Updated at 7 p.m. ET
Public health officials in the cities and states that President Trump visited in recent days are working to contact those who were in close proximity to him, first lady Melania Trump and others who traveled with him.
Since he has tested positive for the coronavirus, health officials worry those who attended events with the president could be at risk for the virus, too.
Over the past two weeks, Trump attended events in Florida, Georgia, Pennsylvania and Minnesota as well as a fundraiser in New Jersey and, of course, the presidential debate in Cleveland. He also went to his golf club in Potomac Falls, Va., and hosted an event announcing his Supreme Court nominee Amy Coney Barrett at the White House.
One of those attending that event, the Rev. John Jenkins, the University of Notre Dame's president, has also tested positive, though it is not clear when he may have been exposed.
"Contact tracing is going to be really important," David Banach, an infectious disease physician in the University of Connecticut's health system, told The Associated Press. "The president comes into contact with many individuals during the day."
It's a situation that Dr. Ashish Jha, dean of the Brown University School of Public Health, calls a "nightmare."
He told NPR's Morning Edition that the incubation period for the coronavirus is two to 14 days, but that in reality it is usually three to five days.
"He has been around a lot of people over the last five, seven days and certainly in the last couple of days when he was likely infectious; he was around a lot of folks, including Vice President [Joe] Biden," Jha said. "I suspect many senior members of the government are going to have to go into quarantine. There's a lot of work ahead. This is going to be complicated. This is — while of course, it's about the president — it's not just about the president."
At the debate Tuesday with Biden in Cleveland, neither wore masks on stage. The president has often downplayed mask-wearing, and he mocked his Democratic opponent for wearing his so often. Dr. Amy Edwards, a professor of infectious diseases at Case Western Reserve University in Cleveland, said the coronavirus could have been incubating in the president even then.
"He did test negative while he was here just prior to the debate, but that was the rapid test," Edwards said, "so I don't know that we can really rely on that test to say he was definitely negative."
The mayor of Duluth, Minn., where Trump held a rally Wednesday night with the first lady and top adviser Hope Hicks, both of whom have also tested positive for the coronavirus, is urging anyone who attended to get tested.
"If you were at the rally on Wednesday, please wear a mask, visit your health care provider to be tested, or go to the DECC [Duluth Entertainment Convention Center] to get a free test," Duluth Mayor Emily Larson said in a statement. "Do everything you can to self-isolate and adhere to Minnesota Department of Health and CDC guidelines to keep yourselves and those around you safe."
The president's rally was held on the tarmac of Duluth International Airport, where according to Minnesota Public Radio, thousands of people attended, including many who didn't distance themselves from each other or wear face masks, with the notable exception of those behind the stage and in camera view.
The Minnesota Department of Health is offering guidance to those who attended the rally, too, warning that community transmission of COVID-19 in the Duluth area was already high before the campaign event, "and people attending the rally may have been infectious without realizing it."
Before Wednesday's campaign rally, Trump attended an afternoon GOP fundraiser at a private home in Shorewood, Minn., a suburb of Minneapolis-St. Paul.
Minnesota Republican Party Chair Jennifer Carnahan said in a statement that about 40 people attended that fundraiser but that she did not meet with Trump.
"I have not been in contact with any of the donors who had been at that event," she said. "My understanding as well, they were all required to take a negative COVID test with results within 24 hours of the president's visit to donors, and it is also my understanding that people were not allowed to shake hands or come into that close of contact with the president while he was there."
In a statement, Minnesota health officials said anyone "associated with the President's visit and who now has symptoms should get tested right away." Those without symptoms should also consider getting tested because anyone carrying the virus can spread it.
"People should get tested five to seven days after the event. If they test negative, they should get tested again around 12 days after the event," the statement said, adding that "it is important to understand that quarantine for 14 days is necessary regardless of test results."
In an interview with Minnesota Public Radio, Dr. Michael Osterholm, an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said he was alarmed by reports that some who attended the president's events think they can be tested once and be in the clear.
"I'm a little disturbed by the fact that I heard some of the individuals who are exposed in the last 48 hours saying, 'Well, I'm going to be tested today and then if I'm negative, I'm going to go ahead and do what I do.' And in fact, they won't even show up positive for at least three up to five days after the exposure."
Trump also held a rally Sept. 26 at the Harrisburg International Airport in Middletown, Pa.
"The commonwealth has no directive or formal recommendations for people who attended those rallies," said Pennsylvania Gov. Tom Wolf, a Democrat, adding "but anybody who has been in any crowd, of any sort for any reason, where they find people have tested positive for COVID-19, you need to be very, very careful."
An official from the Republican National Committee told NPR a series of health measures were taken Thursday at Trump's Bedminster, N.J., golf course for a fundraiser, which raised $5 million for the campaign. The event site was professionally cleaned and sanitized before the event, and the White House Medical Unit and U.S. Secret Service screened all attendees for them to gain access.
Attendees tested negative for the coronavirus on the day of the event, completed a wellness questionnaire and passed a temperature screening, and every guest was at least 6 feet from the president at all times, according to the official.
White House chief of staff Mark Meadows told reporters that positive test results for senior aide Hicks came to light "right as the Marine One [helicopter] was taking off" Thursday to take the president to Joint Base Andrews for the flight to New Jersey.
"We actually pulled some of the people that had been traveling and in close contact," Meadows told reporters Friday at the White House, explaining contact tracing had just begun. Other senior staff, including Dan Scavino and Jared Kushner, have since tested negative, he said.
Public health officials in Somerset County, N.J., are asking Trump's country club, the Trump National Golf Course, for a list of facility staff, event participants and other people who may have come in contact with the president and first lady, according to a statement from the county's Department of Health.
"As the public health department for Bedminster, and in conjunction with the New Jersey Department of Health, Somerset County has begun the contact tracing investigation to determine the potential risk of exposure to attendees and staff at the facility to COVID-19," the statement said.
New Jersey Gov. Phil Murphy, a Democrat, said the golf club, White House and Republican National Committee are all cooperating with state and local health officials, according to NPR member station WNYC.
"The process for gathering information for case investigation and contact tracing has begun, and as far as we know folks are cooperating and we need them to," Murphy said at news conference Friday.
Amid reports that some people who attended the fundraiser are calling doctors' offices and health departments in a panic, Murphy urged everyone who was there to take precautions.
"Self-quarantine everybody. Take yourself off the field," Murphy said. "Wait five to seven days probably and get tested. Even if you test negative, you really have to stay off the field for the full 14 days."
Dr. George Abraham, who heads the infectious disease board for the American Board of Internal Medicine, warned that "a negative test doesn't guarantee that someone is not harboring virus" because there might be too little to detect early on.
Abraham told the AP that "this is a wake-up call" that shows the need for social distancing, wearing masks and other measures to reduce spread.
Trump and many of his supporters have often downplayed the severity of the pandemic and contradicted infectious disease experts on the importance of social distancing and wearing masks to slow the spread of the coronavirus.
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