ROCHESTER, Minn. — It was a Great Gatsby-like notion: the idea that a wealthy person should be able to pay $500 to have their nasal cavity swabbed in the turnaround outside of a catered party, wait with the chauffeur for a negative result, then bound inside for worry-free air-kissing from the pre-pandemic days of our past.
It all seems to have started in the Hamptons, on the outer reaches of Long Island.
Or Redondo Beach, in southern California.
No one is really sure.
But last week, the practice finally made its way into the news in connection to an event here in flyover country. It happened on the evening of Sept. 30, along Lake Minnetonka in the village of Shorewood, officially the richest town in Minnesota. The venue that night was the home of Cambria USA CEO Marty Davis, who was hosting a fundraiser for President Donald Trump.
The president, unbeknownst to all, was infected with COVID-19.
"It was very safely done," as a well-heeled guest later recalled of the maskless indoor fundraiser. Her remark underscores our confusion about rapid testing, but more on that in a minute. The affair was attended by 40 guests who contributed $200,000 a couple for the privilege of meeting the president prior to his visit to Duluth.
The dinner would soon find itself in more elite company than its hosts could have ever imagined. It was destined, in fact, to join a presidential debate and a White House reception for the new nominee to the Supreme Court among a small handful of events connected to a executive branch superspreader outbreak, a public health catastrophe that now counts 36 cases in its wake.
As host to the president while he was infected, the fundraiser is currently monitored on a public dashboard tallying case numbers from the president's activities that week. The opinions from the public have not been kind. As one report put it, "all those serial huggers in the Rose Garden on September 26 did indeed believe their privileged access to rapid tests would exempt them from the hard facts of pandemic life."
And yet it all transpired because the White House, like so much of America, had misunderstood the meaning of a negative test result for COVID-19. That it means almost nothing at all.
As @EricLevitz pointed out, Republicans thought they could buy their way into normal lives that none of the rest of us get to have, by getting free rapid tests every day none of the rest of us get.— David Atkins (@DavidOAtkins) October 6, 2020
But that's not how it works. https://t.co/ozv4hVM6U0
"Having a negative test doesn't mean that you don't have the virus per se," explains Dr. William Morice, a professor of laboratory medicine and pathology at the Mayo Clinic in Rochester. "It's a reflection of the nature of testing, and also the nature of viral infection, that there are people who will have a window where they can test negative and will still spread the virus and not know it."
In short, the progression of COVID-19 works like this: should you get exposed, after a few days you will become contagious, and a few days after that, you will eventually test positive, but no sooner.
You may develop symptoms following these early days after contracting the virus, or you may not. Regardless, there are five or so days after contracting COVID-19 when a person can be infected, contagious and still test negative.
That sets up a very important distinction about getting tested. A positive test, as Morice explains, provides tangible information for contact tracing and isolation of the infected person, and a negative test means remarkably little.
It certainly does not change the need to wear masks, socially distance and wash hands. In fact, Morice says, the only conceivable way a person could get a negative result and then enjoy risk-free masklessness, as the well-heeled pols, reporters and donors hoped to do in the White House and in Shorewood, is really complicated.
"In sports, the example would be the NHL, WNBA or NBA where people get tested, then they get quarantined before they even go into the environment, and they get more testing," he says. "You would have someone come in, test them, keep them isolated, and test them again after a period of 5, 6 or 7 days. If they're still negative after multiple tests, they can be safe -- if they go into an environment known to be COVID-negative."
None of that sounds like something you could pull off in the parking lot outside of a fundraiser. Morice says he has been getting more calls of late asking him to re-explain why a negative test result is not a very meaningful finding.
If anyone contracted COVID-19 at the Shorewood event, that news is not known. No one is said to have gotten very close to Trump. Then again, in that same week, the Centers for Disease Control said the virus can linger in the air if ventilation is poor. That would make the fundraiser arguably more contagion-promoting than the rally at an outdoor airfield in Duluth.
So, how did we get to a place where so many highly educated people didn't know that you could be both infectious and test negative? "I think it's in part the whole sense of COVID fatigue, " says Morice. "The other part is testing giving people a false sense of security ... Testing is not to certify people as safe, it's to identify those who have been infected, and isolate those who might have been in contact with that person."