Donald Trump's COVID-19 Infection

The White House COVID-19 outbreak was a cluster of SARS-CoV-2 infections that began in September 2020 and ended in January 2021 that spread among people, including many U.S. 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. At least 48 White House staff members or associates, closely working with White House personnel, tested positive for the virus. The White House resisted efforts to engage in contact tracing, leaving it unclear how many people were infected in total and what the origins of the spread were.

Many of the infections appeared to be related to a ceremony held on September 26 in the Rose Garden for the nomination of Amy Coney Barrett to the Supreme Court, where seating was not socially distanced and participants were mostly unmasked. His chief of staff recalled that Trump looked "a little tired" and was suspected of having a "slight cold".

Hours after the ceremony, Trump tested positive for COVID-19, although the public would not learn of this result until one year later, in October 2021. 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 in Cleveland, Ohio on September 29. The next day, Presidential Counselor Hope Hicks was placed in quarantine aboard Air Force One while returning with Trump from a campaign event in Minnesota. Following that, the president proceeded on schedule to an October1 New Jersey fundraiser where he mingled, unmasked, with donors. More infections were reported in late October among Vice President Mike Pence's staff, and a second large outbreak occurred after Election Day, after Trump held a watch party in the East Room.

Other infections included First Lady Melania Trump; Republican Senators Thom Tillis, Mike Lee, and Ron Johnson; Republican Representative Matt Gaetz; Trump campaign manager Bill Stepien; RNC Chair Ronna McDaniel; former White House counselor Kellyanne Conway; former New Jersey Governor Chris Christie; Notre Dame president John I. Jenkins; Press Secretary Kayleigh McEnany; presidential advisor Stephen Miller; Chief of Staff Mark Meadows; and Housing and Urban Development Secretary Ben Carson. As of November 11, at least 48 people had tested positive. At least one person, White House security office head Crede Bailey, was reported as "gravely ill," having fallen sick in September prior to the Rose Garden event.

The Rose Garden cluster emerged in the final weeks of Trump's campaign for the 2020 presidential election, a little more than a month before the last day of voting, November3. 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. According to public health experts such as Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a member of the White House Coronavirus Task Force, the outbreak could have been prevented.

Timeline of viral transmission

Background

Throughout the COVID-19 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 March 20, it was announced that a staffer for Vice President Mike Pence had tested positive and was experiencing very mild symptoms, though neither Trump nor Pence had been in close contact with the staffer. On May 7, an unnamed personal valet to the president tested positive, and the following day, Pence spokesperson Katie Miller tested positive for COVID-19. 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.

Campaign events, Crede Bailey diagnosed

A Stanford preprint study concluded that likely over 30,000 cases and 700 deaths could be attributed to Trump rallies held between June 20 and September 22. On June 20, Trump held a campaign rally in Tulsa, the first since the start of the pandemic. Attendees who tested positive include two Secret Service agents, two staffers, the girlfriend of the President's eldest son, Kimberly Guilfoyle and politician Herman Cain. Cain died from the disease on July 30. Tulsa experienced a significant increase in cases after the rally.

From August 17–20, Trump held rallies at Mankato, Minnesota and Lackawanna County, Pennsylvania. About 500 attended Mankato, and masks and social distancing were not used. Several hundred attended the event in Lackawanna, masks were mostly used but social distancing was not. Both communities experienced surges of COVID-19 in the wake of the rallies.

Over Labor Day Weekend (Sept 5–7), Crede Bailey, the head of the White House security office, became sick with COVID-19. He was hospitalized sometime in September, becoming gravely ill. The White House kept his condition secret and declined to comment when his condition was reported in the news on October 7.

On September 13, Trump held a 5,000 person rally in Henderson, Nevada, violating of the state's ban on gatherings larger than 50 people and resulting in a fine. One case was later traced to "a political rally".

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. On September 17, Trump held a rally at an airport in Mosinee, Wisconsin; Thousands attended, few masks were worn and social distancing was not observed. The county experienced a surge in COVID-19.

Trump held a rally in Bemidji, Minnesota on September 18. Thousand attended in violation of the Minnesota ban on gatherings of more than 250, few attendees wore face masks, and there was no social distancing. 16 cases were linked to the rally, including two who were hospitalized. The county saw a spike of COVID-19 after the rally. On September 24, Mike Pence and Ivanka Trump held an event at a Minneapolis hotel. Three attendees would later test positive.

Trump campaign fundraiser, September 25

Trump met Republican National Committee chairwoman Ronna McDaniel, McEnany, and others at a September 25 fundraiser at the Trump International Hotel. On October 1, McDaniel appeared on Fox News and made no mention of her health, despite receiving confirmation of her positive test result on the afternoon of September 30. Two days later, an RNC spokesperson announced that McDaniel had tested positive.

Amy Coney Barrett nomination events, September 26

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, Senators Mike Lee and 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. Michael D. Shear, a White House correspondent for ''The New York Times'', first tested positive for the virus October2, as did many others. He was not present at the Rose Garden event, but had visited the White House on September 27 for a COVID-19 test, required before traveling with the President to a rally in Pennsylvania.

Kellyanne Conway's daughter Claudia revealed on social media on the evening of October2 that her mother had tested positive for COVID-19. The same day, Senators Lee and Tillis were revealed to have tested positive. Christie confirmed on October3 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; Christie received an experimental antibody cocktail from Eli Lilly as well as remdesivir. Lee was filmed hugging other attendees while not wearing a mask. Five of the infected were seated in the front three rows at the event, in close contact with Republican senior officials. Christie was released from the Morristown Medical Center in New Jersey on October 10. 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 superspreader (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. At least 10 members of the Notre Dame faculty besides Jenkins attended the event, but as of October7, none had tested positive. On November 10, it was announced that one attendee, Harry R. Jackson Jr., had died; no cause of death was given.

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.

Trump tests positive, September 26

Hours after the ceremony, Trump tested positive for COVID-19, although the public would not learn of this result until late 2021. His chief of staff recalled that Trump looked "a little tired" and was suspected of having a "slight cold".

Despite testing positive, Trump traveled in Air Force One to a rally at the Harrisburg International Airport in Pennsylvania, which was attended by thousands. The governor opposed the rally, arguing: "It is gravely concerning that the president would insist on holding this event with blatant disregard for social distancing and masking requirements. His decision to bring thousands of people together in a tight space in the midst of a global pandemic caused by an airborne virus is flat out wrong." After Trump's diagnosis was made public, Pennsylvania health officials advised attendees to participate in the state's contact tracing program. In the wake of the rally, the county saw a surge in COVID-19.

Gold Star families reception, September 27

Trump hosted Gold Star families and Pentagon leaders in the East Room of the White House. Attendees were photographed seated in close proximity and 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 October2, Ray attended meetings at the Pentagon with members of the Joint Chiefs of Staff. On Oct6 all but one of the Joint Chiefs of Staff – Gen. David H. Berger, Commandant of the Marine Corps – went into isolation, 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.

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, Alyssa Farah, and Stephen Miller. 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. A year later, Christie—who had spent four days in the room with Trump, roleplaying Joe Biden—recalled that there had been seven people in the debate preparation room, and "six of the seven of us in that room got OVID-19" Those six included Trump, Christie, Hicks, Stepien, Conway, and Miller. Christie, who eventually required intensive care for his COVID-19, said "I think it's undeniable" that Trump was the source of the infection, given that Trump was "the only person bout whomI didn't know his testing regimen." Christie complained that neither Trump nor White House chief of staff Mark Meadows had revealed the president's positive test result before or during the debate preparations.

Prior to the debate, both the Biden and Trump campaigns agreed with the Commission on Presidential Debates that all attendees would be masked, with the exception of the two presidential candidates and debate moderator Chris Wallace. 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, 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, the 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 October6, the New York Times broke news that, despite public impressions to the contrary, Donald Trump was not actually being tested daily. The timeline raised the possibility that Trump "might have tested positive before the Sept. 29 debate, failed to disclose it and showed up at the debate anyway."

Hope Hicks diagnosed

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, accompanied Trump aboard Air Force One. The rally ended around 10p.m. EDT. The Minnesota Department of Health later traced four cases to the Duluth rally.

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, October1, 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 was first reported by Jennifer Jacobs and Jordan Fabian of Bloomberg at 8:07p.m. on October1.

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 did not 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 later tested positive for SARS-CoV-2.

Trump announces positive test result

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 stated, "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. Trump was hospitalized the next day, October 2.

Further outbreak

On October 2, it was announced that Trump 2020 campaign manager Bill Stepien tested positive, as did Wisconsin U.S. Senator Ron Johnson, who had been exposed to someone who tested positive when he returned to Washington D.C. on September 29. When he announced his test on 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 October2, as did a White House staffer who works with the press. On October 9, Representative Mike Bost was announced to have tested positive and developed symptoms after interacting with Sen. Mike Lee.

Trump's personal attendant Nick Luna's positive test results were announced on October3. Luna had been at the debate and on the flight to Minnesota. Claudia Conway, the daughter of Kellyanne Conway, announced on October4 that she had tested positive as well. Also on October 4, Attorney General Barr reversed his previous stance and announced he would be entering quarantine. On October5, 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 October5. On October6, new announced infections included: assistant press secretary Jalen Drummond, presidential military aide Jayna McCarron, and an unidentified military aide.

On October 7, 2020, Bloomberg News cited four people who reported that head of the White House Security Officer Crede Bailey was "gravely ill" with COVID-19 and had been in hospital since September. Bailey had been ill even before the September 26 Rose Garden event.

Presidential hospitalization and early release

Airlift to Walter Reed and experimental treatments, October 2

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 Osteopathic Medicine who had been the Physician to the President since 2018. Because he was a Navy commander, Conley was obliged to follow the orders of his 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 refused to say whether he had ever been given supplemental oxygen.

Trump had Walter Reed personnel sign non-disclosure agreements in 2019 before they could be involved in treating him. Two doctors refused to sign the NDAs and were not allowed to have any involvement in his care. Medical personnel are already prohibited by the Health Insurance Portability and Accountability Act (HIPAA) from releasing personal health information without consent. Medical ethics professor Arthur Caplan called the NDAs redundant.

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 "8gram 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.

Steroid treatment, October 3

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 24hours, and that he was "doing very well". Conley described Trump as being "just 72hours into the diagnosis now", raising questions among journalists about when the diagnosis had actually been made, since it had been publicly announced only 36hours 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 fundraiser 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". When Conley was asked if Trump was on steroids, Conley ended the briefing.

Minutes after the press conference, an anonymous sourcelater identified as Meadowscontradicted the assessment from the doctors, saying "The president's vitals over the last 24hours were very concerning and the next 48hours 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". That night, Conley warned that Trump was "not yet out of the woods" with regard to his condition. The White House released two photos which showed Trump working at the hospital, according to their captions. White House reporter Andrew Feinberg noted that in one of the photos the president was signing documents that appeared to be blank.

Motorcade excursion, October 4

In an October 4 press conference, Trump's medical team said 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. 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 October3 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.

Later in the day, Trump briefly departed the hospital to ride past a gathering of supporters at the medical center, waving from the back seat of an SUV, before returning. Medical experts stated that the short outing endangered the Secret Service agents accompanying Trump inside the vehicle due to his infection. James Phillips, doctor of emergency medicine at George Washington University and an attending physician at Walter Reed, sharply criticized the drive-by as "insanity" for "political theater" and wrote that Trump had endangered the Secret Service agents in the presidential SUV by potentially exposing them to COVID-19.

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 also criticized Secret Service management for an "inexcusable lack of concern" for the health of agents and their families.

Return to White House, October 5

At 2:37p.m. EDT on October 5, Trump tweeted that he would be discharged from the hospital at 6:30p.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. Trump made phone calls in which he shared the idea of him leaving the hospital feigning frailty, but would then rip open his dress shirt to reveal a Superman T-shirt underneath, as reported by ''The New York Times''.

After reportedly pressuring his doctors to release him, he was discharged and arrived at the White House shortly before 7:00p.m. He stood for a photo op

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