplemental oxygen. Trump also had experienced two bouts of low oxygen levels, they said, and had been given oxygen at least once, on Oct. 2.
Trump [tweeted](https://twitter.com/realDonaldTrump/status/1313186529058136070?s=20) on Oct. 5 that he would leave Walter Reed hospital that evening at 6:30.
At 74 years old, Trump is at higher risk of developing a more severe case of COVID-19 than younger people. Figures from the Centers for Disease Control and Prevention, based on data available through Aug. 6, show that people ages 65 to 74 are [five times](https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html) as likely as 18- to 29-year-olds to be hospitalized and 90 times more likely to die.
Other CDC [data](https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data/vbim-akqf) [show](https://data.cdc.gov/d/vbim-akqf/visualization) that for the month of August, 6.5% of people between the ages of 70 and 79 who were diagnosed with COVID-19 died, and 18% were hospitalized, although some data on death or hospitalization is missing or unknown.
Trump is also a man — and males [have consistently](https://www.cdc.gov/pcd/issues/2020/20_0247.htm) had worse outcomes, on average, than females — and his last [physical](https://www.cnn.com/2020/06/03/politics/donald-trump-annual-physical/index.html) showed he was mildly obese, with a [body mass index](https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm) of 30.5 (30 is considered obese).
According to the CDC, obesity [increases the risk](https://www.cdc.gov/obesity/data/obesity-and-covid-19.html) of a severe illness from COVID-19 and may triple the risk of hospitalization. It’s not entirely understood why this is, but carrying too much extra weight has been linked to impaired immune function and fat tissue can also [push up on the diaphragm](https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young), making it more difficult to breathe.
Most people, however — even those with risk factors — do not get seriously ill, so the president’s chances for a mild infection may still be good. He is also not known to have many of the [other risk factors](https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-underlying-medical-conditions.html) for serious disease, such as diabetes or kidney disease, and is likely to receive the best possible medical care.
Scientists are just beginning to understand why certain people fare so poorly with a SARS-CoV-2 infection while others never develop symptoms or only get mildly ill. [Recent](https://science.sciencemag.org/content/early/2020/09/29/science.abd4570) [research](https://science.sciencemag.org/content/early/2020/09/23/science.abd4585) suggests that one difference, which may apply to [about 14%](https://www.sciencemag.org/news/2020/09/hidden-immune-weakness-found-14-gravely-ill-covid-19-patients) of severe cases, is that some people don’t produce enough type I interferons early in infection. The proteins are key players in [fighting off viruses](https://www.cell.com/cell-host-microbe/pdf/S1931-3128\(20\)30290-0.pdf) and help kick off a robust immune response, although [too much of them later on](https://twitter.com/VirusesImmunity/status/1311414807581487104) could be detrimental.
In some cases, a poor interferon response may result from people having antibodies that inappropriately target and cripple the interferon, whereas others may be due to faulty genes. The offending antibodies are much [more common](https://www.nih.gov/news-events/news-releases/scientists-discover-genetic-immunologic-underpinnings-some-cases-severe-covid-19) in males. Older people [may also](https://twitter.com/VirusesImmunity/status/1311414807581487104) have defects in how their bodies mount this type of early, or innate, immune response.
Other [research](https://www.cell.com/cell/fulltext/S0092-8674\(20\)31235-6) [also](https://www.sciencemag.org/news/2020/09/uncoordinated-immune-response-may-explain-why-covid-19-strikes-some-hard-particularly) indicates that older people are less likely to produce a sufficient T cell response to SARS-CoV-2. T cells are part of the body’s later, more specific immune response, and assist with producing antibodies and also kill off infected cells. With fewer of these cells, older patients [don’t create a coordinated response](https://twitter.com/profshanecrotty/status/1306302602863239172) to fight off the virus and are more likely to have poor outcomes.
**What do we know about the president’s health?**
The president’s doctor [provided the latest update](https://twitter.com/GeoffRBennett/status/1268254624517173251) on Trump’s health on June 3. He said the president “remains healthy.” Trump was 6’3″ and weighed 244 pounds; his cholesterol was 167, [lower than](https://twitter.com/KFaulders/status/1096153029341077504/photo/1) the previous physical. (A reading below 200 [is considered desirable](https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601).) His blood pressure was normal: 121/79.
About six months prior to that report, in November 2019, Trump [made](https://www.cnn.com/2019/11/16/politics/trump-annual-physical-walter-reed/index.html) an unannounced visit to Walter Reed National Military Medical Center, which he and his staff later said was to conduct part of his annual physical. Conley’s memo said his summary included information both from November and an April exam Conley conducted.
The president was taking [rosuvastatin](https://www.webmd.com/drugs/2/drug-76701/rosuvastatin-oral/details), a medicine for cholesterol, [finasteride](https://www.drugs.com/mtm/finasteride.html), used to treat an enlarged prostate or hair loss, and aspirin daily.
In 2018, then-White House physician Dr. Ronny Jackson revealed Trump underwent a coronary calcium CT scan that showed the presence of plaque. Dr. Rachel Bond of Lenox Hill Hospital in New York [told CNN](https://www.cnn.com/2018/01/17/health/trump-heart-disease-gupta/index.html) the score of 133 on the test indicates “he certainly has coronary artery disease because calcium is present. But this is also common for someone his gender, race and age.”
**Who in the White House has tested positive over the course of the pandemic?**
Before Trump and First Lady Melania Trump revealed they had tested positive for COVID-19, [Hope Hicks](https://www.npr.org/2020/10/01/919344239/trump-adviser-hope-hicks-tests-positive-for-coronavirus), counselor to the president, tested positive, as of Oct. 1.
CNN [reported](https://www.cnn.com/2020/10/02/media/journalists-white-house-covid-19/index.html) that three journalists who work at the White House, as well as a White House staffer in the press area of the West Wing, had tested positive on Oct. 2.
Nick Luna, a personal assistant to the president, [tested positive](https://www.bloomberg.com/news/articles/2020-10-04/trump-aide-luna-tests-positive-for-virus-in-new-white-house-case?srnd=premium), according to Oct. 3 press reports. White House Press Secretary Kayleigh McEnany [tested positive](https://twitter.com/PressSec/status/1313138387994509313) on Oct. 5, she said on Twitter. CNN [reported](https://www.cnn.com/2020/10/05/politics/kayleigh-mcenany-coronavirus-white-house/index.html) that day that two deputies of McEnany — Chad Gilmartin and Karoline Leavitt — also tested positive.
Stephen Miller, a senior adviser to Trump, [tested positive](https://apnews.com/article/virus-outbreak-donald-trump-health-archive-60688c73019f9f988f73ad54f57b680b) on Oct. 6.
Before these cases, National Security Adviser [Robert O’Brien](https://www.usatoday.com/story/news/politics/2020/07/27/robert-obrien-trumps-top-security-aide-tests-positive-covid/5517038002/) tested positive in late July; campaign fundraiser [Kimberly Guilfoyle](https://www.cnn.com/2020/07/03/politics/kimberly-guilfoyle-positive-coronavirus-test/index.html), the girlfriend of Donald Trump Jr., tested positive the July 4 weekend; and [Katie Miller](https://www.politico.com/news/2020/05/08/mike-pence-staffer-tests-positive-for-coronavirus-244816), Pence’s spokesperson, tested positive in early May.
Others testing positive for COVID-19 include an [unidentified White House staffer](https://thehill.com/homenews/administration/516795-trump-confirms-another-white-house-staffer-tested-positive-for-covid), [unidentified member of Pence’s staff](https://www.usatoday.com/story/news/politics/2020/03/20/staffer-vice-president-mike-pence-tests-positive-coronavirus/2889719001/), a [White House valet](https://www.cnbc.com/2020/05/07/coronavirus-trump-military-aide-at-white-house-tests-positive-for-covid-19.html), former acting chair of the White House Council of Economic Advisers [Tomas Philipson](https://www.thedailybeast.com/top-white-house-economist-tomas-philipson-tests-positive-for-coronavirus), a [Marine](https://www.politico.com/news/2020/07/23/marine-one-helicopter-covid-positive-380444) with the unit operating Marine One, and a [cafeteria worker](https://www.nbcwashington.com/news/national-international/white-house-executive-office-cafeteria-closed-after-positive-coronavirus-test/2369334/) in the Eisenhower Executive Office Building.
**Who has tested positive after attending presidential or campaign events?**
In early October, others have tested positive for COVID-19 who don’t work in the White House complex, but have had contact with Trump and administration staffers through their work for his campaign or by attending events, such as a [Sept. 26 Rose Garden event](https://www.cnn.com/2020/10/03/politics/trump-covid-amy-coney-barrett-event/index.html) introducing Trump’s Supreme Court nominee, Amy Coney Barrett.
[Kellyanne Conway](https://twitter.com/KellyannePolls/status/1312214949658152960), a former White House counselor, and former New Jersey Gov. [Chris Christie](https://twitter.com/GovChristie/status/1312416381758050305) — both of whom [assisted](https://www.cnn.com/2020/10/02/politics/kellyanne-conway-positive-for-covid-19/index.html) the president in debate preparations and [attended](https://www.cbsnews.com/news/chris-christie-tests-positive-for-coronavirus/) the Sept. 26 event — announced on Twitter they had tested positive. Four others who attended the Sept. 26 event have COVID-19: Sens. [Mike Lee](https://twitter.com/SenMikeLee/status/1312055257992753152) and [Thom Tillis,](https://thehill.com/homenews/senate/519443-gop-sen-thom-tillis-tests-positive-for-coronavirus) [Rev. John Jenkins](https://www.insidehighered.com/news/2020/10/05/reverend-john-jenkins-u-notre-dame-president-has-covid-19), president of the University of Notre Dame, and Pastor [Greg Laurie](https://www1.cbn.com/cbnnews/us/2020/october/pastor-greg-laurie-tests-positive-for-covid-after-attending-dc-prayer-rally).
Trump Campaign Manager [Bill Stepien](https://www.usatoday.com/story/news/politics/2020/10/03/trump-campaign-manager-bill-stepien-has-tested-positive-covid-19/3597631001/) tested positive.
Sen. [Ron Johnson](https://madison.com/wsj/news/local/govt-and-politics/sen-ron-johnson-tests-positive-for-covid-19-attended-fundraiser-while-awaiting-test-result/article_f332e740-1a30-574d-9e3d-9c5058f24994.html) also tested positive, he announced on Oct. 3, though he did not attend the Sept. 26 event at the White House. Republican National Committee Chairwoman [Ronna McDaniel](https://www.cnn.com/2020/10/02/politics/ronna-mcdaniel-coronavirus/index.html) also has COVID-19; she last was around the president at a Sept. 25 event, [according to the *New York Times*](https://www.nytimes.com/2020/10/02/us/elections/ronna-mcdaniel-chairwoman-of-the-rnc-tests-positive-for-the-coronavirus.html).
The city of Cleveland [announced](https://clecityhall.com/2020/10/02/city-of-cleveland-statement-regarding-post-debate-covid-19-cases-update-194/?source=email) that it knew of 11 positive cases “stemming from pre-debate planning and set-up” for the Sept. 29 presidential debate. The city didn’t identify those individuals, only saying “the majority” were “out of state residents.”
Before the recent spate of infections, [six members](https://apnews.com/article/23796a826ba86619527363b92ed49a33) of the Trump campaign advance team tested positive prior to a Trump campaign rally on June 20, and [two more staffers](https://www.cnn.com/2020/06/22/politics/two-staffers-coronavirus-trump-rally/index.html) tested positive afterward.
**What COVID-19 treatments are available and how effective are they?**
Despite Trump’s [repeated insistence](https://www.factcheck.org/2020/09/trump-misleads-on-reasons-for-falling-covid-19-fatality-rate/) that great progress has been made on COVID-19 treatment, there are [no Food and Drug Administration-approved drugs](https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-frequently-asked-questions) for COVID-19 and only one medication has been shown in a clinical trial to improve mortality.
As we explained [before](https://www.factcheck.org/2020/09/trump-misleads-on-reasons-for-falling-covid-19-fatality-rate/), when Trump attributed an 85% decline in the [case fatality rate](https://ourworldindata.org/covid-mortality-risk) since April to “pioneering therapies,” most treatment consists of supportive care. And as University of Pennsylvania infectious disease fellow Dr. Aaron Richterman told us in an email, “We have a long way to go in our treatment.”
In a clinical trial, the antiviral drug remdesivir [shortened the time to recovery](https://www.nejm.org/doi/full/10.1056/NEJMoa2007764) among hospitalized patients to a median of 11 days from 15 days. The medication received an emergency use authorization, or EUA, from the FDA, but that is [limited](https://www.fda.gov/media/137564/download) to use among hospitalized patients.
Convalescent plasma may be effective, but the jury is still out on that — and for now, the National Institutes of Health [treatment guidelines](https://www.covid19treatmentguidelines.nih.gov/statement-on-convalescent-plasma-eua/) do not consider it a standard of care and neither recommend for nor against its use. Like remdesivir, it too is only available under [its](https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment) [EUA](https://www.fda.gov/media/141480/download) to those who are hospitalized with COVID-19.
The steroid dexamethasone is the only medication to have [demonstrated a survival benefit](https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19) in COVID-19 patients. As a drug previously approved for other uses, dexamethasone can be given to any patient off-label, but data indicate the drug is only effective for those who need supplemental oxygen — and [may harm](https://www.nejm.org/doi/full/10.1056/NEJMoa2021436) those with less severe cases. Accordingly, the NIH guidelines [do not recommend](https://www.covid19treatmentguidelines.nih.gov/immune-based-therapy/immunomodulators/corticosteroids/) dexamethasone in patients who do not require supplemental oxygen.
There is hope that a new line of drugs known as [monoclonal antibodies](https://www.statnews.com/2020/09/29/regenerons-covid-19-antibody-may-help-non-hospitalized-patients-recover-faster-early-data-show/) will prove to be effective and could serve as a “[bridge](https://www.nature.com/articles/d41586-020-02360-y)” until the arrival of a vaccine. These drugs are similar in concept to convalescent plasma, but are made of optimized synthetic antibodies that may be safer and more potent than the antibodies isolated from human plasma.
Although still being tested in clinical trials, [at least](https://www.sciencemag.org/news/2020/09/provocative-results-boost-hopes-antibody-treatment-covid-19) two companies have announced positive preliminary findings.
On Sept. 16, pharma company Eli Lilly [released](https://investor.lilly.com/news-releases/news-release-details/lilly-announces-proof-concept-data-neutralizing-antibody-ly) initial data from a phase 2 trial of its SARS-CoV-2 neutralizing antibody that reported the therapy reduced the amount of virus in outpatients and also cut the rate of hospitalization.
On Sept. 29, biotech company Regeneron similarly [announced](https://investor.regeneron.com/news-releases/news-release-details/regenerons-regn-cov2-antibody-cocktail-reduced-viral-levels-and?fbclid=IwAR3D7V7vYn2rbC5oYAh09DLKTcCnOvL43JWiZvhuwKoTEphdA8UFx6KlznU) that its antibody cocktail reduced viral levels and reduced symptoms among non-hospitalized COVID-19 patients.
[Neither](https://www.sciencemag.org/news/2020/09/provocative-results-boost-hopes-antibody-treatment-covid-19) company, however, has published its data yet and the results should not be viewed as definitive.
Trump’s physician [said](https://twitter.com/PressSec/status/1312122950133272576) in the afternoon of Oct. 2 that the president had received an 8 gram dose of Regeneron’s antibody cocktail “as a precautionary measure.” According to Regeneron’s [press release](https://investor.regeneron.com/news-releases/news-release-details/regenerons-regn-cov2-antibody-cocktail-reduced-viral-levels-and?fbclid=IwAR3D7V7vYn2rbC5oYAh09DLKTcCnOvL43JWiZvhuwKoTEphdA8UFx6KlznU), that is the “high” dose the company is currently testing.
On the evening of Oct. 2, Trump [started on a five-day course of remdesivir](https://www.rev.com/blog/transcripts/dr-conley-donald-trumps-doctor-press-conference-transcript-from-walter-reed-on-trumps-condition-october-3) and on Oct. 3 was given his [first dose of dexamethasone](https://www.rev.com/blog/transcripts/dr-conley-donald-trumps-doctor-press-conference-transcript-from-walter-reed-on-trumps-condition-october-4).
**What are the testing procedures at the White House?**
On April 3, the White House [announced](https://thehill.com/homenews/administration/491052-white-house-anyone-in-close-proximity-to-trump-or-pence-will-be) that anyone in “close proximity” to Trump and Vice President Mike Pence would be tested.
On July 21, White House Press Secretary Kayleigh McEnany [said](https://www.youtube.com/watch?v=m7kVfvHsRyI) the president himself is tested “multiple times a day,” but Trump contradicted that [hours later](https://trumpwhitehouse.archives.gov/briefings-statements/press-briefing-press-secretary-kayleigh-mcenany-072120/). He [said](https://trumpwhitehouse.archives.gov//briefings-statements/remarks-president-trump-press-briefing-072120/): “I do take probably, on average, a test every two days, three days. And I don’t know of any time I’ve taken two tests in one day, but I could see that happening.”
On Aug. 3, Politico [reported](https://www.politico.com/news/2020/08/03/white-house-requires-random-coronavirus-tests-390934) that executive branch employees were told they would be subject to random testing. A White House spokesperson told Politico: “As part of our ongoing efforts to protect the health and safety of the entire White House Complex, randomized testing of Executive Office of the President staff, which has been ongoing for several months, will become mandatory rather than voluntary.”
[News](https://www.statnews.com/2020/10/02/why-the-white-houses-testing-only-strategy-to-shield-trump-from-covid-19-fell-short/?utm_campaign=rss) [reports](https://www.cnn.com/2020/07/03/politics/coronavirus-white-house-test-abbott/index.html) and Trump’s former campaign manager Corey Lewandowski have indicated the White House uses an [Abbott labs test](https://www.abbott.com/IDNOW.html), which can provide results in 15 minutes. Lewandowski [said](https://www.today.com/video/corey-lewandowski-describes-white-house-covid-testing-procedure-92996677539) in an interview on the “Today” show on Oct. 2 that he received such a quick-results test twice this week when seeing Trump.
**Why didn’t the White House’s testing regimen prevent the president from becoming infected?**
Rigorous testing procedures can help identify cases and reduce the risk of an outbreak, but can’t ensure that no one will get infected.
As Harvard epidemiologist [Michael Mina](https://ccdd.hsph.harvard.edu/people/michael-mina/) [explained](https://twitter.com/michaelmina_lab/status/1312048742376378370) on Twitter, frequent testing worked in the sense that the transmission chain “is severed.” But, he added, tests are “not prophylactics.”
“They alone cannot stop the test taker from getting infected. But can serve to stop onward spread from the tester,” he wrote. “To stop from getting infected, masks/social distancing are needed.”
It’s also important to recognize the inherent limitations in diagnostic tests. Even if someone tests negative, that doesn’t necessarily mean that a person isn’t infected — only that the test didn’t detect the presence of the virus at that specific time.
Given that it can take [a few days](https://medical.mit.edu/covid-19-updates/2020/07/when-should-i-be-tested) or even longer for the virus to become detectable, a negative result means someone still could be infectious and other public health measures should still be taken.
The White House was reportedly using Abbot’s [ID NOW test](https://www.abbott.com/IDNOW.html) as a rapid test for screening staff. The test is a molecular test that [looks for the viral genome](https://www.abbott.com/corpnewsroom/product-and-innovation/how-id-now-tackles-covid-19.html) in a nasal swab sample, but is faster and less sensitive than the standard PCR tests.
Mina said in an Oct. 2 press call that the test was very good — perhaps the best rapid test available. But no test is perfect, and the test is not actually designed to be used the way the White House deployed it.
The FDA’s EUA was [revised](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-daily-roundup-september-18-2020) in mid-September to specify that testing is intended to be “from individuals who are suspected of COVID-19 by their health care provider within the first seven days of the onset of symptoms.” In other words, the test is meant for those who have symptoms, not for surveillance.
**What is the status of a COVID-19 vaccine?**
There are currently four companies running phase 3 trials of a [coronavirus vaccine](https://www.factcheck.org/2020/09/qa-on-coronavirus-vaccines/) in the U.S. One or more vaccines may be available by the end of the year or by early 2021 to select groups, assuming the trials go well and the shots are found to be safe and effective. Members of the general population who are not prioritized for vaccination, however, are [not expected](https://www.factcheck.org/2020/09/trump-again-overstates-speed-of-covid-19-vaccine-rollout/) to be able to receive a vaccine until later in 2021.
The leading company, in terms of timing, is Pfizer/BioNTech, which has enrolled 35,469 participants in its trial and given 24,298 volunteers both doses of its mRNA vaccine [as of](https://www.pfizer.com/science/coronavirus/vaccine) Sept. 28. It is the only company that still claims to be able to have an answer on whether its vaccine is safe and effective prior to Nov. 3.
Moderna’s phase 3 trial of its mRNA vaccine has [enrolled](https://www.modernatx.com/cove-study) 27,232 participants as of Sept. 25, 15,454 of whom have received two doses. Moderna’s CEO [said](https://www.ft.com/content/9b242ecc-3dce-4534-9171-cdf624468a2a) on Sept. 30 that the earliest he expected the company to be able to file an EUA with the FDA is Nov. 25, with a wider approval coming perhaps in March 2021.
Oxford-AstraZeneca’s viral vector vaccine trial is [still on pause](https://www.reuters.com/article/health-coronavirus-vaccine-astrazeneca/exclusive-fda-widens-us-safety-inquiry-into-astrazeneca-coronavirus-vaccine-sources-idUSL1N2GR1SK) in the U.S. pending an investigation into a possible severe side effect in a volunteer in the U.K.
Johnson & Johnson’s vaccine, which also uses a viral vector, albeit a different one, [began](https://www.jnj.com/johnson-johnson-initiates-pivotal-global-phase-3-clinical-trial-of-janssens-covid-19-vaccine-candidate) phase 3 testing on Sept. 23. It is the only candidate of the four to require only one dose and [not to need](https://www.wbur.org/commonhealth/2020/09/26/phase-three-trial-beth-israel-vaccine) subzero temperatures.
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| Readable Markdown | *Editor’s Note: We will continue to update this story as needed.*
On Oct. 2, President Donald Trump [revealed](https://twitter.com/realDonaldTrump/status/1311892190680014849) that he and First Lady Melania Trump had tested positive for COVID-19. Here we answer common questions about the risks of the disease, treatments available and the shortcomings of testing.
**What do we know about Trump’s risk of developing serious COVID-19?**
Without knowing all of Trump’s medical history, it is difficult to know how dangerous his SARS-CoV-2 infection might be. On the morning of Oct. 2, news [outlets](https://www.cnbc.com/2020/10/02/trump-experiencing-mild-symptoms-after-coronavirus-diagnosis.html) [reported](https://www.nytimes.com/live/2020/10/02/us/trump-vs-biden/trumps-virus-case-is-mild-so-far-with-cold-like-symptoms) — and White House Chief of Staff Mark Meadows [confirmed](https://www.rev.com/blog/transcripts/mark-meadows-says-trump-has-mild-covid-19-symptoms-transcript-october-2) — that the president was experiencing only mild symptoms.
White House Press Secretary Kayleigh McEnany [reiterated](https://www.usatoday.com/story/news/politics/elections/2020/10/02/trump-heads-walter-reed-hospital-after-positive-covid-19-test/5894256002/ "https://www.usatoday.com/story/news/politics/elections/2020/10/02/trump-heads-walter-reed-hospital-after-positive-covid-19-test/5894256002/") the symptoms were “mild” in the afternoon, though Trump was taken to Walter Reed National Military Medical Center and would be “working from the presidential offices at Walter Reed for the next few days,” McEnany said.
On Oct. 3, a source familiar with the president’s health, who was [later revealed to be Meadows](https://www.cnbc.com/2020/10/05/trump-and-medical-team-will-decide-later-monday-whether-hes-discharged-chief-of-staff-says.html), suggested that Trump’s condition was more serious. “The president’s vitals over the last 24 hours were very concerning and the next 48 hours will be critical in terms of his care,” Meadows told a White House pool reporter in a pool report issued at about noon. “We’re still not on a clear path to a full recovery.”
The president’s doctor, Navy physician Sean P. Conley, gave a more upbeat assessment at a [press conference](https://www.c-span.org/video/?476593-1/white-house-physician-president-doing-well) Oct. 3, describing the president as being fever-free and “doing great.”
During a [press conference](https://www.rev.com/blog/transcripts/dr-conley-donald-trumps-doctor-press-conference-transcript-from-walter-reed-on-trumps-condition-october-4) on Oct. 4, Trump’s physicians emphasized that he continued “to improve” but said that the president had been given the steroid dexamethasone, which [is not recommended](https://www.covid19treatmentguidelines.nih.gov/immune-based-therapy/immunomodulators/corticosteroids/) unless patients require supplemental oxygen. Trump also had experienced two bouts of low oxygen levels, they said, and had been given oxygen at least once, on Oct. 2.
Trump [tweeted](https://twitter.com/realDonaldTrump/status/1313186529058136070?s=20) on Oct. 5 that he would leave Walter Reed hospital that evening at 6:30.
At 74 years old, Trump is at higher risk of developing a more severe case of COVID-19 than younger people. Figures from the Centers for Disease Control and Prevention, based on data available through Aug. 6, show that people ages 65 to 74 are [five times](https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html) as likely as 18- to 29-year-olds to be hospitalized and 90 times more likely to die.
Other CDC [data](https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data/vbim-akqf) [show](https://data.cdc.gov/d/vbim-akqf/visualization) that for the month of August, 6.5% of people between the ages of 70 and 79 who were diagnosed with COVID-19 died, and 18% were hospitalized, although some data on death or hospitalization is missing or unknown.
Trump is also a man — and males [have consistently](https://www.cdc.gov/pcd/issues/2020/20_0247.htm) had worse outcomes, on average, than females — and his last [physical](https://www.cnn.com/2020/06/03/politics/donald-trump-annual-physical/index.html) showed he was mildly obese, with a [body mass index](https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm) of 30.5 (30 is considered obese).
According to the CDC, obesity [increases the risk](https://www.cdc.gov/obesity/data/obesity-and-covid-19.html) of a severe illness from COVID-19 and may triple the risk of hospitalization. It’s not entirely understood why this is, but carrying too much extra weight has been linked to impaired immune function and fat tissue can also [push up on the diaphragm](https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young), making it more difficult to breathe.
Most people, however — even those with risk factors — do not get seriously ill, so the president’s chances for a mild infection may still be good. He is also not known to have many of the [other risk factors](https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-underlying-medical-conditions.html) for serious disease, such as diabetes or kidney disease, and is likely to receive the best possible medical care.
Scientists are just beginning to understand why certain people fare so poorly with a SARS-CoV-2 infection while others never develop symptoms or only get mildly ill. [Recent](https://science.sciencemag.org/content/early/2020/09/29/science.abd4570) [research](https://science.sciencemag.org/content/early/2020/09/23/science.abd4585) suggests that one difference, which may apply to [about 14%](https://www.sciencemag.org/news/2020/09/hidden-immune-weakness-found-14-gravely-ill-covid-19-patients) of severe cases, is that some people don’t produce enough type I interferons early in infection. The proteins are key players in [fighting off viruses](https://www.cell.com/cell-host-microbe/pdf/S1931-3128\(20\)30290-0.pdf) and help kick off a robust immune response, although [too much of them later on](https://twitter.com/VirusesImmunity/status/1311414807581487104) could be detrimental.
In some cases, a poor interferon response may result from people having antibodies that inappropriately target and cripple the interferon, whereas others may be due to faulty genes. The offending antibodies are much [more common](https://www.nih.gov/news-events/news-releases/scientists-discover-genetic-immunologic-underpinnings-some-cases-severe-covid-19) in males. Older people [may also](https://twitter.com/VirusesImmunity/status/1311414807581487104) have defects in how their bodies mount this type of early, or innate, immune response.
Other [research](https://www.cell.com/cell/fulltext/S0092-8674\(20\)31235-6) [also](https://www.sciencemag.org/news/2020/09/uncoordinated-immune-response-may-explain-why-covid-19-strikes-some-hard-particularly) indicates that older people are less likely to produce a sufficient T cell response to SARS-CoV-2. T cells are part of the body’s later, more specific immune response, and assist with producing antibodies and also kill off infected cells. With fewer of these cells, older patients [don’t create a coordinated response](https://twitter.com/profshanecrotty/status/1306302602863239172) to fight off the virus and are more likely to have poor outcomes.
**What do we know about the president’s health?**
The president’s doctor [provided the latest update](https://twitter.com/GeoffRBennett/status/1268254624517173251) on Trump’s health on June 3. He said the president “remains healthy.” Trump was 6’3″ and weighed 244 pounds; his cholesterol was 167, [lower than](https://twitter.com/KFaulders/status/1096153029341077504/photo/1) the previous physical. (A reading below 200 [is considered desirable](https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601).) His blood pressure was normal: 121/79.
About six months prior to that report, in November 2019, Trump [made](https://www.cnn.com/2019/11/16/politics/trump-annual-physical-walter-reed/index.html) an unannounced visit to Walter Reed National Military Medical Center, which he and his staff later said was to conduct part of his annual physical. Conley’s memo said his summary included information both from November and an April exam Conley conducted.
The president was taking [rosuvastatin](https://www.webmd.com/drugs/2/drug-76701/rosuvastatin-oral/details), a medicine for cholesterol, [finasteride](https://www.drugs.com/mtm/finasteride.html), used to treat an enlarged prostate or hair loss, and aspirin daily.
In 2018, then-White House physician Dr. Ronny Jackson revealed Trump underwent a coronary calcium CT scan that showed the presence of plaque. Dr. Rachel Bond of Lenox Hill Hospital in New York [told CNN](https://www.cnn.com/2018/01/17/health/trump-heart-disease-gupta/index.html) the score of 133 on the test indicates “he certainly has coronary artery disease because calcium is present. But this is also common for someone his gender, race and age.”
**Who in the White House has tested positive over the course of the pandemic?**
Before Trump and First Lady Melania Trump revealed they had tested positive for COVID-19, [Hope Hicks](https://www.npr.org/2020/10/01/919344239/trump-adviser-hope-hicks-tests-positive-for-coronavirus), counselor to the president, tested positive, as of Oct. 1.
CNN [reported](https://www.cnn.com/2020/10/02/media/journalists-white-house-covid-19/index.html) that three journalists who work at the White House, as well as a White House staffer in the press area of the West Wing, had tested positive on Oct. 2.
Nick Luna, a personal assistant to the president, [tested positive](https://www.bloomberg.com/news/articles/2020-10-04/trump-aide-luna-tests-positive-for-virus-in-new-white-house-case?srnd=premium), according to Oct. 3 press reports. White House Press Secretary Kayleigh McEnany [tested positive](https://twitter.com/PressSec/status/1313138387994509313) on Oct. 5, she said on Twitter. CNN [reported](https://www.cnn.com/2020/10/05/politics/kayleigh-mcenany-coronavirus-white-house/index.html) that day that two deputies of McEnany — Chad Gilmartin and Karoline Leavitt — also tested positive.
Stephen Miller, a senior adviser to Trump, [tested positive](https://apnews.com/article/virus-outbreak-donald-trump-health-archive-60688c73019f9f988f73ad54f57b680b) on Oct. 6.
Before these cases, National Security Adviser [Robert O’Brien](https://www.usatoday.com/story/news/politics/2020/07/27/robert-obrien-trumps-top-security-aide-tests-positive-covid/5517038002/) tested positive in late July; campaign fundraiser [Kimberly Guilfoyle](https://www.cnn.com/2020/07/03/politics/kimberly-guilfoyle-positive-coronavirus-test/index.html), the girlfriend of Donald Trump Jr., tested positive the July 4 weekend; and [Katie Miller](https://www.politico.com/news/2020/05/08/mike-pence-staffer-tests-positive-for-coronavirus-244816), Pence’s spokesperson, tested positive in early May.
Others testing positive for COVID-19 include an [unidentified White House staffer](https://thehill.com/homenews/administration/516795-trump-confirms-another-white-house-staffer-tested-positive-for-covid), [unidentified member of Pence’s staff](https://www.usatoday.com/story/news/politics/2020/03/20/staffer-vice-president-mike-pence-tests-positive-coronavirus/2889719001/), a [White House valet](https://www.cnbc.com/2020/05/07/coronavirus-trump-military-aide-at-white-house-tests-positive-for-covid-19.html), former acting chair of the White House Council of Economic Advisers [Tomas Philipson](https://www.thedailybeast.com/top-white-house-economist-tomas-philipson-tests-positive-for-coronavirus), a [Marine](https://www.politico.com/news/2020/07/23/marine-one-helicopter-covid-positive-380444) with the unit operating Marine One, and a [cafeteria worker](https://www.nbcwashington.com/news/national-international/white-house-executive-office-cafeteria-closed-after-positive-coronavirus-test/2369334/) in the Eisenhower Executive Office Building.
**Who has tested positive after attending presidential or campaign events?**
In early October, others have tested positive for COVID-19 who don’t work in the White House complex, but have had contact with Trump and administration staffers through their work for his campaign or by attending events, such as a [Sept. 26 Rose Garden event](https://www.cnn.com/2020/10/03/politics/trump-covid-amy-coney-barrett-event/index.html) introducing Trump’s Supreme Court nominee, Amy Coney Barrett.
[Kellyanne Conway](https://twitter.com/KellyannePolls/status/1312214949658152960), a former White House counselor, and former New Jersey Gov. [Chris Christie](https://twitter.com/GovChristie/status/1312416381758050305) — both of whom [assisted](https://www.cnn.com/2020/10/02/politics/kellyanne-conway-positive-for-covid-19/index.html) the president in debate preparations and [attended](https://www.cbsnews.com/news/chris-christie-tests-positive-for-coronavirus/) the Sept. 26 event — announced on Twitter they had tested positive. Four others who attended the Sept. 26 event have COVID-19: Sens. [Mike Lee](https://twitter.com/SenMikeLee/status/1312055257992753152) and [Thom Tillis,](https://thehill.com/homenews/senate/519443-gop-sen-thom-tillis-tests-positive-for-coronavirus) [Rev. John Jenkins](https://www.insidehighered.com/news/2020/10/05/reverend-john-jenkins-u-notre-dame-president-has-covid-19), president of the University of Notre Dame, and Pastor [Greg Laurie](https://www1.cbn.com/cbnnews/us/2020/october/pastor-greg-laurie-tests-positive-for-covid-after-attending-dc-prayer-rally).
Trump Campaign Manager [Bill Stepien](https://www.usatoday.com/story/news/politics/2020/10/03/trump-campaign-manager-bill-stepien-has-tested-positive-covid-19/3597631001/) tested positive.
Sen. [Ron Johnson](https://madison.com/wsj/news/local/govt-and-politics/sen-ron-johnson-tests-positive-for-covid-19-attended-fundraiser-while-awaiting-test-result/article_f332e740-1a30-574d-9e3d-9c5058f24994.html) also tested positive, he announced on Oct. 3, though he did not attend the Sept. 26 event at the White House. Republican National Committee Chairwoman [Ronna McDaniel](https://www.cnn.com/2020/10/02/politics/ronna-mcdaniel-coronavirus/index.html) also has COVID-19; she last was around the president at a Sept. 25 event, [according to the *New York Times*](https://www.nytimes.com/2020/10/02/us/elections/ronna-mcdaniel-chairwoman-of-the-rnc-tests-positive-for-the-coronavirus.html).
The city of Cleveland [announced](https://clecityhall.com/2020/10/02/city-of-cleveland-statement-regarding-post-debate-covid-19-cases-update-194/?source=email) that it knew of 11 positive cases “stemming from pre-debate planning and set-up” for the Sept. 29 presidential debate. The city didn’t identify those individuals, only saying “the majority” were “out of state residents.”
Before the recent spate of infections, [six members](https://apnews.com/article/23796a826ba86619527363b92ed49a33) of the Trump campaign advance team tested positive prior to a Trump campaign rally on June 20, and [two more staffers](https://www.cnn.com/2020/06/22/politics/two-staffers-coronavirus-trump-rally/index.html) tested positive afterward.
**What COVID-19 treatments are available and how effective are they?**
Despite Trump’s [repeated insistence](https://www.factcheck.org/2020/09/trump-misleads-on-reasons-for-falling-covid-19-fatality-rate/) that great progress has been made on COVID-19 treatment, there are [no Food and Drug Administration-approved drugs](https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-frequently-asked-questions) for COVID-19 and only one medication has been shown in a clinical trial to improve mortality.
As we explained [before](https://www.factcheck.org/2020/09/trump-misleads-on-reasons-for-falling-covid-19-fatality-rate/), when Trump attributed an 85% decline in the [case fatality rate](https://ourworldindata.org/covid-mortality-risk) since April to “pioneering therapies,” most treatment consists of supportive care. And as University of Pennsylvania infectious disease fellow Dr. Aaron Richterman told us in an email, “We have a long way to go in our treatment.”
In a clinical trial, the antiviral drug remdesivir [shortened the time to recovery](https://www.nejm.org/doi/full/10.1056/NEJMoa2007764) among hospitalized patients to a median of 11 days from 15 days. The medication received an emergency use authorization, or EUA, from the FDA, but that is [limited](https://www.fda.gov/media/137564/download) to use among hospitalized patients.
Convalescent plasma may be effective, but the jury is still out on that — and for now, the National Institutes of Health [treatment guidelines](https://www.covid19treatmentguidelines.nih.gov/statement-on-convalescent-plasma-eua/) do not consider it a standard of care and neither recommend for nor against its use. Like remdesivir, it too is only available under [its](https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment) [EUA](https://www.fda.gov/media/141480/download) to those who are hospitalized with COVID-19.
The steroid dexamethasone is the only medication to have [demonstrated a survival benefit](https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19) in COVID-19 patients. As a drug previously approved for other uses, dexamethasone can be given to any patient off-label, but data indicate the drug is only effective for those who need supplemental oxygen — and [may harm](https://www.nejm.org/doi/full/10.1056/NEJMoa2021436) those with less severe cases. Accordingly, the NIH guidelines [do not recommend](https://www.covid19treatmentguidelines.nih.gov/immune-based-therapy/immunomodulators/corticosteroids/) dexamethasone in patients who do not require supplemental oxygen.
There is hope that a new line of drugs known as [monoclonal antibodies](https://www.statnews.com/2020/09/29/regenerons-covid-19-antibody-may-help-non-hospitalized-patients-recover-faster-early-data-show/) will prove to be effective and could serve as a “[bridge](https://www.nature.com/articles/d41586-020-02360-y)” until the arrival of a vaccine. These drugs are similar in concept to convalescent plasma, but are made of optimized synthetic antibodies that may be safer and more potent than the antibodies isolated from human plasma.
Although still being tested in clinical trials, [at least](https://www.sciencemag.org/news/2020/09/provocative-results-boost-hopes-antibody-treatment-covid-19) two companies have announced positive preliminary findings.
On Sept. 16, pharma company Eli Lilly [released](https://investor.lilly.com/news-releases/news-release-details/lilly-announces-proof-concept-data-neutralizing-antibody-ly) initial data from a phase 2 trial of its SARS-CoV-2 neutralizing antibody that reported the therapy reduced the amount of virus in outpatients and also cut the rate of hospitalization.
On Sept. 29, biotech company Regeneron similarly [announced](https://investor.regeneron.com/news-releases/news-release-details/regenerons-regn-cov2-antibody-cocktail-reduced-viral-levels-and?fbclid=IwAR3D7V7vYn2rbC5oYAh09DLKTcCnOvL43JWiZvhuwKoTEphdA8UFx6KlznU) that its antibody cocktail reduced viral levels and reduced symptoms among non-hospitalized COVID-19 patients.
[Neither](https://www.sciencemag.org/news/2020/09/provocative-results-boost-hopes-antibody-treatment-covid-19) company, however, has published its data yet and the results should not be viewed as definitive.
Trump’s physician [said](https://twitter.com/PressSec/status/1312122950133272576) in the afternoon of Oct. 2 that the president had received an 8 gram dose of Regeneron’s antibody cocktail “as a precautionary measure.” According to Regeneron’s [press release](https://investor.regeneron.com/news-releases/news-release-details/regenerons-regn-cov2-antibody-cocktail-reduced-viral-levels-and?fbclid=IwAR3D7V7vYn2rbC5oYAh09DLKTcCnOvL43JWiZvhuwKoTEphdA8UFx6KlznU), that is the “high” dose the company is currently testing.
On the evening of Oct. 2, Trump [started on a five-day course of remdesivir](https://www.rev.com/blog/transcripts/dr-conley-donald-trumps-doctor-press-conference-transcript-from-walter-reed-on-trumps-condition-october-3) and on Oct. 3 was given his [first dose of dexamethasone](https://www.rev.com/blog/transcripts/dr-conley-donald-trumps-doctor-press-conference-transcript-from-walter-reed-on-trumps-condition-october-4).
**What are the testing procedures at the White House?**
On April 3, the White House [announced](https://thehill.com/homenews/administration/491052-white-house-anyone-in-close-proximity-to-trump-or-pence-will-be) that anyone in “close proximity” to Trump and Vice President Mike Pence would be tested.
On July 21, White House Press Secretary Kayleigh McEnany [said](https://www.youtube.com/watch?v=m7kVfvHsRyI) the president himself is tested “multiple times a day,” but Trump contradicted that [hours later](https://trumpwhitehouse.archives.gov/briefings-statements/press-briefing-press-secretary-kayleigh-mcenany-072120/). He [said](https://trumpwhitehouse.archives.gov//briefings-statements/remarks-president-trump-press-briefing-072120/): “I do take probably, on average, a test every two days, three days. And I don’t know of any time I’ve taken two tests in one day, but I could see that happening.”
On Aug. 3, Politico [reported](https://www.politico.com/news/2020/08/03/white-house-requires-random-coronavirus-tests-390934) that executive branch employees were told they would be subject to random testing. A White House spokesperson told Politico: “As part of our ongoing efforts to protect the health and safety of the entire White House Complex, randomized testing of Executive Office of the President staff, which has been ongoing for several months, will become mandatory rather than voluntary.”
[News](https://www.statnews.com/2020/10/02/why-the-white-houses-testing-only-strategy-to-shield-trump-from-covid-19-fell-short/?utm_campaign=rss) [reports](https://www.cnn.com/2020/07/03/politics/coronavirus-white-house-test-abbott/index.html) and Trump’s former campaign manager Corey Lewandowski have indicated the White House uses an [Abbott labs test](https://www.abbott.com/IDNOW.html), which can provide results in 15 minutes. Lewandowski [said](https://www.today.com/video/corey-lewandowski-describes-white-house-covid-testing-procedure-92996677539) in an interview on the “Today” show on Oct. 2 that he received such a quick-results test twice this week when seeing Trump.
**Why didn’t the White House’s testing regimen prevent the president from becoming infected?**
Rigorous testing procedures can help identify cases and reduce the risk of an outbreak, but can’t ensure that no one will get infected.
As Harvard epidemiologist [Michael Mina](https://ccdd.hsph.harvard.edu/people/michael-mina/) [explained](https://twitter.com/michaelmina_lab/status/1312048742376378370) on Twitter, frequent testing worked in the sense that the transmission chain “is severed.” But, he added, tests are “not prophylactics.”
“They alone cannot stop the test taker from getting infected. But can serve to stop onward spread from the tester,” he wrote. “To stop from getting infected, masks/social distancing are needed.”
It’s also important to recognize the inherent limitations in diagnostic tests. Even if someone tests negative, that doesn’t necessarily mean that a person isn’t infected — only that the test didn’t detect the presence of the virus at that specific time.
Given that it can take [a few days](https://medical.mit.edu/covid-19-updates/2020/07/when-should-i-be-tested) or even longer for the virus to become detectable, a negative result means someone still could be infectious and other public health measures should still be taken.
The White House was reportedly using Abbot’s [ID NOW test](https://www.abbott.com/IDNOW.html) as a rapid test for screening staff. The test is a molecular test that [looks for the viral genome](https://www.abbott.com/corpnewsroom/product-and-innovation/how-id-now-tackles-covid-19.html) in a nasal swab sample, but is faster and less sensitive than the standard PCR tests.
Mina said in an Oct. 2 press call that the test was very good — perhaps the best rapid test available. But no test is perfect, and the test is not actually designed to be used the way the White House deployed it.
The FDA’s EUA was [revised](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-daily-roundup-september-18-2020) in mid-September to specify that testing is intended to be “from individuals who are suspected of COVID-19 by their health care provider within the first seven days of the onset of symptoms.” In other words, the test is meant for those who have symptoms, not for surveillance.
**What is the status of a COVID-19 vaccine?**
There are currently four companies running phase 3 trials of a [coronavirus vaccine](https://www.factcheck.org/2020/09/qa-on-coronavirus-vaccines/) in the U.S. One or more vaccines may be available by the end of the year or by early 2021 to select groups, assuming the trials go well and the shots are found to be safe and effective. Members of the general population who are not prioritized for vaccination, however, are [not expected](https://www.factcheck.org/2020/09/trump-again-overstates-speed-of-covid-19-vaccine-rollout/) to be able to receive a vaccine until later in 2021.
The leading company, in terms of timing, is Pfizer/BioNTech, which has enrolled 35,469 participants in its trial and given 24,298 volunteers both doses of its mRNA vaccine [as of](https://www.pfizer.com/science/coronavirus/vaccine) Sept. 28. It is the only company that still claims to be able to have an answer on whether its vaccine is safe and effective prior to Nov. 3.
Moderna’s phase 3 trial of its mRNA vaccine has [enrolled](https://www.modernatx.com/cove-study) 27,232 participants as of Sept. 25, 15,454 of whom have received two doses. Moderna’s CEO [said](https://www.ft.com/content/9b242ecc-3dce-4534-9171-cdf624468a2a) on Sept. 30 that the earliest he expected the company to be able to file an EUA with the FDA is Nov. 25, with a wider approval coming perhaps in March 2021.
Oxford-AstraZeneca’s viral vector vaccine trial is [still on pause](https://www.reuters.com/article/health-coronavirus-vaccine-astrazeneca/exclusive-fda-widens-us-safety-inquiry-into-astrazeneca-coronavirus-vaccine-sources-idUSL1N2GR1SK) in the U.S. pending an investigation into a possible severe side effect in a volunteer in the U.K.
Johnson & Johnson’s vaccine, which also uses a viral vector, albeit a different one, [began](https://www.jnj.com/johnson-johnson-initiates-pivotal-global-phase-3-clinical-trial-of-janssens-covid-19-vaccine-candidate) phase 3 testing on Sept. 23. It is the only candidate of the four to require only one dose and [not to need](https://www.wbur.org/commonhealth/2020/09/26/phase-three-trial-beth-israel-vaccine) subzero temperatures.
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