WASHINGTON — In a memorandum sent to White House staffers on Saturday, Vice President Mike Pence counseled that “limited interactions” — such as shaking hands — with someone who may have tested positive for the coronavirus did not require cautionary measures, including diagnostic testing and home quarantine.
Few gestures have been made more problematic by the coronavirus pandemic than the handshake, a commonplace greeting in many societies around the world. Though there are many ways for the coronavirus to spread, including through airborne droplets and on contaminated surfaces, direct contact with an infected person is a highly effective means of transmission.
Yet, in the email sent Saturday, Pence, who heads the White House Coronavirus Task Force, appeared to indicate that the Centers for Disease Control and Prevention did not count that as close contact, a conclusion that some health experts dispute.
“At this time, the CDC recommends home quarantine only for those who have had close (more than 10 minutes contact) with a symptomatic (cough, fever, etc.) COVID-19 patient, or their respiratory droplets,” Pence wrote, boldfacing part of the sentence for emphasis.
“This excludes,” the note continues with boldface letters and underlining, “casual, limited interactions such as handshakes, photographs, etc.”
The email was sent one day after President Trump declared a national emergency in an effort to contain and mitigate the coronavirus outbreak, which has sickened more than 3,000 people in the U.S. and killed more than 60.
“As an employee aboard the White House Complex,” the note from the vice president counsels, “we have an additional duty to protect the health of our Executive Branch and those working with us.”
The message proceeds to list several measures that White House complex employees can take “to reduce transmission and illness.” Those measures include several that have become staples of the coronavirus response, including frequently washing hands and practicing social distancing.
But the Pence email also says that shaking hands with a potentially infected person is not necessarily prohibited. “If you interact with an individual when they are without symptoms (asymptomatic), but who subsequently received a positive test, the risk of you becoming infected from that interaction is considered LOW,” the email advises.
“You do not require testing, nor home isolation,” the email continues. “Active social distancing would be appropriate.”
A Pence spokesperson declined to comment on the email.
“I could see no reason not to test that person,” said William Schaffner, an infectious disease expert at Vanderbilt University in Nashville. “I think all of my colleagues here would test that person.”
President Trump has continued to shake hands with both foreign leaders and members of the coronavirus response team, even as he has counseled Americans to listen to public health experts, who have roundly counseled against close contact with others.
But the handshake guidance in Pence’s memo troubled at least one recipient, who sent the message to Yahoo News. “Guidance coming from the White House seems to contradict what the CDC and health experts are saying,” said the person, who was granted anonymity because the source was not authorized to speak to the press. “If I knew I came into contact with someone who later tested positive, I would not go in to work. That is extremely irresponsible.”
The person worried that Pence’s stance on direct contact with a coronavirus carrier could put at risk employees in the White House complex — which includes both the iconic residence itself and the much larger Eisenhower Executive Office Building. “That isn’t a safe workplace,” the person said.
Many executive branch employees have been instructed to work from home, and guidance sent late Sunday from the White House Office of Management and Budget instructs all departments in the capital area to encourage workers who can telework to do so. The White House campus itself remains open and working, however.
“With so many young, eager employees ready to please the administration, we are looking at one of the most unsafe places to go to work next week,” the person who received Pence’s message told Yahoo News.
Whether asymptomatic coronavirus carriers can spread the virus, which causes a disease known as COVID-19, is one of the primary questions of the global pandemic. It increasingly appears, however, that a lack of symptoms does not prevent a person from transmitting the virus. That potentially makes the Pence guidance dangerously incorrect, particularly when it’s still unclear exactly how the virus is transmitted.
The Pence email appears to be based on an interpretation of the CDC guidance that defines close contact as being with 6 feet of someone infected “for a prolonged period of time” or “having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).”
The CDC guidance does not exclude handshakes, which are regarded as a common transmission route, according to health professionals.
“These asymptomatic people can be transmitters,” said Schaffner of Vanderbilt. He called the Pence guidance “dated,” expressing surprise that it was issued so late in the outbreak, after so much about the pathogenesis of the coronavirus had been learned and published.
“The recommendations for preventing coronavirus infection are still evolving,” explained Kathryn Jacobsen, a Yahoo News public health contributor. “Because this is a novel virus, we don’t yet fully understand how it spreads.”
The CDC recommends that people in high-risk groups be more careful about minimizing close contacts,” she continued. “Older adults are considered to be a high-risk population, and many of the people with responsibility for guiding the country through this public health emergency are in that older age group.”
The vice president has generally displayed proper social distancing techniques, including the use of elbow bumps instead of handshakes. He has also been credited with being a reliable messenger for the Trump administration’s coronavirus response, even as the president has faced criticism for not taking the threat seriously.
Harvard epidemiologist Michael Mina, who is a member of the university’s Center for Communicable Disease Dynamics, criticized the handshaking guidance.
“There should be a broad recommendation to stop handshaking. This is a non-essential activity and presents an unnecessary risk,” Mina told Yahoo News in an email. “This is a particularly transmissible virus, and shaking hands with a person who is symptomatic means that it is very likely that you have become exposed.”
While not everyone who shakes hand with someone who is sick will necessarily get infected, it is, Mina wrote, “very likely that a handshake with a symptomatic person will cause some viral particles to be on your skin, your hand, and given how frequently we humans touch our face, eventually on our face.”
Face-touching is one of the surest ways to contract the virus.
Mina went on to say that given White House employees’ proximity to the president himself, there should have been greater emphasis in Pence’s guidance for staffers to work from home, regardless of whether or not they are experiencing any COVID-19 symptoms.
“I understand that we cannot quarantine everyone that has come in contact with someone else who is sick, but I’d say that if you shake hands with people who are symptomatic with COVID-19, you run the risk of yourself becoming infected and thus should highly consider those around you,” Mina said.
“This is not good advice,” he said of the Pence memo.
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