- Experts say the confirmed infections at the White House are an indication of how easily COVID-19 can spread in a workplace.
- They say the White House relied too heavily on testing while not requiring face coverings and encouraging physical distancing.
- They note that the White House is also a small working space with narrow hallways.
- Experts did say many workplaces can reopen in the near future with proper precautions, such as face masks and regular handwashing.
During a national crisis, many Americans look to the White House for guidance and reassurance on how to act and carry on.
But during the COVID-19 pandemic, they may look to the White House for a different reason: as a cautionary tale for how the new coronavirus can take hold in absence of proper precautions.
Last week, two White House staffers tested positive for the virus. They were Vice President Mike Pence’s press secretary Katie Miller and one of President Donald Trump’s valets.
This has prompted several key officials and members of the administration’s COVID-19 task force to self-quarantine, including the heads of the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), as well as Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases.
“SARs-CoV-2 is able to move person to person. Therefore, close contact and daily interactions may promote spreading of the infection,” said Dr. Andres Romero, an infectious disease specialist at Providence Saint John’s Health Center in Santa Monica, California.
“Face masks and physical distancing are the strongest strategies we currently have at hand to control the virus spread,” he said.
The White House now says it will be asking all employees to wear cloth masks while in the building, except for at their desks. However, President Trump won’t be wearing a mask.
What we can learn from the White House
As many states and cities in the nation gear up to reopen restaurants and workplaces, understanding how and why workplace transmission of the virus occurs — and putting policies in place to protect workers — becomes more critical than ever.
One of the key lessons the White House’s response can teach us is the limitations of testing as a way to control COVID-19 spread, according to Susan Hassig, DrPH, MPH, an epidemiologist and director of the master’s in public health program at the Tulane University School of Public Health and Tropical Medicine in Louisiana.
“While testing is a useful tool, it is not a replacement for barrier protection against the virus,” she told Healthline. “Testing is fine, but we know that people can shed the virus before it is detectable. And so proximity and density are still important. The bottom line is that even with frequent testing, you are not going to catch everything, [because] the test can have false negatives.”
And there has been, up until now, a conspicuous lack of barrier protection, such as face masks as well as proper physical distancing measures, even among health professionals during Trump’s briefings on the virus.
“It’s confusing to us as healthcare people to watch these press conferences and none of these people are wearing masks,” said Dr. Eric Mizuno, an internist on staff at Weiss Memorial Hospital and medical director at The Admiral at the Lake nursing home in Chicago.
The Trump administration hasn’t said if any other staff members have contracted the virus or what the total number of infections might be.
But experts say that given the lack of protection and the high likelihood of false negatives in testing, it’s almost certainly higher than reported.
“We know that it’s highly contagious even before you become symptomatic for a few days. So, if you do the math, there are a significant number of likely asymptomatic people in the White House now,” Mizuno told Healthline.
Consider the architecture
How successfully a workplace can safely reopen also has to do with the design of the space, and how close in proximity workers are to each other.
The White House, with cramped offices and narrow hallways, may represent exactly the kind of nonideal workplace space.
But open-plan workspaces could also be dangerous, depending on a variety of factors.
“We used to talk about the ‘sick buildings,’ [where virus and infections spread easily], and it’s gonna be an issue with COVID,” Hassig told Healthline.
“The other problem is airflow that will pull potentially infected particles, especially in an open work plan kind of environment, across a broader distance that you might not think physically would be in the realm of exposure,” she said.
What if just one person refuses to wear a mask?
Both Trump and Pence have come under fire for refusing to wear protective masks in public, though a recent Morning Consult poll found that 71 percent of registered voters thought the two leaders should.
Unlike most Americans, Trump and Pence are tested daily for the virus, and the president has downplayed the risks to himself, saying he’s “not close to anybody.”
The White House has a level of testing most Americans don’t have.
But even with that level of testing, it may not be enough.
“I think part of what’s happened in the White House is that they made the assumption that testing was sufficient, and thus they didn’t need to worry about physical distance and density and certainly not facial covering, and that was the flaw,” Hassig said.
“But, you know, I’m sorry. Biology applies to you even if you’re the CEO or the president,” she said.
Time to reopen?
The reports of confirmed infections at the White House and elsewhere have many experts skeptical about reopening businesses right now.
“I don’t see how we can reopen now,” Mizuno said.
He cites a lack of widely available protective masks, including N95s, which are currently limited largely to healthcare workers.
In addition, many people don’t feel safe under current conditions.
“If you flip the switch [and reopen now], 70 percent of people don’t want to jump back into the proverbial pool. There has to be some kind of scientifically based rationale that you give to the public,” Mizuno said.
That said, with the proper precautions, most places should be able to reopen — eventually.
But we’ll have to adjust to a new normal, including masks and physical distancing, Hassig says.
In addition, workplaces need to encourage and implement policies, such as generous paid sick leave, to make sure no one with a potential infection comes to work and starts a new conflagration of cases, Hassig adds.
And that sick person should stay out long enough to be tested for COVID-19 more than once in case of a false negative.
In other words, there are some significant hurdles, but doable ones.
“I think if people wear masks, if they stay reasonably separate, and if they’re conscious about repeatedly sanitizing their hands in the workplace — when they go to the break room, to the bathroom, touching office elevator buttons, all that kind of stuff — that’s going to take care of most of the potential transmission,” Hassig said.
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