Trump tested positive for Covid-19. His refusal to wear face masks is a catastrophe

Early Friday morning, we learned President Donald Trump and first lady Melania Trump have tested positive for the novel coronavirus. White House aide Hope Hicks, who had traveled with the president earlier in the week, also tested positive and was reportedly experiencing symptoms Wednesday. The president and first lady reportedly have “mild symptoms.”

It’s a stunning turn of events for a world leader whose egregious mishandling of the Covid-19 pandemic is the main reason the virus’ toll on Americans has been so severe, in terms of both cases and deaths. It’s also a reminder of how important it is for everyone to take well-established precautions to prevent infection — precautions the president has scorned, dismissed, and misconstrued over the course of the pandemic.

In particular, the president’s failure to consistently wear a face mask while in close contact with colleagues in the White House and in public settings — the guidance of his own Centers for Disease Control and Prevention — put him at higher risk for infection and of spreading the virus to others, since asymptomatic people can transmit the virus.

On Twitter, public health experts pointed out that a mask might have protected Trump when he was around Hicks:

Let’s walk through why face masks remain one of our most important tools for fighting Covid-19 — along with hand-washing, distancing, isolation, and contact tracing — and why the president’s own words and actions on face masks have been so detrimental to America’s battle with the virus.

Why face masks protect against Covid-19

Scientists have learned a lot about how SARS-CoV-2, the virus that causes Covid-19, spreads and what we can do to stop it. The first step is when a sick person exhales, laughs, sings, or coughs, they expel heavy droplets and tiny aerosols containing the virus into the air. The heavy droplets will typically fall to the ground within 6 feet of the person, but studies show that under the right indoor conditions, the virus can float in the air in small particles, like aerosols, and spread to others that way, too.

Infected people in close contact with people they know drive the majority of infections, according to contract tracing. As Muge Cevik, a physician and virology expert at the University of St. Andrews, has written, when we’re around people outside our immediate household, “the risk increases with longer and frequent exposure, close proximity, number of contacts, and group activities especially dining.” The risk goes up in indoor settings, particularly in crowded and poorly ventilated spaces.

Maintaining at least 6 feet of distance between people has been a critical piece of guidance to prevent spread via large drops. But we’ve also learned that face masks covering the nose and mouth prevent both heavy droplets and aerosols (in the case of N95 masks) from being released by an infected wearer in the first place — and from being inhaled by a non-infected wearer. It’s why the World Health Organization and the CDC for several months have recommended cloth masks for the general public.

Since the virus began spreading uncontrolled around the world, there’s been a ton of new research looking at the efficacy of masks of different materials and in different settings for preventing the spread of Covid-19. The consensus has settled around this: face masks (including cloth masks and N95s) worn consistently in higher-risk settings, like public or social gatherings, significantly reduce the transmission of the coronavirus and other respiratory diseases. (Read the Mayo Clinic’s helpful tips for putting on and taking off a cloth mask.)

President Trump and first lady Melania Trump wearing face masks while standing beside the flag-draped coffin of Ruth Bader Ginsburg.
Alex Wong/Getty Images

To be clear, masks are not 100 percent effective, and they have to be worn properly and consistently to get the most out of them. And while there’s more evidence showing that masks prevent the wearer from spreading the virus to others, there’s also new evidence that they protect the wearer from being infected — reducing risk by 65 percent, according to one study.

“If you ask me my opinion about what’s the simplest, most effective option? Mask-wearing,” Harvard T.H. Chan School of Public Health epidemiologist Michael Mina told WBUR. “I think there’s no doubt about that.”

Because of the growing evidence that masks work, 86 percent of the world’s population lives in places that have a nationwide or statewide requirement of masks in public places or universal mask use. It’s why most US states now have some kind of mask mandate, and why some cities, like New York City, are distributing masks for free and imposing fines on people who don’t wear them in public.

Trump’s refusal to wear a mask might have put others at risk

Trump has a long history of questioning, scorning, and mocking the practice of wearing face masks to prevent Covid-19 spread. When the CDC changed its guidance in April to recommend that all Americans wear masks when they leave home, Trump said, “You can do it. You don’t have to do it. I am choosing not to do it. Somehow, I don’t see it for myself.”

The New York Times has a helpful timeline of his other comments on masks, which reveals a confusing amalgam of statements on his own use of them and their effectiveness.

It’s hard to overstate how problematic it is for a leader like Trump to be misconstruing and undermining public health guidance like this for the general public. Consistent, clear, and evidence-based public health messaging in a pandemic is critical. And by casting doubt on face masks and failing to set an example for the country by wearing one, Trump has done the American people a terrible disservice.

He has also repeatedly made fun of his opponent former Vice President Joe Biden on the campaign trail for following the guidance and wearing a mask in public:

The stark contrast between the two candidates’ positions on mask-wearing was also on display at the debate in how their family members showed up. According to Washington Post columnist Josh Rogin, “[Cleveland] Clinic officials tried to give masks to Trump’s family and guests at the Cleveland debate, but ‘they refused to put those masks on.’”

Trump’s rejection of mask-wearing is fundamentally irresponsible behavior not just because he’s put his own health at great risk.

“People who don’t wear a mask increase the risk of transmission to everyone, not just the people they come into contact with,” Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital, said in a recent statement about his research on face masks. “It’s all the people those people will have contact with. You’re being an irresponsible member of the community if you’re not wearing a mask.”

But even after the president’s positive test, masks are optional at the White House, a staffer told Vox’s Alex Ward.

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