Medical Examiner

How Likely Is It That Trump Is Still Contagious?

His doctor cleared him to travel to Florida for a rally. Can we trust that?

Trump standing on an outdoor stage in front of a large crowd of his supporters
President Donald Trump at a rally in Sanford, Florida, on Monday. Saul Loeb/Getty Images

Less than 11 days after announcing he had been diagnosed with COVID-19, President Donald Trump traveled on Air Force One to a packed rally in Florida, where he spoke for an hour, declared that he was now immune to the virus, threatened to kiss the entire audience, and mocked Joe Biden for adhering to social distancing measures at his rallies. This behavior, in the middle of a deadly pandemic, would be questionable for any leader, but these actions are all the worse because it’s possible that Trump is still infectious.

The argument that Trump is not infectious comes from his doctor, Sean Conley. Conley’s reasoning hinges largely on two things: 1) that Trump meets the Centers for Disease Control and Prevention’s “criteria for the safe discontinuation of isolation,” as Conley wrote in a memo dated Oct. 10, because more than 10 days had passed since Trump first tested positive; and 2) that Trump has tested negative for the virus using a rapid test, as Conley wrote in an Oct. 12 memo.

It is certainly possible that Trump is no longer infectious. But the CDC guidance notes that it’s people with “mild to moderate COVID-19” who aren’t infectious 10 days following symptom onset. So if Trump’s illness was indeed “mild to moderate,” then, yes, according to the CDC, there is good reason to believe he was not infectious. But was it a mild to moderate illness? That narrative is contradicted by Trump’s trip to the hospital and the slew of drugs Trump received there, including steroids, a treatment shown to be effective only for very sick COVID-19 patients (steroids are potentially harmful to others). Trump himself declared last week on Twitter that he had been “very sick” when he headed to Walter Reed National Military Medical Center. It’s hard to say what this—the hospital, the drugs, the proclamation that he was “very sick”—really tells us about Trump’s illness. It could signal the kind of precautions we take with a president, or it could be an attempt to sell an experimental drug cocktail made by a member of one of the president’s golf clubs. But how bad Trump’s illness was matters for understanding his recovery. According to those CDC guidelines, “a limited number of persons with severe illness … may warrant extending duration of isolation and precautions.” That duration is up to 20 days, putting Trump and his rally squarely in the window of “potentially still infectious.”

These guidelines are largely for people without access to testing, which is not the situation the president is in. He can, and did, get tested. The test that Conley says he used is the Abbott BinaxNOW antigen card, and it showed he was negative “on consecutive days,” according to Conley. But at BuzzFeed, reporter Stephanie Lee assembles a convincing case for not taking Trump’s negative antigen tests at face value: The Food and Drug Administration has authorized them for use on patients who are within a week of the onset of COVID-19 symptoms. It’s not meant to be used days after, as the infection declines. The CDC does not recommend using antigen tests to clear patients from isolation. What experts really want to see are the results of a PCR test. So how did Trump do on that test? As Conley wrote in the Oct. 10 memo, “this morning’s COVID PCR sample demonstrates, by currently recognized standards, he is no longer considered a transmission risk to others.”

That sure sounds like he tested negative—but then, why wouldn’t they just state outright that Trump tested negative on the PCR test? Maybe because he didn’t. Conley has already proven—both prior to and during Trump’s illness—to be willing to hide and massage the facts about Trump’s health. We can’t trust Conley’s word, perhaps particularly when it coincides with the version of the truth that is most convenient for Trump. It’s not even clear that Trump was getting regularly tested prior to being infected with COVID; at minimum, Conley was unwilling to share information about that testing with the public. After Trump had spent the weekend in the hospital, Conley wouldn’t even tell reporters when Trump’s last negative test was, on the logic that “I don’t want to go backwards.”

Attending a crowded campaign event less than two weeks after a COVID-19 diagnosis, without full disclosures, is just the latest move in Trump’s attempts to paint his case of COVID-19 as mild to moderate. The effort echoes his guidance on the coronavirus in general: He wants people to think that the pandemic is not that big of a deal. Whether or not he was actively shedding the virus when he traveled to Florida, the message of the anemic disclosures on Trump’s health is perhaps the most dangerous of all: What’s most important to him is to show that there’s nothing to worry about here.