U.S. President Donald Trump points to a test kit for ID Now Covid-19 from Abbott Laboratories during a Coronavirus Task Force press conference in the Rose Garden of the White House in Washington, DC, United States, on Monday, March 30, 2020.
Michael Reynolds | Bloomberg | Getty Images
The White House has relied on frequent, rapid coronavirus tests for months to keep its officials and staff safe. However, President Donald Trump's diagnosis shows that tests alone cannot stop the virus.
Public health specialists, including Assistant Secretary of Health Brett Giroir who leads the US testing effort, have long insisted that testing alone is not a public health intervention. It should be implemented alongside strategies such as masking, social distancing, hand washing, and quarantining suspicious patients.
However, the White House has largely relied on all White House staff and visitors to be screened for the virus with a quick turnaround test. Trump and other administration officials have used frequent tests as a justification for why the president and his officials are often not required to wear masks or social distancing.
"I put on a mask when I think I need it," said Trump on Tuesday at the presidential debate. "Tonight, for example, everyone had a test and you had social distance and all the things you had to do, but … I wear masks when I need to."
Department of Health and Human Services secretary Alex Azar even doubled the president's comments Friday after Trump announced that he tested positive.
"The first family and the protection of the president are a different situation than the rest of us because of the protocols around the first family," Azar said at a congressional hearing when asked if the president and his family were not wearing masks . He added that most Americans should follow all public health guidelines, including wearing masks and social distancing.
Testing not a substitute
While the screening caught some infected people with no symptoms before entering the White House, it's not a perfect way to keep the virus out, and epidemiologists who spoke to CNBC said they weren't surprised to find the virus sneaked past the system.
"I don't think experts recommend using medical screening tests as a substitute for social distancing, masks, or other types of mitigation measures," said Dr. Ben Mazer, anatomical and clinical pathologist at Johns Hopkins Hospital, gave a telephone interview. "They all believe that this should be done in combination with masks, social distancing and any other recommended action."
Dr. Sadiya Khan, an epidemiologist at Northwestern University, compared the White House's testing strategy with that of various sports leagues. Despite frequent and extensive testing, both Major League Baseball and National Football League have seen infections in their ranks, she said. But the NBA, she added, has successfully kept the virus at bay by not only testing, but also quarantining its players in what is known as the bubble.
"Tests don't make you immune and tests don't eliminate the virus," she said. "No single strategy is likely to ever succeed on its own."
The White House said in a statement to CNBC that its procedures include current CDC guidelines and best practices both at the White House complex and during the President's trip.
"In addition to promoting social distancing, readily available hand sanitizer, regular deep cleaning of all work areas and recommended face covers, those in close proximity to the president will continue to be tested for COVID-19 to ensure that exposure is largely limited," the said White House Speaker Judd Deere.
Abbott ID now
Staff, guests and reporters had to be tested for the coronavirus with Abbott Laboratories' ID Now test before entering the White House grounds. This test is a rapid molecular test that can give results in just 15 minutes. However, some epidemiologists have raised questions about the accuracy of the tests.
"It wasn't really a surprise what happened here," said Dr. Michael Osterholm of the University of Minnesota told CNBC. "I have been a fairly vocal public critic of the White House testing program that used the antigen test as it was used because it is actually so insensitive. Up to half of those infected could test negative by this test. "
In a statement, Abbott spokesman Ross Darcy defended the accuracy of the ID Now tests and wished the president and first lady a speedy recovery.
Justin Lessler, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, called Abbott's ID Now an "imperfect test". He added that the tests can diagnose someone as negative even if they are infected, especially if they are at the beginning of their infection.
However, he added that the White House's testing program appeared to have helped identify the virus in the president early in the course of the infection. That helps cut chains of transmission and possibly helps with treatment, Lessler said.
To test employees who may have been exposed to the President or other infected people in his orbit, the White House is turning to a new test, Abbott's BinaxNOW test, a senior White House official told CNBC's Kayla Tausche.
However, this test test is currently only approved by the Food and Drug Administration for testing people with symptoms. When asked about the plan, Pia MacDonald, an epidemiologist at the nonprofit RTI International, said the White House should use the more accurate PCR or molecular testing.
"I just know if I had been in the same room with the president for 15 minutes or more, even wearing a mask, even 10 feet apart, I would want to do a very good test," she said. "I would give the PCR diagnosis [which has] a better chance of actually picking it up."