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President Trump and First Lady Test Positive for COVID-19

— Ramifications are significant, potentially both near and far-term

MedpageToday
President Donald Trump and First Lady Melania Trump with their arms around each other

In the dark of night, in a tweet retweeted over 600,000 times in the first three hours in which it posted, Trump announced both he and first lady Melania Trump have tested positive for COVID-19, the disease he has publicly downplayed since the start of the pandemic and which has now killed over 207,000 people in the U.S.

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

According to a letter written by White House physician Sean Conley, DO, FACEP, Trump and his wife are both feeling well at this time, and they will stay at the White House during their quarantine and illness. Conley sought to assure the American public in his statement, saying "The White House medical team and I will maintain a vigilant watch, and I appreciate the support provided by some of our country's greatest medical professionals and institutions."

Trump may have contracted the disease from Hope Hicks, the aide who traveled with him aboard Air Force One both to and from the presidential debate on Tuesday. Hicks also accompanied Trump to his rally in Minnesota on Wednesday, and began developing symptoms late that day.

The potential ramifications to this are many: At the very least, Trump will be required to temporarily halt his campaign while he quarantines, and will miss the next presidential debate, planned for October 15. Longer term, should the President exhibit symptoms, under the 25th Amendment he would have the option to transfer power to Vice President Mike Pence while he recovers.

According to the CDC, a 74-year old man, as Trump is, has a five-times higher risk of being hospitalized by COVID-19 than their current reference group (18-29 year-olds), and is 90 times more likely to die. As symptoms tend to emerge between 2-14 days after exposure and infection, all eyes will be on the White House until at least mid-October.

Bloomberg that Hicks had tested positive for the virus and was experiencing symptoms.

, Hicks tested negative Wednesday morning, so she boarded Air Force One to accompany the President to a rally in Duluth, Minnesota. She started experiencing symptoms mid-day Wednesday and a second test subsequently turned up positive. The President and Melania Trump both tested positive Thursday evening.

It's not clear when Trump knew about Hicks' positive test, but by Thursday morning a small group of administration officials knew Hicks had COVID-19, .

Trump attended an indoor fundraiser at his golf course in Bedminster, New Jersey on Thursday afternoon.

Many have raised questions as to whether Trump could have been infectious on Tuesday night during the first presidential debate with former Vice President Joe Biden, who is 78 years old. CNN reported that Biden will be .

Trump's debate prep on Monday involved a total of 5 or 6 people, including Chris Christie and Rudy Giuliani, in a small room. Christie said no one was wearing a mask.

Contact tracing will involve the highest levels of U.S. government. As of Friday morning, Vice President Mike Pence and second lady Karen Pence have tested negative, according to .

Sanjay Gupta, MD, said on CNN that "given the president's age and his pre-existing conditions, he's going to be at increased risk. But ... the odds are very much in his favor ... greater than 90%, 95% chance that he will get through this."

Bob Wachter, MD, chair of medicine at the University of California San Francisco, questioned whether Trump may receive investigational monoclonal antibodies, which have shown promise but aren't yet authorized or approved for use.

"I thought I was no longer capable of being shocked, but this is a truly jaw-dropping development," . "This virus is remarkably wily and cruel, and everyone needs to take it deadly seriously. Perhaps this will galvanize the country and our citizens into doing so."