Since news broke that President Donald Trump, several of his staffers, and three Republican senators have tested positive for the coronavirus, people have been poring over pictures and video of Trump at various events, marveling at the lack of precautions.
But which Trump moment was the worst offender for coronavirus exposure? The massive Rose Garden ceremony announcing his nomination of Judge Amy Coney Barrett to the Supreme Court? The debate at the Cleveland Clinic where his family members and aides refused to abide by mask-wearing guidelines? The limo ride outside Walter Reed National Military Medical Center to wave at his supporters outside the hospital?
There’s an app for that. The website microcovid.org has a free tool that estimates the Covid-19 risk of different situations accounting for a range of factors. A San Francisco team, with input from doctors and researchers, has incorporated epidemiological studies on transmission risks from dozens of papers into the tool. The site attempts to provide a simple way to understand how the different risk factors for Covid-19 interact.
For each situation, you enter risk factors: How many people are nearby? How close are they? For how long? Are people wearing masks? From there, the website quantifies risk using a metric called “microCOVID.” Borrowed from the term “micromort,” coined by Stanford engineer Ronald Howard for discussing mortality risk, a microcovid is a one-in-a-million chance of getting the virus.
The site introduced the terminology to make it easier for people to think about the Covid-19 risk of our daily activities that involve contact with people outside our household or a closed “bubble.” All such activities involve a few microcovids, but how many varies enormously — based on whether the activity is indoors or outdoors, the number of people around, how many are wearing masks, how loudly they’re speaking, and how long they interact.
Bob Wachter, the chair of the UCSF Department of Medicine, has recommended microcovid.org to help people better understand and minimize risk. I also know people who have used it to estimate the risks of a new day care, a trip to the dentist, or a run to the farmer’s market. And in this instance, it seems it would be informative to use it to measure the White House’s social distancing failures by how much actual coronavirus transmission risk they presented.
To be clear, tools like this can only offer approximations — scientists are still learning more about the virus. And we don’t have a complete accounting of Trump and White House officials’ activities. But approximations can be helpful for assessing, and learning from, the reckless decisions made by the country’s elite.
Here, I ranked eight pictures from now-infamous recent events by how hazardous the activity really was (from least risky to most risky) — using the information in the pictures and additional information from reporting on the events — to complete the fields in the microcovid calculator, and estimate how risky the White House’s activities were.
#8 Rose Garden reception for Amy Coney Barrett, outdoors (September 26)
Even outdoors, getting lots of people tightly packed in one place adds up to some Covid-19 risk. This Rose Garden event to announce Trump’s nomination of Judge Amy Coney Barrett to the Court involved at least 150 people, most of whom were not wearing masks.
How risky is that? Assuming it lasted about one hour (a full event schedule has not been released) the typical attendee was exposed to 50 microcovids of risk — or a 50-in-a-million chance to catch the coronavirus. The site classifies this as a “moderate risk activity,” not too much more dangerous than a masked trip to the grocery store. As for the people who can be spotted wearing masks in the picture, they lowered their risk to about 20 microcovids.
For people sitting near the front, their risk was higher because they may have been exposed to the coronavirus from the event’s speakers, who were not wearing masks. Talking makes a big difference in the transmission of the virus: People sitting in the front rows were facing a risk more like 400 microcovids.
Even a 2,000-per-million chance of getting the coronavirus may sound quite low. But it’s important to keep in mind that even dangerous activities don’t cause serious problems every time. Drunk drivers only cause a crash about 1 in every 625 trips. Similarly, attending an event that exposes you to 1,600 microcovids will only cause you to catch the coronavirus 1 in every 625 times.
But if you take such risks routinely, as the White House has been doing, eventually they are likely to catch up to you.
#7 The first presidential debate: The debaters (September 29)
President Trump and Vice President Biden didn’t wear masks during their debate on September 29, two days before the president said he tested positive. However, they were about 12 feet apart. How dangerous was the debate for the two debaters?
From what we knew at the time, not that dangerous: two people who meet indoors 12 feet apart in order to talk loudly and sometimes shout at one another for about 100 minutes incur only about 300 microcovids of risk.
However, we have since learned that President Trump had likely already been exposed to the coronavirus at the time of the debate. He would test positive only about 48 hours after the debate, and significant research establishes that people are often contagious in the two days before they experience symptoms.
Assuming that Trump already had Covid-19, what was the risk to Joe Biden? The calculator estimates a terrifying 100,000 microcovids, or a 10 percent chance of becoming sick (though note that the epidemiological data the tool uses is all from lower transmission risk events, so the calculator is less reliable for unusual cases like this one).
That said, Biden’s campaign has reported a negative test every day in the 10 days since the debate. The typical incubation period is 5 to 7 days, though it can be up to 12, so it’s a very good sign that he is not yet sick, though he’s not out of the woods entirely.
#6 Trump’s motorcade drive-by (October 4)
While recovering at Walter Reed, the president left in his limo for a drive-by trip to see his supporters. This was criticized as an unnecessary risk to the two other people visible in the car — the driver and a Secret Service agent in the front passenger seat. How much risk were they at? The answer is about 500 microcovids assuming that the car trip was short (about 20 minutes) and that the president wasn’t talking (which expels viral particles). The risk might even be less if the agents had access to high quality personal protective equipment (the calculator is meant for normal everyday decision-making, not exposure in medical settings with medical PPE).
Being in a sealed environment with someone who has the coronavirus is not a safe thing to do, and it’s not acceptable to make employees take that risk frivolously. That said, studies have found that duration of exposure is very important for a person’s odds of catching the coronavirus. The president’s limo ride was reportedly brief, and it makes a big difference that both the president and his staff were masked.
By contrast, if a Secret Service agent is with him all day, that agent is exposed to 90,000 microcovids of risk per 12-hour shift, or potentially up to a 9 percent chance of catching the virus from the president, though the details of the agent’s personal protective equipment — is he wearing a fitted N95 mask? — would make a big difference.
#5 The first presidential debate: The audience (September 29)
The Cleveland Clinic in Ohio, where the debate was held, had required masks be worn by the attendees. The president’s family, sitting in the audience, did not wear them. The risk associated with a two-hour indoor gathering where the participants are reasonably spaced but not wearing masks is about 600 microcovids for each attendee. If everyone had been wearing a mask, it’d be only 70 microcovids. That’s how important mask-wearing is.
#4: Amy Coney Barrett Rose Garden reception, indoors (September 26)
From tomorrow’s NYT A1, a reminder that the Amy Coney Barrett WH event was not entirely outdoors pic.twitter.com/wSJvKOY4JD— Rebecca Buck (@RebeccaBuck) October 3, 2020
The celebration of Barrett’s nomination to the Supreme Court was not just outdoors — participants also gathered within the White House to congratulate the nominee. It appears from pictures that they overwhelmingly did not wear masks. The White House hasn’t stated how many people participated in the indoor reception, but if about 30 people mixed and mingled indoors for an hour, that was much riskier than the outdoor events, posing about 5,000 microcovids of risk to each person in the room.
#3 White House reception to honor Gold Star families (September 27)
The Sunday reception to honor Gold Star families has gotten less publicity than most of the events of the last week, but from a coronavirus perspective it was extraordinarily dangerous. From counting the number of people in various event pictures, approximately 70 people were present, indoors, with no apparent spacing between chairs and without masks, at the formal event.
The event featured speakers including the president, and after the ceremony they mingled and posed for non-distanced pictures with the president and Vice President Mike Pence. Assuming it lasted an hour, such an event would pose about 6,000 microcovids of risk (the picture-taking and socializing contributes more than the quiet sitting during the ceremony).
At least one person who attended this event and not other weekend White House events — vice commandant of the Coast Guard, Adm. Charles W. Ray — has tested positive. Because the White House is not contact tracing, the total virus spread at this event is not known.
A key question for evaluating this event from a Covid-risk standpoint is one that can’t be answered from pictures: Was only the uniformed person at the microphone in this White House publicity photo singing, or was the crowd singing along as well? Singing is a high-risk activity, and maskless singing in an indoor area would bump this event up to 30,000 microCOVIDs.
#2 Trump rally in Duluth, Minnesota (September 30)
One full day before he announced his diagnosis with coronavirus, the president spoke at a packed campaign event in Duluth, Minnesota, with about 3,000 people present. The event featured every single coronavirus risk factor: lots of people, tightly packed in one place, cheering and shouting, and not wearing masks.
Even worse, the event happened in Duluth, where the Minnesota Department of Health says that “community transmission was high in St. Louis County prior to this week’s rally, and people attending the rally may have been infectious without realizing it.”
Yes, it was outdoors, which mitigates the risk dramatically. But the fact that the tool rates this as a slightly higher risk than some indoor events underscores how risky activities like shouting and cheering without masks in densely packed crowds and in an area with a growing outbreak can still pose substantial risks even though it’s outdoors. All in all, the tool estimates that such an event presents 7,000 microcovids of risk.
Some attendees did wear masks, making themselves and those around them safer: wearing a mask would drop your risk down to around 4,000 microcovids, and universal masks would drop it to around 900 microcovids. But there’s no way around it: gathering huge numbers of people for loud, non-socially-distanced campaign rallies in places where community spread is high is a risky thing to do. Being outdoors makes an enormous difference, but it has to be accompanied by other measures too.
#1 Trump fundraiser, Bedminster, New Jersey (October 1)
On Thursday, after Trump’s close advisor Hope Hicks tested positive for the coronavirus but hours before the president announced his own positive test, he attended a fundraising dinner with 200 supporters at the Trump National Golf Club in Bedminster, New Jersey. According to the Wall Street Journal, the event was both indoor and outdoor, and participants did not reliably wear masks, though the president did enforce six feet of social distancing during photos with supporters.
The event reportedly had 206 attendees and 19 workers, though only a select group met inside with the president for a roundtable and photos. The risk would have been similar to that in many of the above scenarios if not for one key thing: The president knew he had been exposed to Covid and may already have been experiencing symptoms. Because of that, these events posed a very high level of risk to attendees.
The calculator estimates that the outdoor portion of the event presented roughly 4,000 microcovids of risk to attendees, while the indoor event (what we know of it, at least) presented 20,000 microcovids of risk. Those numbers reflect that the president already had the coronavirus, and may well have already been contagious — he tested positive only a few hours later. The state of New Jersey is now trying to reach the attendees and workers to determine how many, if any, were infected.
A White House in denial
From Ohio to New Jersey to the White House, these pictures tell the same story: The president has been routinely ignoring Covid-19 precautions. If you keep doing that, those 1 percent and 5 percent chances of catching it add up, and the coronavirus will eventually catch up to you.
If you instead use what scientists have learned about virus transmission to make smart choices — avoiding indoor gatherings, especially loud ones, wearing a mask and expecting the same of others, socially distancing and staying home if you are exposed or sick — then it is possible to manage the risk to you and the people around you.
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