President Donald Trump revealed on Twitter this week that he tested positive for COVID-19 — a virus that has infected more than 7 million people nationwide.
His diagnosis comes after a close adviser, Hope Hicks, tested positive, but also after a whirlwind week of campaign stops and travel, including to Minnesota on Wednesday, where he attended a fundraiser at a private home in Shoreview and a rally in Duluth.
Trump’s diagnosis raises myriad questions, including how public health officials will alert the hundreds of people who may have also been exposed in recent days while the president and his entourage were working and traveling.
But it also raises the same question that thousands of Minnesotans have had to think about since the coronavirus began spreading across the state in March: What do you do if you think you might have been exposed to someone with the coronavirus? And how do you know if you might have been exposed?
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And this week, if you attended any of the Trump campaign’s Minnesota events, you might be wondering whether it’s time to quarantine or get tested.
Here’s what to do if you think you might have been exposed to the coronavirus.
1) Assume you’ve been exposed to the virus, and act accordingly
Officials with the Minnesota Department of Public Health have urged people who think they might have been exposed to COVID-19 to operate as though they have been.
That means monitoring yourself for symptoms, wearing a mask, washing and sanitizing your hands, and social distancing when interacting with people outside your household. (You might want to consider staying home and separating yourself from other people — including other people you live with, if possible.)
It also means limiting social interactions with people outside your household — including in places like stores and restaurants — and avoiding crowds while you work to determine whether you were, indeed, exposed.
According to the Minnesota Department of Health, COVID-19 symptoms include: “fever, cough, shortness of breath, chills, headache, muscle pain, sore throat, fatigue, congestion, or loss of taste or smell. Other less common symptoms include gastrointestinal symptoms like nausea, vomiting, or diarrhea.”
Risk of exposure depends on many factors, said Dr. Andrew Badley, an infectious disease expert at Mayo Clinic.
“Factors to be considered include: length of time that the exposure occurred, distance from the infected individual, whether masking was used,” he said. “In general terms, risk is higher with prolonged exposure, proximity to the infected case, and not using masking.”
If in doubt about whether to quarantine, Badley said to ask a health care provider for advice.
According to the Centers for Disease Control and Prevention, exposure happens when you’ve spent 15 minutes or more within 6 feet of someone who has the virus — with or without a mask.
If that applies to you, the CDC recommends staying home for 14 days after your last contact with the person who tested positive, and watching for symptoms consistent with COVID-19.
In the meantime, the state health department is urging anyone who was in direct contact with President Trump or anyone else who has tested positive for COVID-19 to quarantine for 14 days.
That’s what some top Minnesota Republican officials who were in close contact with Trump during his visit are doing, including state Senate Majority Leader Paul Gazelka.
“My wife and I were in close contact with the president. So CDC guidelines talk about the fact that we should get a test and quarantine for two weeks or 14 days. So we will do that. I think it’s important that people know that this is a pandemic. It’s serious,” Gazelka said on WCCO.
How do you quarantine? Quarantining involves staying home and away from other people, especially those who are at higher risk of getting very sick from COVID-19. That includes people who are over the age of 65, and those with underlying health conditions.
How long should you quarantine? State and federal health officials say quarantine should last 14 days from the time of exposure, regardless of whether a COVID-19 test comes back negative, since symptoms can occur at any time during that period.
Does your whole household have to quarantine? Minnesota Department of Health infectious disease director Kris Ehresmann said Friday that state guidance on quarantining generally only applies to the person who was directly exposed to the coronavirus. But if the individual in question starts to develop COVID-19 symptoms, the whole household should consider quarantining at that point.
3) Get tested — maybe twice
In general, the Minnesota Department of Health recommends that people get tested if they:
have COVID-19 symptoms; or
know that they were exposed to someone with COVID-19 (see above for how to tell), even if they don’t have symptoms.
But those recommendations come with some important caveats. Because testing supply stocks fluctuate, some providers may prioritize testing people who are older than 65, work in a school or health care setting, or who are first responders.
State health officials are recommending that anyone who attended Trump campaign events in Minnesota over the past week — whether they have symptoms or not — get tested.
“Anyone who attended events associated with the President’s visit and who now has symptoms should get tested right away,” the Minnesota Department of Health said in a release Friday.
“People should consider getting tested even if they do not have symptoms because some people may not develop or recognize symptoms and people can spread the virus even without displaying symptoms.”
If you attended one of the events, when should you get tested?
If you have symptoms: Get tested immediately
Otherwise: Get tested 5 to 7 days after the event you attended
If you’re tested and the result comes back negative, the state recommends you continue your 14-day quarantine, because symptoms can pop up at any time. The incubation period of the virus is understood to last between two and 14 days.
Health department officials recommend being re-tested 12 days after you were exposed to the coronavirus — in the case of campaign event attendees, that’s 12 days after the event.
How do I get tested? There are several ways to get tested for COVID-19 in Minnesota.
One way: If you have a regular doctor, call them to get a referral for the test. To avoid charges, make sure the testing location is in your insurance company’s network. The state department of health maintains an active and changing list of testing sites across the state.
Another way: The state health department is partnering with communities across Minnesota to offer testing at pop-up sites across the state. Testing at these sites is free and doesn’t require that patients bring identification or have insurance. The health department encourages people to schedule an appointment at its pop-up sites.
A third way: The health department has launched its first saliva testing site in Duluth. Testing is free and available to anyone who wants it. Patients don’t need identification or insurance to be tested. Registration is not required but is encouraged.
What will it cost? COVID-19 diagnostic testing should not cost you anything. Federal law requires tests and any associated office-visit cost to be covered by insurance companies without what’s called cost-sharing. In plain English, that means it shouldn't cost you anything. Minnesota's private health insurance companies have committed to these rules indefinitely.
If you get your insurance through Medicare or Medicaid, you shouldn't be charged, either.
To avoid charges, you need a doctor's referral for the test — and it needs to be in your insurance company’s network.
Meanwhile, the state periodically opens pop-up testing sites around the state that bypass insurance all together. The tests there are free and covered by the state.
What is testing like? Two primary types of COVID-19 diagnostic tests are being administered in Minnesota. One involves a swab in a patient’s nose, and the other involves spitting a saliva sample into a small tube. The tests are used to determine if someone is actively fighting the disease by detecting the genetic information of the virus. They are only viable when someone is actively infected with the virus.
How long will it take to get my results? A test result can take as little as a day or as many as several days to get back to the patient. The speed of return depends on several factors, including the availability of supplies, backlogs at labs and where a person is tested.
4) Take care
Test results can take as little as a day — or, more likely, several days — to make their way back to patients.
While you wait, you’ll need to continue to operate as though you have the virus and continue to quarantine.
The waiting, as many things in the pandemic era, can be stressful. Take care!
If your test is negative: If your test result comes back negative, the state recommends you remain under quarantine for a full 14 days since you were exposed to the virus.
If you have symptoms but test negative, the state recommends you continue to “stay home from work, school, and other settings until your symptoms are better and you do not have a fever.”
If you don’t have symptoms and test negative, the state recommends being retested, 12 days from the day you were exposed.
If your test is positive: If you test positive, state health officials say you need to stay home, and away from other people, including members of your household.
If you do need to be around other people, wear a face mask.
Don’t share things like plates or glasses or linens or personal items with other people, even those in your household.
Wash and sanitize your hands frequently.
You feel better. Your cough, shortness of breath, or other symptoms are better; and,
It has been 10 days since you first felt sick; and,
You have had no fever for the last 24 hours, without using medicine that lowers fever.
Will I interact with a contact tracer? If you test positive, you’ll be contacted by public health employees. They’ll ask you about where you’ve been and who you’ve been in contact with. From there, they’ll reach out to your known contacts in an effort to track and stop the spread of the virus.
You may also be contacted by public health staff if you were in close contact with someone who tested positive.
It’s likely that White House staff are being asked about who they were in contact with over the last week, so it’s likely people who attended Trump events in Minnesota will be contacted as part of this tracing, Badley said.
Minnesota Department of Public Health contact tracers will only be contacting people in Minnesota who may have been exposed, said infectious disease and prevention director Kris Ehresmann.
But given the complexity of the situation, with many people in many states involved, Badley said it will require public health staff working across state lines, and include federal and state health departments.