Vice President Mike Pence has decided not to quarantine despite being deemed a close contact of at least one staff member who tested positive for Covid-19. A White House spokesman said Mr. Pence would follow guidelines for essential personnel.
The vice president will maintain his campaign schedule, including a planned stop in Minnesota on Monday. He will take extra precautions, which include wearing a mask and social distancing, White House chief of staff Mark Meadows said Sunday.
The U.S. Centers for Disease Control and Prevention’s guidance for what it calls “critical infrastructure workers” who may have had exposure to a person with suspected or confirmed Covid-19 says such staffers who must continue to work should wear masks at all times and socially distance as duties permit. The agency also recommends that workers take their temperatures before work and avoid crowded spaces.
Epidemiologists and infectious-disease specialists say quarantining should be a key part of the administration’s plan to mitigate the virus’s spread among officials and others. The CDC recently altered its definition of a close contact for Covid-19 cases, saying it is someone who was within 6 feet of an infected person for a total of 15 minutes or more over 24 hours.
“The activities the vice president is pursuing are all heavily public-facing,” said Nahid Bhadelia, an infectious-diseases physician and medical director of Boston Medical Center’s special pathogens unit. She suggested doing campaign gatherings virtually and forgoing travel to avoid putting others at risk.
Critical infrastructure workers include those in 16 sectors of work, according to the CDC, such as federal, state and local law enforcement; 911 call-center employees; hazardous-material responders from the government and the private sector; janitorial and other custodial staff; and workers in food and agriculture, critical manufacturing, informational technology, transportation, energy and government facilities.
The 16 sectors are considered “so vital to the United States that their incapacitation or destruction would have a debilitating effect on security, national economic security, national public health or safety, or any combination thereof,” according to the U.S. Cybersecurity and Infrastructure Security Agency, or CISA, website.
“The concept of not requiring quarantine for essential workers started with the concern that hospitals would not be able to function safely if all exposed didn’t work—and this was before it was clear that asymptomatic transmission occurs and may be common,” said former CDC director Tom Frieden, who served under President Obama.
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He said there is a potential nonessential role for officials responsible for national defense, though he didn’t see what category political rallies would fall under.
“Only essential workers performing essential activities should have a potential ability to continue working despite exposure,” he said. “And even if these individuals test negative daily, they may infect others, so must be scrupulous about wearing a mask and maintaining distance.”
National security adviser Robert O’Brien said campaign events were essential travel. “Free elections are the foundation of our democracy, so I think campaigning and voting are about the most essential thing we can be doing,” he said on CBS.
The CDC didn’t immediately respond to a request for comment, and CISA referred questions to the White House.
It takes days for people infected with the novel coronavirus to develop symptoms, likely because the virus can evade the body’s natural defenses against invading pathogens early on in the infection. That gives the virus a window during which it can multiply exponentially, undetected by its human host.
This period between exposure and feeling sick is called the incubation period, which can stretch up to 14 days—the length of time the CDC generally recommends people quarantine after exposure to someone with the virus. Why the incubation time varies between individuals isn’t yet understood. During that period, a patient’s viral load, which tends to peak around the time symptoms start, might not be high enough to be detected by a test, virologists said, but they could be shedding virus at levels high enough to infect others.
“One of the things that has made this virus so hard to contain is presymptomatic, silent spread,” said Abraar Karan, a global health physician at Brigham and Women’s Hospital and Harvard Medical School. “If you quarantine as soon as you have an exposure, you’ll prevent any forward transmission, and that’s the key to break the transmission chain.”
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