Pence Shouldn't Be at VP Debate, Infectious Disease Expert Says

Ken Terry

October 07, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Vice President Mike Pence should be self-quarantining rather than attending tonight's debate in Salt Lake City with Democratic vice presidential candidate Kamala Harris, said Rochelle Walensky, MD, during a press briefing held this morning by the Infectious Diseases Society of America.

From media reporting and TV images from last weekend's White House event in the Rose Garden, Walensky said, it appears that Pence was sitting for longer than 15 minutes within 6 feet of people who subsequently tested positive for COVID-19. Consequently, she said, he meets the definition of the Centers for Disease Control and Prevention (CDC) for being exposed to the virus.

"Based on that, I think he should follow the CDC guidance to quarantine," she said. "To quarantine means he'd be at home and not out or about for 14 days after that event, which takes him beyond the vice presidential event tonight."

Walensky, who is chief of the infectious diseases division at Massachusetts General Hospital, added that by attending the debate, Pence is placing a number of other people at risk.

"For Vice President Pence to get to the debate tonight, there are many people he needs to be in contact with. People who will drive his car, who will fly his plane, who work in hotels — all those people will be exposed, not just Senator Harris. That's why I find it very important that he follow CDC guidance, " she said.

In a memo released on Tuesday, CDC Director Robert Redfield said that after consultation with White House physician Jesse Schonau, MD, the agency decided that "the Vice President is not a close contact of any known person with COVID-19, including the President." Therefore, the memo said, Pence, who tested negative on Tuesday for COVID-19, can safely participate in tonight's debate.

The memo defined close contact as being "within six feet of an infected person for at least 15 minutes starting from two days before illness onset."

The mostly maskless gathering in the Rose Garden to introduce US Supreme Court nominee Amy Coney Barrett to about 150 attendees is suspected of being the source of a COVID-19 outbreak, according to the Washington Post.

At last count, at least 14 or 15 people connected to the White House have become infected, Walensky said. All of these people should be in isolation for at least 10 days, she noted, and anybody who came in contact with them should be quarantined for 14 days.

Isolation Essential

It's essential for people infected with COVID-19 to be isolated for 10 days or more because a negative test doesn't necessarily mean they're no longer infectious, explained Rajesh Gandhi, MD, director of HIV clinical services and education at Massachusetts General Hospital, at the briefing.

Therefore, he said, "The CDC has moved toward a guideline that for most people, if your test is normal and you have moderate or mild disease, you should isolate for 10 days after the onset of symptoms if the symptoms are improving. You should also have no fever for at least 24 hours without use of fever-reducing medicine."

President Trump has announced that he plans to participate in the second debate with Democratic presidential nominee Joe Biden on October 15. "I'm hopeful that by the time the president and the others he travels with go back on the campaign trail, he'll meet the CDC qualifications that allow him to be out of isolation," Walensky said. "That would be 10 days from when we believe he received his last diagnosis, which was last Thursday."

However, in response to a question about Trump's medication regimen, Gandhi left no doubt that he believes the president has a severe case of COVID-19.

"Once we learned that he needed oxygen, then it made good sense that he'd get remdesivir and dexamethasone," the infectious disease expert said. "The treatment guidelines support the use of those drugs when people have severe COVID-19, defined as people needing oxygen. The antibodies are an experimental treatment, but they look promising to treat milder disease."

Despite all of the people in Trump's circle who according to multiple media reports have tested positive for COVID-19, the White House has not initiated any contact tracing of the people who attended the Rose Garden ceremony. Walensky noted that contact tracing should be conducted not only for the VIPs but also for the many essential workers who may have come in contact with those infected.

"There are a lot of people that likely merit contact tracing who you might not have seen on television in the Rose Garden," she said. "Over 300 people work in the White House who might be considered essential personnel. They might go home to places where it might be harder to find a test, they might find it harder to quarantine, and they might live in multigenerational households."

Similarly, Walensky said, contact tracing should be conducted for people who attended recent Trump campaign events. "There are places where the Trump campaign has been where we now know there were exposures. [Bedminister,] New Jersey is one of them. There should definitely be contact tracing and quarantining going on there."

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