White House's inept 'contact tracing' effort leaves the work to others
Posted October 4, 2020 2:36 p.m. EDT
CNN — Three days after President Donald Trump and first lady Melania Trump were diagnosed with coronavirus, there is little clarity about how the White House is contact tracing and alerting those who may have been exposed at a string of events and gatherings he attended, leaving the work to the individuals themselves and ramping up the risk of exponential spread.
So far the efforts appear mostly contained to White House staff who interacted with the President, first lady and top adviser Hope Hicks, and do not include many who attended their intimate meetings or crowded events. After reaching out to more than half a dozen people who came into contact with Trump over the past week, CNN has uncovered little more than a few phone calls and emails to potentially infected people encouraging them to get tested.
The absence of a robust contact tracing effort is emblematic of the White House's relaxed approach to preventing the spread of the virus among its ranks. Until this week, masks were worn only infrequently by staffers and social distancing was absent at Trump's events and within the corridors of the West Wing.
The White House insisted a "full contact tracing, consistent with CDC guidelines" had been conducted following Trump's New Jersey fundraiser on Thursday, and that similar efforts were taking place for other events. But some of the most high-profile contacts say they have gotten little or no outreach from the White House since coming into proximity with the first couple or their inner circle in the days since the diagnoses.
As a result, the individuals themselves are muddling through on their own. After spending multiple days in close proximity to the President while preparing for last week's debate, Trump's lawyer Rudy Giuliani said he has been running a do-it-yourself operation, quarantining himself, arranging for a coronavirus test (it was negative), and alerting those who he has come in contact with -- all decisions he made without guidance from the White House. Chris Christie, the former New Jersey governor, was also part of the President's debate prep. On Friday, he tested positive and has been hospitalized. Christie told CNN that he has similarly had no formal directions from the President's team to assist in contact tracing.
Meanwhile, two White House officials said they had been reached by the White House Medical Unit to alert them of potential exposure, but that they were not asked to trace their own contacts.
The lackluster effort is of special concern because of the sheer number of people involved but also because of who many of them are -- members from all three branches of the federal government and others responsible for seeing the country through the current pandemic.
The list of infected people extends deep into the ranks of the GOP. In the past week, two Republican senators, Mike Lee of Utah and Thom Tillis of North Carolina, tested positive after attending a White House event last Saturday. So did former White House senior counselor Kellyanne Conway. The President's campaign manager Bill Stepien has tested positive and so has Ronna McDaniel, the chair of the Republican National Committee. Some of those potential spreaders have spent time at other spots in Washington, DC, and around the country: the recent presidential debate, the campaign trail and Capitol Hill.
Working against the clock
If done properly, experts say, contact tracing could have helped contain the spread of the virus around the country. But the practice is arduous and requires an army of staffers to trace the movements of those infected with the virus. Also, time is crucial when it comes to contact tracing. The longer it takes, the harder it gets since the number of contacts to be traced multiplies exponentially each passing day.
The last week of the President's schedule illustrates that point vividly. Beginning with the Saturday event in the Rose Garden, Trump kept a busy calendar filled with campaign events and numerous meetings. Trump traveled to Minnesota for a campaign rally, then on Tuesday traveled to Cleveland for the presidential debate. On Thursday he held meetings at the White House before leaving to go to Bedminster for his fundraiser. Throughout, he came into contact, either personally or via his staff, with dozens of people -- all of whom could potentially now be at risk.
Thus far, the White House outreach is a far cry from the contact tracing outlined by the US Centers for Disease Control and Prevention. Those guidelines call for a specialized, trained staff that can identify, monitor and support potentially infected people -- even those who may not feel sick.
Speaking outside Walter Reed National Military Medical Center on Saturday, the President's physician Dr. Sean Conley said it was his department at the White House that was handling contact tracing.
"The White House Medical Unit, in collaboration with CDC and local state and health departments, are conducting all contact tracing per CDC guidelines," he said.
But one person familiar with the matter conceded the scale of the potential contagion at the White House has made it difficult to mount the type of contact tracing that will be required in the coming days. The White House Medical Unit, with a staff of under 30 people, has been stretched during the coronavirus pandemic conducting the extensive testing at the White House and at events Trump is attending.
It also wasn't clear Sunday how involved the CDC was in assisting the White House in its contact tracing efforts. While Conley suggested his unit was collaborating with the health agency, a person familiar with the matter said a full CDC contact tracing team hadn't yet been mobilized.
The CDC referred all questions about its efforts in relation to Trump's diagnosis to the White House.
The person said the White House seemed to be relying on the fact the events have been heavily covered in the media and hard to miss for anyone who attended them or came into contact with those who tested positive.
"People would know if they come into contact with Trump," the person said.
David Harvey, the executive director of the National Coalition of STD Directors, told CNN earlier this year that contact tracing works if done properly.
"A person will typically be told, 'You may have been exposed. We recommend that you isolate for the next 14 days. Here's where you can get a test. What questions can I answer for you? Tell me folks that you've had sustained closed proximity with, and together we'll work to notify these people,'" Harvey said.
Missing pieces in Bedminster
The White House said Saturday that contact tracing had been completed for the Oct. 1 fundraiser at the President's Bedminster golf club, and officials say Trump didn't have any "close' interactions with anyone there based on CDC guidance.
"During the roundtable event and remarks, the President was more than 6 feet away from all participants," White House deputy press secretary Judd Deere said. "All White House staff considered to be in close contact during this trip have been identified, contacted, and recommended to quarantine."
Three attendees told CNN that most people at the events were not wearing masks; all three said they have not been contacted by any contact tracers. Among them is Charles Kolean, a campaign donor and fundraiser from Texas who told CNN he received an email from the campaign and RNC's joint Trump Victory Fund late on Friday morning. The email, which he shared with CNN, encouraged him to go to the doctor if he felt ill. Kolean said he has quarantined since but has not received any communication from the White House or any other officials about contact tracing.
The Bedminster event has New Jersey health officials concerned, too. As of Sunday morning, state health officials still did not have a full account of who had been at the event nor all the necessary information needed to trace their movements, a senior state official told CNN.
New Jersey state officials requested detailed information from the White House, including how many people attended and a full itinerary of the day, the official said.
The state received a spreadsheet of names and emails around 2:30 p.m. Friday and shortly after the White House indicated that its medical unit would be conducting the contact tracing, the official said. But as of Sunday morning the White House had not shared any contract tracing information it had gathered, the New Jersey official said. In addition, the list the governor's office has received includes only invited guests, not country staff, the official said.
"We need full transparency and collaboration among local, state and federal partners on this to ensure that everybody who was at the event and needs to be contacted because of their proximity to the President, is contacted very quickly," the official said on Saturday.
The New Jersey state health department and local health office in Somerset County are working with Trump's Bedminster club and the White House to "get significantly more information" and undergo the state's normal contact tracing process for New Jerseyans, the official added.
It was also not immediately clear if people who attended the event had traveled from other states.
"We don't have that information, which again is the issue," the official said. "What we need is exactly how many of these are New Jerseyans and their addresses and phone numbers. I would expect that every state in the country wants to know."
The exposed are on their own
Meanwhile, a spokeswoman for Mayor Muriel Bowser told CNN that the Washington DC health department would not be assisting with contact tracing for those exposed during recent events at the White House.
"The White House physician will do their own contact tracing and provide guidance to impacted individuals," said LaToya Foster.
Yet it's not clear who at the White House is actually conducting that tracing. Giuliani, for instance, told CNN Saturday that he missed a phone call from a White House number early Friday morning. A few hours later, Giuliani said he left a message with chief of staff Mark Meadows to inform Meadows he would be getting a test.
The former New York City mayor told CNN he had spent much of last Sunday, Monday and Tuesday preparing the President for the debate in close quarters with other people who have since tested positive for coronavirus, including Christie and Hicks.
"I was in a room with six or seven people, including Chris and Hope, and Chris and I were right next to each other," Giuliani told CNN Saturday. "So I guess I'm just lucky."
Giuliani said he took it upon himself to let the 10 or so people he had interacted with since Tuesday know that he was potentially exposed and even helped arrange for some of those contacts' own tests, all of which he says came back negative. Giuliani called Meadows back to let him know about his own unofficial contract-tracing effort, despite no one at the White House asking him to do so.
That's more interaction than others have had with the White House about contact tracing. A spokesman for Sen. Lee, who was at the September 26 event at the White House announcing Amy Coney Barrett's nomination to the Supreme Court, told CNN the senator has not heard from anyone from the White House medical unit since his diagnosis. Congress's attending physician did recommend Lee get in touch with others he may have exposed to the virus, which the senator has done.
An aide to a different senator attending the Barrett event said there has been no communication from the White House even though the lawmaker may have been exposed to the virus there.
At least one person potentially exposed at the White House did receive a phone call. This person, who attended the Barrett event, told CNN that someone from the White House called to recommend a list of clinics where the person could get a test.