President Trump’s COVID-19 diagnosis reveals just how far short the federal pandemic response has fallen, local public health leaders said Friday, showing that it has failed to protect even the commander-in-chief.
But experts said that failure need not be the end of the story. In the president’s diagnosis, some saw an opportunity for him to course-correct after months of diminishing the virus’s threat, even as it killed more than 207,000 people in the United States and more than 1 million around the world. The question, they said, is whether Trump will see his illness as a way to change his own narrative.
“Because of the partisan nature around what should be about science and public health, no coherent message has evolved,” said Dr. Sandro Galea, a physician and dean of the Boston University School of Public Health. “Depending on what [President Trump] says, it will really make a difference on whether this is a teachable moment or not.”
The president’s case “is exemplary of our failure at the federal level," said Dr. Michael Mina, an assistant professor of epidemiology at the Harvard T. H. Chan School of Public Health.
“If the president of the United States can’t figure out how to keep himself from getting COVID, it shows how challenging this virus is to prevent, but this is also a direct reflection of his policies and directly reflects on his rhetoric," Mina said. “It’s a shame that this is happening right now. It’s shameful that this is even a conversation.”
The president has drawn criticism both at home and abroad for his tendency to downplay the virus. News of his illness came just days after the first 2020 presidential election debate, in which Trump mocked former vice president Joe Biden’s adherence to mask-wearing.
During Tuesday’s debate, Trump, when asked by moderator Chris Wallace why he typically appears in public without a mask, said, “I put a mask on, you know, when I think I need it.”
Now, news of the president’s illness “underlines where we are in this pandemic," said Samuel Scarpino, a mathematical epidemiologist at Northeastern University. “There should be no way that the president of the United States gets COVID."
“We know that individuals in a pandemic like coronavirus get the disease partly because of their own behavior, but mostly because of how people around them behave and how the public health system is functioning," Scarpino said. In this case, Trump doesn’t wear a mask, the people around him don’t wear masks, and the public health system hasn’t been given enough resources to keep the virus under control, he said.
First lady Melania Trump and top Trump aide Hope Hicks also tested positive this week, and other White House staffers have previously contracted the virus, a fact that experts said could be of concern to workers across the country who generally do not have access to regular, rapid testing and other resources available to White House staff.
The White House outbreak exemplifies the need to communicate and follow strict measures, such as mask wearing and social distancing, in the workplace, Galea said.
“We have workplaces and schools, and the way to optimize chances to keep cases from becoming clusters is through contact tracing and taking measures to keep this from spreading and this was not being done in the White House,” Galea said. “He was someone in a workplace not taking this seriously and as a result there was transmission.”
The president’s and White House’s lack of adherence to public health guidance has likely affected many more than those close to the president, Mina said. “Hundreds of thousands of people have probably gotten COVID because they have followed his lead,” he said.
Successful public health campaigns, including antismoking efforts that began in the 1960s, have often relied on celebrities to nudge the public toward making healthier choices. Now that Trump, perhaps the world’s best known celebrity, has COVID-19, public health leaders wondered whether his diagnosis could be a golden opportunity for the White House to promote masks and social distancing.
Several experts noted that even British Prime Minister Boris Johnson, known for a cavalier attitude toward coronavirus protections before he was hospitalized with COVID six months ago, emerged from his illness thanking the country’s National Health Service for saving his life.
“It certainly seems to have had a lasting effect on [Johnson],” said Dr. William Hanage, a professor at Harvard’s T.H. Chan School. “He became less bombastic.”
If Trump similarly undergoes a “really severe illness, he may have a greater sense of what the consequences are and so might the public,” Hanage said.
But the president’s change of heart is hardly a foregone conclusion, experts said.
When Herman Cain, a former Republican presidential candidate and Trump supporter who pointedly refused to wear a mask, died in July after contracting the virus, it didn’t appear to change the party’s or president’s messaging, said Shan Soe-Lin, managing director of Pharos Global Health Advisors, a Boston nonprofit focused on global health matters. Cain attended an indoor Trump rally in Tulsa, Okla., where few were wearing masks or distancing, less than two weeks before he was hospitalized.
“I hope Trump will recover quickly, but if he does, I don’t know what lessons will be learned here,” Soe-Lin said, echoing other experts' concerns that a speedy recovery could actually help reinforce the president’s rhetoric minimizing the virus. “But if he has something that is more severe I would hope the silver lining for him and his group is that this is a real virus, it’s not a hoax.”
Joseph Allen, director of the Healthy Buildings Program at the T.H. Chan School, said he was skeptical that Trump would change course. “I don’t have a lot of hope that his messaging will change. From the beginning, it’s been consistently misleading," he said.
But Allen and others held out hope that the public will learn from the president’s illness, regardless of the White House’s messaging.
“It illustrates that fighting the pandemic is something that we’re all involved in," Hanage said. “There’s no us and them. It’s us and the virus.”
Dr. Philip Landrigan, director of the Global Public Health & Common Good program at Boston College, said there was a lesson in Trump’s illness for everyone. “It’s just a reminder to all of us that nobody is immune from this disease," he said. “We all have to take precautions, young or old, humble or exalted.”
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