The U.S. President stated that he’s “not contagious at all” after spending time in the hospital due to a case of COVID-19, and would like to appear at an in-person debate next week. (The debate commission has said the debate will be remote.) Could he be correct? It’s complicated.
Counting the days since symptoms first appeared
First, let’s check with the official U.S. CDC guidelines. They say that if you know or think you had COVID, and you had symptoms:
You can be around others after:
- 10 days since symptoms first appeared and
- 24 hours with no fever without the use of fever-reducing medications and
- Other symptoms of COVID-19 are improving*
*Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation
Trump’s medical team has not disclosed when he first tested positive for the coronavirus, nor when symptoms first appeared. According to a timeline assembled by the New York Times, he gave a shorter-than-usual campaign speech on Wednesday, September 30, and the following day (October 1) he had a cough, nasal congestion, and fatigue. His positive test was announced later that night, in the wee hours of Friday, October 2.
If October 1 was the first time he experienced symptoms, he would meet the CDC’s first requirement as of October 11 (this coming Sunday). If symptoms developed earlier, the ten-day mark would be moved back to match.
We don’t really know about his current symptoms
The President has stated that he feels fine, but the checklist doesn’t ask how you feel. The second bullet point relates to being fever-free without medication.
Some medications can bring down your body temperature even though your body really wants to have a fever. For example, if your toddler has strep throat and feels feverish, you can give them Tylenol. Their fever may disappear, but you still can’t send them to day care, because they’re still sick. Masking the fever doesn’t count.
We do know that Trump received dexamethasone at the hospital, a steroid that reduces inflammation and improves survival rates in people with moderate to severe cases of COVID. Dexamethasone can hide a fever. (It also tends to make people feel amazing, and can cause mood changes and agitation.)
For COVID, dexamethasone is typically prescribed for up to 10 days or until the patient leaves the hospital. The New York Times reported that he was still receiving the medication at home on Monday, October 5.
Further information, including symptoms and other potentially symptom-masking medications, has not been forthcoming. We know that he has received the antiviral remdesivir and Regeneron’s experimental antibody cocktail, as well as a few supplements like zinc and melatonin, but the updates provided by his medical team have been vague and not very helpful in understanding his health status.
Recommendations for the rest of us
In addition to the guidelines above, the CDC states that if you have had a severe case of COVID, or if you have a weakened immune system, you may need to stay home (which is called isolation, not quarantine, by the way — quarantine is for people who do not know if they are sick) for 20 days instead of 10. Your doctor will let you know what you should do, and they may recommend further testing to guide the decision.
If you never had symptoms, only a positive COVID test, the CDC’s recommendation is to stay away from others for 10 days. If you develop symptoms during that time, the 10-day clock resets and the guidelines above apply.
If you haven’t had a test or symptoms yourself, but you have been in close contact with someone who has COVID, you should stay away from others (quarantine) for 14 days after your last contact with that person. This rule would apply to several people within the administration, as it turns out.