White House COVID-19 outbreak

White House COVID-19 outbreak
President Donald Trump speaking during the event held to announce Amy Coney Barrett's nomination to the Supreme Court in the White House Rose Garden. Social distancing was not practiced and most attendees were not wearing face masks.
Disease	COVID-19
Virus strain	SARS-CoV-2
Location	White House, Washington, D.C., United States
First reported	October 1, 2020
Index case	September 30, 2020
Arrival date	September 26, 2020 (2020-09-26)
Confirmed cases	At least 36
Hospitalized cases	3

The White House COVID-19 outbreak is a cluster of SARS-CoV-2 infections in September and October 2020 among people, including many government officials, who were in close contact during the COVID-19 pandemic in Washington, D.C. Numerous high-profile individuals were infected, including President Donald Trump, who was hospitalized for three days.

Many of the infections appeared to be related to a ceremony held on September 26 in the White House Rose Garden for the nomination of Amy Coney Barrett to the Supreme Court, where seating was not socially distanced and participants were mostly unmasked. Trump himself may have been infectious at that point, but he and his entourage attended several subsequent events unmasked, including the first presidential debate against Joe Biden. While returning to Washington aboard Air Force One, press advisor Hope Hicks was placed in quarantine after testing positive and developing symptoms. The president proceeded on schedule to a New Jersey fundraiser where he mingled, unmasked, with donors.

Other infections included First Lady Melania Trump; Republican Senators Thom Tillis, Mike Lee, and Ron Johnson; Trump's 2020 campaign manager Bill Stepien; Republican Party Chairwoman Ronna McDaniel; former White House counselor Kellyanne Conway; former New Jersey Governor Chris Christie; University of Notre Dame president John I. Jenkins; White House press secretary Kayleigh McEnany; and Senior Advisor to the President Stephen Miller. As of October 6, at least 35 people had tested positive.

The cluster emerged in the final weeks of Trump's campaign for the 2020 presidential election, a little more than a month before Election Day, November 3. Commentators were critical of the White House for providing conflicting information about Trump's condition and the timeline of his infection, as well as delaying the disclosure of the initial diagnoses of White House staffers. Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci, a member of the White House Coronavirus Task Force, said the outbreak could have been prevented.

Timeline of viral transmission

Background

Throughout the pandemic, Donald Trump and William Barr discouraged officials and staff from wearing masks. Those in the West Wing who did use them often faced ridicule from others. In April, the White House became one of the first locations to gain access to rapid-turnaround COVID-19 tests. The White House relied upon rapid-tests which lacked FDA-approval for use in asymptomatic individuals.

Throughout the spring, there had been sporadic cases of COVID-19 reported at the White House. On the evening of March 20, Katie Miller, the spokesperson for Vice President Mike Pence, announced that a staffer for the vice president had tested positive and was experiencing very mild symptoms, though neither Trump nor Pence had been in close contact with the staffer. Miller herself would test positive for COVID-19 on May 8, an announcement that came only one day after an unnamed personal valet to the president tested positive. Miller's positive test result caused several other Pence staffers who were in close contact with her to be removed from Air Force Two before Pence's trip to Iowa, but neither Trump nor Pence had been in recent close contact with Miller.

In June, the White House scaled back the screening regime, but still required screening and testing for anyone coming into contact with the president or vice president.

Crede Bailey, the head of the White House security office, became sick with COVID-19 sometime before the Supreme Court nomination ceremony on September 26 and was hospitalized sometime in September, becoming gravely ill. The White House declined to comment when his condition was reported in the news on October 7.

On September 16, it was reported that at least one unnamed staffer had tested positive. After Trump's hospitalization, it was revealed that two members of the residence staff had tested positive that week.

Trump meets with Ronna McDaniel, September 25

Trump met RNC chairwoman Ronna McDaniel, McEnany, and others at a September 25 fundraiser and had not met with McDaniel again when she tested positive on September 30. On October 1 McDaniels appeared on FoxNews and made no mention of having tested postive. An RNC spokesperson waited until October 2 to announce that McDaniel had tested positive.

Amy Coney Barrett nomination, September 26

President Trump announcing his Supreme Court nomination in the Rose Garden

On September 26, 2020, an event was held in the White House Rose Garden announcing Amy Coney Barrett's nomination to the Supreme Court following the death of Ruth Bader Ginsburg. More than 150 people attended; they were told they did not need to wear masks if they had tested negative that day. Chairs for the outdoor ceremony were placed side by side, and there were two crowded indoor receptions. At least seven attendees tested positive for SARS-CoV-2 in the following week, including President Trump, First Lady Melania Trump, Mike Lee, Thom Tillis, University of Notre Dame president John I. Jenkins, former Counselor to the President Kellyanne Conway, and former New Jersey Governor Chris Christie. Barrett had suffered infection in the summer before recovering and testing negative.

Conway's daughter Claudia revealed on social media on the evening of October 2 that Kellyanne Conway had tested positive for COVID-19. The same day, Senators Lee and Tillis were revealed to have tested positive. Christie confirmed on October 3 that he had tested positive for COVID-19. Christie had been present at debate preparation for Trump as well as the nomination ceremony for Barrett. Later that day, Christie announced he was hospitalized after his condition worsened. Lee was filmed hugging other attendees while not wearing a mask. Five of these people were seated in the front three rows at the event, in close contact with other Republican senior officials. Jenkins later issued a statement saying: "I regret my error of judgment in not wearing a mask during the ceremony and by shaking hands with a number of people in the Rose Garden."

Infectious disease physician Robert L. Murphy said that if the infections are traced to the Rose Garden ceremony, they may have been started by a super-spreader (a highly contagious person), and that they could have been avoided if face masks were worn and social distancing was practiced. He said, "Whoever got this thing going is a superspreader". The outdoor portion of the event was less likely to be a super-spreader event than the indoor portion.

The White House did not do contact tracing to minimize the spread of the outbreak, limiting any effort to notify those who have been exposed to Trump. The Centers for Disease Control made several offers to assist the White House with contact tracing, but they were repeatedly declined. On October 6, the White House announced that it had completed contact tracing, but several reporters who had tested positive for the virus said the White House had not reached out to them.

Joint Chiefs of Staff exposed, September 27

Trump hosted Gold Star Families and Pentagon leaders in the East Room of the White House. Trump and military leaders were photographed not wearing masks. Defense Secretary Mark Esper and General Mark Milley, Chairman of the Joint Chiefs of Staff, attended the event. Admiral Charles Ray, vice commandant of the Coast Guard, attended the event, later tested positive and entered isolation on Oct 6. On October 2, Ray attended meetings at the Pentagon with members of the Joint Chiefs of Staff. On Oct 6 all but one the Joint Chiefs of Staff—Gen. David H. Berger, Commandant of the Marine Corps—— went into quarantine, including Milley, Vice Chairman John E. Hyten, Chief of Naval Operations Michael M. Gilday, Chief of Staff of the Army James C. McConville, Air Force Chief of Staff Charles Q. Brown Jr., Chief of Space Operations John W. Raymond, Chief the National Guard Bureau Daniel Hokanson, and Commander of U.S. Cyber Command Paul Nakasone. Of those quarantined, General Nakasone is a combatant commander, part of the direct chain of command from the president to the military, and also the Director of the National Security Agency. General Gary L. Thomas, assistant commandant of the Marine Corps, stood in for Gen. Berger at the meeting and later tested positive with symptoms.

First presidential debate, September 26–29

Multiple White House personnel attended the September 29 debate at the Cleveland Clinic. Trump, Melania, and senior advisor Hope Hicks attended the debate and later tested positive. senior advisor Stephen Miller was also on Air Force One for the trip and later tested positive. Also in attendance were Ivanka Trump and her siblings, Donald Jr., Eric, Lara and Tiffany Trump.

Debate preparation

Trump prepared for the debate between September 26 and September 29 in the Map Room of the White House. His debate preparation team included Chris Christie, Hope Hicks, Kellyanne Conway, Rudy Giuliani, Jason Miller, Mark Meadows, Jared Kushner, Kayleigh McEnany, and Alyssa Farah. Christie stated that no masks were worn. Five of the 10 debate prep team members tested positive for SARS-CoV-2 within a week after the debate. The City of Cleveland said that at least 11 people who "were either members of the media or were scheduled to work logistics/set-up the days prior to the event" later tested positive.

Lack of masks and testing

Prior to the debate, both campaigns agreed with the Commission on Presidential Debates that all attendees would be masked, with the exception of the two presidential candidates and the debate moderator. Masking was enforced at the door, but several of Trump's guests in the audience, including his wife Melania, his family members, and senior staff, removed their masks after entering the hall. When Trump's guests were personally offered masks by Cleveland Clinic staff, they declined.

All attendees were supposed to be tested for coronavirus before admission. After the outbreak was public, debate moderator Chris Wallace revealed that Trump and his personnel arrived too late to be tested and were instead admitted to the debate hall under "an honor system". In the coming days, White House repeatedly declined to say when Trump last tested negative, raising speculation that he may have gone untested or even tested positive prior to the debate. On October 6, the New York Times broke news that, despite public impressions to the contrary, Donald Trump was not actually being tested daily.

Minnesota fundraiser and rally, September 30

On Wednesday, Trump went to suburban Minneapolis for a private fundraiser at the home of Marty Davis, CEO of kitchen counter-top manufacturer Cambria. Thirteen members of the catering staff were quarantined after their exposure. That fundraiser was followed by a rally in Duluth. Hope Hicks, one of his closest advisors, was with him for the trip. The rally ended around 10 p.m. EDT.

Hicks diagnosed amid secrecy

During the Minnesota rally, Hicks stayed aboard the plane because she was not feeling well, and she quarantined herself at the back of the plane for the flight home. A test confirmed her diagnosis as COVID-positive. Aides sensed that Trump was not feeling well during the Wednesday trip.

The White House initially sought to keep Hicks' diagnosis secret, and as of the morning of Thursday, October 1, only a very small group of senior White House officials knew of Hicks' diagnosis. No mention of her diagnosis was made in press secretary Kayleigh McEnany's news briefing that day. McEnany later tested positive. After learning of Hicks's positive test, CNN reporter Kaitlan Collins said, "Why did the press secretary still hold a briefing despite knowing she had come into contact with somebody who had just tested positive for coronavirus? She didn't even tell us. Didn't even tell reporters who were on the plane. Didn't disclose any of that." McEnany later said she did not learn about Hicks until later that day.

Hicks diagnosis becomes public

Hicks' diagnosis was first reported by Jennifer Jacobs and Jordan Fabian of Bloomberg at 8:07 p.m. on October 1.

Bedminster fundraiser, October 1

At least five of Trump's closest associates cancelled their scheduled travel to a fundraiser at Bedminster: daughter Ivanka Trump, son-in-law Jared Kushner, body man Nick Luna, Trump's deputy chief of staff for communications Dan Scavino, and press secretary Kayleigh McEnany. Despite his exposure, Trump proceeded with the event, flying aboard Air Force One. The event had an indoor roundtable, an indoor VIP reception, and an outdoor reception. Trump spoke without a mask to over 200 supporters, most of whom also didn't wear a mask. Attendees noted that Trump seemed "lethargic" and "not himself". He showed symptoms of a mild cough, some nasal congestion, and fatigue. Jayna McCarron, Coast Guard aide to President Trump, was assigned to accompany Trump to the Bedminster fundraiser. She has since tested positive for SARS-CoV-2.

Widespread outbreak

On October 2, it was announced that Trump 2020 campaign manager Bill Stepien tested positive. On October 2, Wisconsin U.S. Senator Ron Johnson, who was exposed to someone who tested positive when he returned to Washington D.C. on September 29, tested positive for COVID-19 which he waited to reveal until October 3. Johnson said he had been with Trump over the last several weeks. Three White House press room journalists, including Michael D. Shear, also tested positive on October 2, as did a White House staffer who works with the press.

Trump's personal attendant Nick Luna's positive test results were announced on October 3. Luna had been at the debate and on the flight to Minnesota. Claudia Conway, the daughter of Kellyanne Conway, announced on Oct 4 that she had tested positive as well. On October 5, White House Press Secretary Kayleigh McEnany announced she had also tested positive. Two other White House press room staffers, Chad Gilmartin and Karoline Leavitt, were also reported to have tested positive on October 5. On October 6, new announced infections included: assistant press secretary Jalen Drummond, presidential military aide Jayna McCarron, and an unidentified military aide.

In the wake of their exposure to White House personnel, multiple individuals announced having tested negative for SARS-CoV-2, although a negative result does not imply one is not infected. Vice President Mike Pence and his wife Karen, presidential candidate Joe Biden, Biden's running mate Kamala Harris, Biden's wife Jill Biden, Attorney General William Barr, and Trump nominee Barrett all tested negative in the day following public revelation of the outbreak. Many of Trump's family members, including Ivanka Trump, Barron Trump, Jared Kushner, Eric Trump, Lara Trump, and Donald Trump Jr. also received a negative result.

Vice presidential debate, October 7

Further information: 2020 United States presidential debates § Vice presidential debate (University of Utah)

Two days before the Wednesday debate between Pence and Sen. Kamala Harris, the Commission on Presidential Debates announced that the stage at the University of Utah would feature plexiglass barriers separating Pence, Harris, and the moderator Susan Page of USA Today.

At the Rose Garden ceremony on September 26, Pence had sat one row away from Mike Lee, five seats away from Thom Tillis, and three rows away from Kayleigh McEnany. Pence was also with Trump and Melania at the reception for Gold Star Families and was with Trump in the Oval Office the day of the first presidential debate. Pence's physician said that Pence, who tested negative, was not a close contact with anyone who had tested positive and did not need to quarantine. Some outside observers raised continuity-of-goverment concerns with Pence declining to quarantine.

Despite his known exposure, Pence asked to not have a plexiglass barrier on his side of the stage, with his spokesman arguing that the twelve feet of distance between the participants made the precaution unnecessary and mocking Harris for using the barrier. The day before the debate, Pence dropped his objections and agreed to the barrier.

Presidential hospitalization and early release

October 1

After returning from Bedminster, Trump received a positive test result on a rapid test and was waiting to get results of a PCR test when he did a live phone interview on Hannity. Sean Hannity of Fox News brought up Bloomberg's report about Hicks and asked for an update, whereupon Trump publicly mentioned Hicks' diagnosis for the first time, saying, "I just heard about this. She tested positive." Trump blamed the military and law enforcement for Hope Hicks's infection, saying, "It is very, very hard when you are with people from the military, or from law enforcement, and they come over to you, and they want to hug you, and they want to kiss you because we really have done a good job for them." Without disclosing that he had already tested positive, he announced that he and the first lady were being tested for SARS-CoV-2. He repeated this via Twitter after the interview. Later that night, the result of the PCR test also came in positive.

October 2

Avatar of Donald Trump

Donald Trump

@realDonaldTrump

Tonight, @FLOTUS and I tested positive for COVID-19. We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!

October 2, 2020

At 12:54 a.m. EDT on October 2, Trump announced via Twitter that both he and the first lady had tested positive for the SARS-CoV-2 virus that night. The afternoon of the same day, the White House announced that Trump would be hospitalized at Walter Reed National Military Medical Center in Bethesda, Maryland "for the next few days" "out of an abundance of caution", on the recommendation of the medical team headed by Sean Conley, a doctor of osteopathy who has been the Physician to the President since 2018. Conley is a Navy commander obliged to follow the orders of the commander in chief. Trump, who was wearing a mask, was briefly filmed walking unassisted from the White House to the Marine One helicopter outside to transport him to Walter Reed. According to White House Chief of Staff Mark Meadows, Trump was hospitalized because he "had a fever and his blood oxygen level had dropped rapidly". The Associated Press reported that "a person familiar with Trump's condition confirmed that Trump was given oxygen at the White House" in the morning before arriving at Walter Reed, although Trump's doctors have refused to say whether he had ever been given supplemental oxygen.

On Friday afternoon, physicians revealed Trump had been given an experimental course of monoclonal antibodies from drug maker Regeneron Pharmaceuticals, which further confirmed that Trump had received an "8 gram dose of REGN-COV2". The drug was immediately provided in response to a "compassionate use" request from the medical team. That night, Trump received his first infusion of remdesivir, an antiviral drug that disrupts virus replication. Remdesivir has not been approved by the Food and Drug Administration, but has been used as an emergency treatment for hospitalized COVID-19 patients. The extremely aggressive combination was described as "uncharted territory"; Trump is believed to be the first individual to ever undergo both treatments simultaneously.

October 3

'Dr. Sean Conley, Physician to the President, Provides an Update on President Trump' – video courtesy of the White House.

At an 11 a.m. press conference on October 3, Conley stated that Trump was not currently on oxygen, that he had not had a fever for the past 24 hours, and that he was "doing very well". However, minutes after the press conference, an anonymous source — later identified as Meadows — contradicted the assessment from the doctors, saying "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", adding "We're still not on a clear path yet to a full recovery." Shortly thereafter, Meadows stated on the record the president was "doing very well".

Trump in the Walter Reed conference room, October 3. There were some reports of speculation that the photo was "staged".

On Saturday night, Conley warned that Trump was "not yet out of the woods" with regard to his condition. In the press briefing on the morning of October 3, Conley described Trump as being "just 72 hours into the diagnosis now", raising questions among journalists about when the diagnosis had actually been made, since it had been publicly announced only 36 hours previously. A 72-hour timeline would suggest that Trump actually knew he had the infection on September 30, but proceeded with his plans for a public rally that evening and a fund-raiser on October 1. Conley later clarified that he had meant "day three" instead of "72 hours", referring to the then-current time of Saturday morning compared to the diagnosis time of Thursday night (about 36 hours). Doctors also revealed that he had exhibited symptoms on October 1, including a "mild cough, and some nasal congestion and fatigue". On the night of October 3, the White House released two photos whose captions say they show him working at the hospital; he was shown signing documents but they appeared to be blank.

October 4

Sean Conley's press update on President Trump, October 4 – video courtesy of the White House

In an October 4 press conference, Trump's medical team claimed that he was "doing really well" after his oxygen level dipped the day before and after he was given the steroid dexamethasone, which works by reducing inflammation in the lungs, but can have significant mental health side effects, including psychosis, delirium and mania. Asked if CT scans showed pneumonia or lung damage, Conley said, "There's some expected findings, but nothing of any major clinical concern." He declined to say what was found. When asked why he was reluctant to disclose that Trump had been given oxygen during the October 3 briefing, Conley stated that he did not want to "give any information that might steer the course of illness in another direction" and "it came off that we're trying to hide something, which wasn't necessarily true." White House Director of Strategic Communications Alyssa Farah later stated that it was "a common medical practice that you want to convey confidence, and you want to raise the spirits of the person you're treating," while also asserting that Meadows' anonymous statement to reporters was intended to "give you guys more information just to try to be as transparent as we can,” effectively conceding Conley was addressing the president on television, rather than the public. The president was reported to be angry about Meadows' off-the-record assessment.

Trump greets supporters from inside an SUV on October 4.

Later in the day, Trump left the hospital in order to ride past a gathering of supporters at the medical center, waving from the back seat of an SUV, before returning to the hospital. Medical experts stated that the outing recklessly endangered the Secret Service agents inside the car by exposing them to the virus. The stunt drew sharp criticism from James Phillips, doctor of emergency medicine at George Washington University and an attending physician at Walter Reed, who called it "insanity" and wrote: "That Presidential SUV is not only bulletproof, but hermetically sealed against chemical attack. The risk of COVID-19 transmission inside is as high as it gets outside of medical procedures. The irresponsibility is astounding. My thoughts are with the Secret Service. ... Every single person in the vehicle during that completely unnecessary Presidential 'drive-by' just now has to be quarantined for 14 days. They might get sick. They may die. For political theater. Commanded by Trump to put their lives at risk for theater."

Within the Secret Service, some agents expressed outrage or frustration with Trump's behavior. One anonymous agent told journalists, "He's not even pretending to care now." Joseph Petro, a former veteran Secret Service agent and senior official, wrote in a Washington Post op-ed that Trump's behavior was part of a longstanding pattern of endangering others; he criticized Secret Service management for an "inexcusable lack of concern" for the health of agents and their families, writing: "The Secret Service cannot protect the president from himself, but its management has a solemn responsibility to protect those agents who put their lives on the line every day to protect him."

October 5

Sean Conley's press update on President Trump on October 5 – video courtesy of the White House

At 2:37 p.m. EDT on October 5, Trump tweeted that he would be discharged from the hospital at 6:30 p.m. that day. However, doctors said in an afternoon news briefing that Trump continued to be treated with dexamethasone and remdesivir. The prospect of Trump's early release astonished infectious-disease experts, who noted that Trump planned to be discharged in a period when COVID-19 patients are particularly vulnerable (7–10 days after symptoms first appear) to unpredictable and rapid declines in condition. Outside physicians stated that the depiction of Trump's illness as relatively mild was inconsistent with the aggressive treatment he was receiving. Trump's medical team made cryptic remarks about his status and declined to say whether Trump's CT scans contained indications of pneumonia or lung damage.

After reportedly pressuring his doctors to release him, he was discharged and arrived at the White House shortly before 7 p.m. He stood for a photo op at the South Portico balcony, where he removed his mask, potentially exposing nearby staffers. Having climbed two flights of stairs to the balcony, Trump appeared to breathe heavily as he steadied himself. He then gave a salute before walking inside. He later went back outside with a camera crew to reshoot his entrance. Within an hour of his arrival he released a video showing Marine One's flight and landing and his saluting pose. The video included a message saying, "We're going back to work. We're going to be out front. As your leader, I had to do that. I knew there's danger to it, but I had to do it. I stood out front. I led. Nobody that's a leader would not do what I did. And I know there's a risk, there's a danger, but that's OK. And now I'm better and maybe I'm immune, I don't know. But don't let it dominate your lives." The message was widely criticized. The New York Times commented, "Trump's statement was meant to cast his illness as an act of courage rather than the predictable outcome of recklessness." He also echoed a message he had earlier tweeted: "Don't be afraid of Covid. Don't let it dominate your life" - a message which angered many survivors of the virus or people who had lost loved ones to the disease. Trump's tests, treatments, airlifts, and hospital stay, if given to an average American, would have cost more than $100,000. The helicopter rides alone would have cost $40,000 after insurance.

October 6–7

On October 6 and 7, Trump made no public appearances and had an empty public schedule, although he made more than 50 Twitter posts. In tweets from the White House, Trump compared SARS-CoV-2 to the flu and falsely claimed that the flu had higher death rates: "Are we going to close down our Country (because of the flu)? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!" Many doctors expressed alarm at the notion that the public should "learn to live with" the pandemic. Twitter tagged the post with a "misleading and potentially harmful information" flag, and Facebook removed a similar post by Trump. Four hours after the tweet, and after it was flagged by Twitter's staff, Trump tweeted "REPEAL SECTION 230", an attack against Section 230 of the Communications Decency Act, which protects online platforms from litigation surrounding the content their users post.

In the White House Trump continued to receive dexamethasone and remdesivir. He conducted business without wearing a mask. Conley said in a memo that Trump has "no symptoms" and is doing "extremely well."

Trump announced on October 6 that he was ending talks with House Democrats and Speaker of the U.S. House of Representatives Nancy Pelosi for an additional coronavirus relief bill. Three days earlier he had tweeted, "OUR GREAT USA WANTS & NEEDS STIMULUS. WORK TOGETHER AND GET IT DONE." Trump's behavior caused some White House staffers to wonder if he was being influenced by the cocktail of drugs he had been taking. A plan for a live nationwide address was discussed but was replaced with a plan to tape one instead. Aides said that Trump still sometimes sounded as if he was trying to catch his breath. Less than 8 hours after announcing that he would end talks with Pelosi, he announced that he would "IMMEDIATELY" sign a stimulus bill, reversing his previous decision.

Continuity of government implications

Presidential power

As of October 3, 2020, a White House spokesperson confirmed that Trump remained active as president and that there had been no transfer of presidential power to the vice president. On October 2, House Speaker Nancy Pelosi, next in line for the presidency after Pence, said that the White House had not contacted her about continuity of government.

Stock markets briefly slumped more than 1.5 percent after Trump announced his diagnosis, but they cut their losses after Pelosi said she anticipated an economic relief deal. The S&P 500 Index ended the day down almost 1 percent.

The incident has been compared to the non-fatal shooting of Ronald Reagan in 1981, which saw similar concerns over continuity of government amid incapacitation of the president.

Military

Some national security analysts said the president's diagnosis put the United States into "uncharted territory" and "deep into the danger zone". Former Defense Secretary Leon Panetta said that Trump's hospitalization raises serious national security concerns and that adversaries should be expected to exploit any vulnerabilities of the United States. However, several former defense officials downplayed concerns of foreign opportunism and argued that the U.S. national security apparatus — including the nuclear command-and-control elements of that system — is resilient enough to withstand the impact of an ill or incapacitated president. Former Deputy Assistant Secretary of Defense for the Middle East Mick Mulroy said, "Unless symptoms are severe enough for the commander-in-chief to be incapacitated, it would not require a change of the chain of command," and that it was unlikely an adversary would use the situation to "test" the U.S. Mulroy did, however, call on national security leaders to be present in Washington, D.C., to "ensure the continuity of government and send a message to any adversary that may want to exploit the situation." On October 2, the Pentagon issued a statement saying, "There's no change to the readiness or capability of our armed forces. Our national command and control structure is in no way affected" by Trump's diagnosis.

Potential concerns

Foreign intelligence concerns

Former senior CIA officers noted that the crisis created counterintelligence challenges, as foreign intelligence services routinely collect information on health of leadership, using various sources and methods. Former CIA Director John E. McLaughlin said that "foreign intelligence services, particularly hostile ones, have no higher priority than understanding events in a president’s inner circle, it's reasonable to assume that they have sources somewhere seeking access to reliable information on his diagnosis." Mick Mulroy, an ABC News analyst and retired CIA officer, stated that foreign adversaries could take advantage of information in an atmosphere of confusion.

Fitness concerns

There was some concern that Trump's steroid treatment could affect his mental state. One expert commented: "Some patients may develop psychiatric symptoms after being treated with steroids including euphoria, mood instability, rage or psychosis. It is rare, but occurs often enough that we recognize them as undesirable side effects of steroid therapy."

After Trump left the hospital for a motorcade excursion and posted over a dozen all-caps tweets, it was speculated that the president was suffering from "steroid-induced psychosis". Megan Ranney, an emergency physician and professor at Brown University, told CNN's Wolf Blitzer: "I would never want to say the president is experiencing steroid-induced psychosis, but it is certainly concerning to see some of his actions today in the wake of this potentially deadly diagnosis and infectious disease."

According to reporting by Gabriel Sherman of Vanity Fair, Donald Trump Jr. expressed concerns on October 4 that the president was "acting crazy". On October 5, Trump tweeted that he was "Feeling really good" and felt "better than I did 20 years ago", contributing to some speculation that his mental state was a side effect of medication.

At 2:48 p.m. EDT on October 6, Trump unexpectedly announced on Twitter that he was halting negotiations on a coronavirus stimulus bill. The announcement caused another sudden drop in the stock market, and Speaker Pelosi questioned if his steroid use was affecting his decision-making. Trump reversed this decision in another tweet sent at 10:18 p.m. EDT on the same day.

Reactions

Arthur Caplan, a bioethicist at the NYU Grossman School of Medicine, has stated that the outbreak and specifically Trump's diagnosis would lead to more calls for transparency about Trump's health as well as conspiracy theories about how he was infected.

Some medical experts noted that dexamethasone is typically administered in severe and critical cases of infection, to suppress an immune system overreaction that attacks vital organs which can lead to death. Dexamethasone has not been shown to be effective in milder cases of the disease. Others noted that such steroids can have mood-altering side affects ranging from depression to mania, even delirium and psychosis. There was also a risk of harmful drug interactions by administering several therapeutics at once. Some experts noted a so-called “VIP syndrome,” in which a prominent patient insists on directing his own medical care, suggesting the president may have sought aggressive treatment without understanding the potential risks. As a Navy doctor, Conley is obliged to follow orders of the commander in chief. After Trump extensively promoted hydroxychloroquine as a defense against infection in spring 2020, Conley administered him a two-week regimen of the drug, despite no studies finding it was effective and it had potentially dangerous side effects.

United States public

The response from the US public was mixed, and often split along ideological lines. Some supporters of Joe Biden said they weren't surprised that Trump and other Republicans had tested positive, due to a perceived lack of precautions from Trump and other Republican party members. Trump supporters expressed sympathy for the president. Some people, on the left and on the right, said they did not believe the diagnosis. Fox News noted that comedian Michael Che wished Trump "a very lengthy recovery" on the news satire sketch Weekend Update.

An October 2–3 Reuters/Ipsos poll found that American disapproval of Trump's handling of the pandemic had increased from the previous week, with 65% of registered voters agreeing with the statement "if President Trump had taken coronavirus more seriously, he probably would not have been infected." Another poll on October 6 revealed that 21% of respondents were more likely to wear a mask due to the news of Trump acquiring the disease.

Twitter announced that any posts wishing for Trump's death would be removed for violating the platform's terms of service. Congresswomen Rashida Tlaib, Alexandria Ocasio-Cortez, Ilhan Omar, and Ayanna Pressley criticized Twitter for not taking threats against them seriously, pointing to longstanding posts calling for their deaths that had not been removed. Facebook and TikTok announced similar policies.

United States politicians

On October 2, Democratic presidential nominee Joe Biden said that he and Jill Biden send their "prayers for the health and safety" of Donald and Melania Trump. He took all of his negative political ads off the air following the announcement of Trump's diagnosis. His running mate Sen. Kamala Harris said that she and her husband Doug are sharing their "deepest prayers for the health and recovery of the president and the first lady." Former president Barack Obama extended his "best wishes" to Trump and said that he and Michelle Obama hope for a speedy recovery for the Trumps. House Speaker Nancy Pelosi said, "I always pray for the president and his family that they're safe" and said that she received the news with "great sadness". Senate Minority Leader Chuck Schumer wished Donald and Melania Trump and White House staffers a "speedy recovery".

International politicians and leaders

Many politicians around the world expressed wishes for a quick recovery; others commented on the lack of response to the pandemic and the downplaying of the virus. Indian Prime Minister Narendra Modi, Israel Prime Minister Benjamin Netanyahu, Russian President Vladimir Putin, British Prime Minister Boris Johnson and others issued statements of support over the outbreak through social media. Others were more critical of the outbreak; French government spokesman Gabriel Attal warned that the virus spared no one, even those skeptical about its reality and seriousness. Radoslaw Sikorski, a European Parliament member and former Polish foreign minister, tweeted that Trump should not try to treat himself with bleach, referring to Trump's earlier suggestion to try using disinfectants as a Covid-19 treatment "by injection inside or almost a cleaning."

Misinformation and conspiracy theories

Shortly after the announcement that Trump had tested positive, misinformation and conspiracy theories were seen throughout social media postings. Some theories were spread by believers in the QAnon conspiracy theory, who believe that COVID-19 is a narrative constructed by a Democratic Party deep state to seize power in the United States, and that Trump's positive diagnosis was tactical as part of a larger plan to arrest Hillary Clinton. Other theories posted on social media ranged from the theory Trump was feigning the illness so he could quickly recover and downplay the threat of COVID-19, to the theory Trump wanted to delay the election or distract the public from his tax returns. Many of the conspiracy theories are politically motivated, aided by conflicting and contradictory information announced to the public by the White House, the presidential medical team, and Trump's own tweets.

List of COVID-19 infections and notable exposures

Tested positive

Timeline of the COVID-19 outbreak with positive tests

Person	Position	Event status					Current status	Date reported
		Barrett nomination Sep 26	Gold Star Day Sep 27	Ohio debate Sep 29	Duluth rally Sep 30	Bedminster fundraiser Oct 1
Multiple unidentified staffers	White House staffers	Unknown					Positive	Sep 16
Crede Bailey	Head of White House Security Office	Diagnosed before Barrett nomination event, hospitalized in September					Hospitalized	Oct 6
Hope Hicks	Senior Counselor to the President					Isolating	Positive and symptomatic	Oct 1
Donald Trump (R)	45th President of the United States						Hospitalized; Discharged	Oct 2
Mike Lee (R)	United States Senator from Utah						Positive and symptomatic	Oct 2
Thom Tillis (R)	United States Senator from North Carolina						Positive and symptomatic	Oct 2
Melania Trump	First Lady of the United States						Positive and symptomatic	Oct 2
Kellyanne Conway	Former Counselor to the President						Positive and symptomatic	Oct 2
Ronna McDaniel	Chair of the Republican National Committee	Attended D.C. fundraiser with Trump on Sept. 25					Positive and symptomatic	Oct 2
Michael D. Shear & wife	White House correspondent for The New York Times	Michael Shear traveled with Trump and Kayleigh McEnany on a round trip aboard on Sept. 26					Positive and symptomatic	Oct 2
Bill Stepien	Trump campaign manager, former White House Director of Political Affairs	Traveled to Cleveland debate aboard Air Force One with President, First Lady, Hope Hicks, and Steven Miller					Positive and symptomatic	Oct 2
Al Drago	White House press room photojournalist						Positive	Oct 2
One unidentified journalist	White House press room journalist		Unknown				Positive	Oct 2
11 unidentified persons	Debate preparation staff or media						Positive	Oct 2
Nick Luna	Body man to Donald Trump					Cancelled	Positive	Oct 3
Chris Christie (R)	Former Governor of New Jersey		Exposed to Trump at Amy Coney Barrett meeting on Sept. 26, at debate prep meetings and a press conference on Sept. 27				Hospitalized	Oct 3
John I. Jenkins	President of the University of Notre Dame						Positive and symptomatic	Oct 3
Ron Johnson (R)	United States Senator from Wisconsin	Exposed to unnamed individual on Sept. 14					Positive but asymptomatic	Oct 3
Claudia Conway	Daughter of Kellyanne Conway	Exposed to mother					Positive and symptomatic	Oct 4
Kayleigh McEnany	White House press secretary					Cancelled	Positive	Oct 5
Greg Laurie	Senior pastor of Harvest Christian Fellowship						Positive	Oct 5
Chad Gilmartin	Principal assistant press secretary						Positive	Oct 5
Karoline Leavitt	Assistant press secretary						Positive	Oct 5
Two unidentified staffers	White House residence staff	Regularly exposed to First Family					Positive	Oct 5
Jayna McCarron	U.S. Coast Guard aide to the president						Positive	Oct 6
One unidentified military personnel	President's valet	Regularly exposed to Trump					Positive	Oct 6
Adm. Charles Ray	Vice commandant of the Coast Guard						Positive	Oct 6
Jalen Drummond	Assistant White House Press Secretary						Positive	Oct 6
Stephen Miller	Senior Advisor to the President						Positive	Oct 6
Salud Carbajal (D)	United States Representative from CA-24	Reportedly exposed to Sen. Mike Lee					Positive and symptomatic	Oct 6
Gen. Gary Thomas	Marine Corps’ assistant commandant	Exposed to Gen. Milley					Positive and symptomatic	Oct 7

Tested negative or unknown

Timeline of negative tests related to the White House COVID-19 outbreak

Person	Position	Event status					Current status
		Barrett nomination Sep 26	Gold Star Day Sep 27	Ohio debate Sep 29	Duluth rally Sep 30	Bedminster fundraiser Oct 1
Jared Kushner (R)	Trump advisor, son-in-law					Cancelled	Negative
Ivanka Trump (R)	Trump advisor, daughter					Cancelled	Negative
Eric Trump (R)	Son of Donald Trump						Negative
Lara Trump	Wife of Eric Trump, daughter-in-law of Donald Trump						Negative
Donald Trump Jr. (R)	Son of Donald Trump						Negative
Dan Scavino	White House Deputy Chief of Staff for Communications and Director of Social Media					Cancelled	Negative
Mike Pence (R)	Vice President of the United States						Negative
Karen Pence	Second Lady of the United States						Negative
William Barr (R)	Attorney General of the United States						Negative
Amy Coney Barrett	Federal appellate judge, nominee to the Supreme Court						Negative (previously infected)
Joe Biden (D)	Former Vice President, 2020 Democratic nominee for President						Negative
Jill Biden	Former Second Lady						Negative
Mark Meadows (R)	White House Chief of Staff						Negative
Eugene Scalia (R)	United States Secretary of Labor						Negative
Ben Sasse (R)	United States Senator from Nebraska						Negative
Deb Fischer (R)	United States Senator from Nebraska						Negative
Kelly Loeffler (R)	United States Senator from Georgia						Negative
Josh Hawley (R)	United States Senator from Missouri						Negative
Jim Jordan (R)	United States Representative from OH-04						Negative
Chris Coons (D)	United States Senator from Delaware						Negative
Lisa Blunt Rochester (D)	United States Representative from DE-AL						Negative
Chris Wallace	Fox News anchor, debate moderator						Negative
Tiffany Trump	Daughter of Donald Trump						Unknown
Kimberly Guilfoyle	Trump advisor, romantic partner of Donald Trump Jr.						Unknown (previously infected)
Pat Cipollone (R)	White House counsel						Unknown
Rudy Giuliani (R)	Former Mayor of New York City, Trump advisor						Awaiting results, potentially symptomatic
Mike Crapo (R)	United States Senator from Idaho						Unknown
Marsha Blackburn (R)	United States Senator from Tennessee						Unknown
Mark Esper	Secretary of Defense						Unknown
Gen. Mark Milley	Chairman of the Joint Chiefs of Staff						Unknown
Barron Trump	Son of Donald and Melania Trump	Presumed exposed to parents.					Negative
Joni Ernst (R)	United States Senator from Iowa	Exposed to Sen. Mike Lee on Oct. 1 at Judicary Committee meeting.					Negative
Tate Reeves (R)	Governor of Mississippi	Exposed to Trump on Sept. 28 at a event announcing a COVID-19 testing initiative					Negative
Alex Azar (R)	United States Secretary of Health and Human Services	Exposed to Trump and five others at White House meeting with Amy Coney Barrett on Sept. 26. Exposed to Trump on Sept. 28 at a event announcing a COVID-19 testing initiative.					Negative
Mike Turner (R)	United States Representative from OH-10	Exposed to Trump on Sept. 28 at event featuring Lordstown Motors					Negative
Robert B. Ford	CEO of Abbott Laboratories	Exposed to Trump on Sept. 28 at a event announcing a COVID-19 testing initiative					Negative
Betsy DeVos	United States Secretary of Education	Exposed to Trump on Sept. 28 at a event announcing a COVID-19 testing initiative					Negative
Steven Mnuchin	United States Secretary of the Treasury	Exposed to Trump on Sept. 30 at an Oval Office meeting					Negative
Paula Reid	White House correspondent for CBS News	Exposed to Kayleigh McEnany and another staffer at press briefing on Oct. 1					Awaiting results
Ben Carson (R)	United States Secretary of Housing and Urban Development	Exposed to Trump at campaign event in Atlanta on Sept. 25					Unknown
Rob Portman (R)	United States Senator from Ohio	Exposed to Trump on Sept. 28 at event featuring Lordstown Motors					Unknown
Peter Navarro (R)	Director of the Office of Trade and Manufacturing Policy	Exposed to Trump on Sept. 28 at event featuring Lordstown Motors					Unknown
Gen. John E. Hyten	Vice Chairman of the Joint Chiefs of Staff	Quarantined after exposure to Adm. Charles Ray.					Unknown
Gen. James C. McConville	Chief of Staff of the Army	Suspected quarantined after exposure to Adm. Charles Ray.					Unknown
Gen. David H. Berger	Commandant of the Marine Corps	Suspected quarantined after exposure to Adm. Charles Ray.					Unknown
Gen. Charles Q. Brown Jr.	Chief of Staff of the Air Force	Quarantined after exposure to Adm. Charles Ray.					Unknown
Gen. John W. Raymond	Chief of Space Operations	Quarantined after exposure to Adm. Charles Ray.					Unknown
Gen. Daniel R. Hokanson	Chief of the National Guard Bureau	Suspected quarantined after exposure to Adm. Charles Ray.					Unknown
Adm. Mike Gilday	Chief of Naval Operations	Suspected quarantined after exposure to Adm. Charles Ray.					Unknown
Gen. Paul Nakasone	Director of the NSA	Suspected quarantined after exposure to Adm. Charles Ray.					Unknown
Robert C. O'Brien	United States National Security Advisor	Traveled to Cleveland for the Presidential Debate aboard Air Force One					Unknown

Timeline of events

• September 16: At least one unnamed staffer tests positive
• September 26:
  • Rose Garden ceremony nominating Amy Coney Barrett to the Supreme Court, and reception following
  • Middletown, Pennsylvania rally
  • Debate prep team meets at White House
• September 27:
  • Golfing, Reception for Gold Star families
  • Debate prep team meets at White House
• September 28:
  • Debate prep team meets at White House
  • Press conference announcing a new COVID-19 testing initiative
• September 29:
  • Debate prep team meets at White House
  • First presidential debate
• September 30:
  • Shorewood fundraiser
  • Duluth rally
  • Hope Hicks quarantined
• October 1, 3 known cases:
  • Kayleigh McEnany holds press briefing despite knowledge of exposure
  • Bedminster fundraiser
  • Trump tests positive
  • Hope Hicks diagnosis revealed by Bloomberg News
  • Sean Hannity appearance
  • Stephen Miller begins self-quarantine.
• October 2, 25+ known cases:
  • Trump announces his diagnosis via Twitter
  • Trump airlifted to Walter Reed
• October 3, 28+ known cases: Trump in hospital
• October 4, 28+ known cases: Trump in hospital, motorcade excursion
• October 5, 32+ known cases: Trump returns to White House
• October 6, 35+ known cases:
  • Admiral Charles Ray tests positive
  • Coast Guard aide to the President Jayna McCarron tests positive
  • An unnamed military person who serves as valet to the President tests positive
  • Joint Chiefs of Staff self-quarantine due to exposure via Admiral Ray
  • Assistant Press Secretary Jalen Drummond's positive test is announced
  • White House aide Stephen Miller tests positive
• October 7, 36+ known cases:
  • General Gary Thomas tests positive
  • Vice presidential debate

See also

• 2020 Trump Tulsa rally
• 2020 United States presidential election
• COVID-19 pandemic in Washington, D.C.
• COVID-19 pandemic in the United States
• October surprise, a news event that may influence the outcome of an upcoming election
• Trump administration communication during the COVID-19 pandemic
• Twenty-fifth Amendment to the United States Constitution