Trump tested positive for COVID. An October Surprise that comes as no surprise

On Thursday, President Donald Trump tested positive for COVID-19. For months he had downplayed the threat of the coronavirus, compared it to the flu, said young people were practically immune, joked about how his opponent Joe Biden looks wearing a mask. All the while, the president and those closest to him frequently engaged in what health experts say is one of the riskiest things you can do when it comes to the coronavirus: spend time in crowds of (often) mask-less people.

If Trump follows guidelines, he’ll have to isolate—stay away from others as much as possible—for at least 10 days during what would ordinarily be one of the most intense periods of a presidential campaign. Trump’s positive test is certainly an October Surprise, one for the presidential history books. For, epidemiologist and infection prevention expert Saskia Popescu, though, the diagnosis is not actually surprising.

“I don’t think it’s surprising to hear that somebody who doesn’t wear masks, really doesn’t socially distance, surrounds himself with unmasked people, and consistently relies only on testing is positive,” Popescu says.

Instead of maintaining social distances, wearing masks, and holding group events outside, Trump, the White House, and his presidential campaign have tried to use an aggressive testing program to keep the virus at bay. Over the summer, Trump reportedly was getting tested several times a week. The people around him are also tested.

This is what happens when you entirely and repeatedly ignore public health and infection prevention guidance – from masks to distancing to crowded rooms…

— Dr. Saskia Popescu (@SaskiaPopescu) October 2, 2020

But no test is perfect. A rapid test Trump was reportedly using over the summer, produced by Abbott Laboratories, has been criticized for high rates of false negatives. Now Trump is facing the limitations of testing, up close and personally.

“It seems they more heavily relied on testing as a prevention strategy instead of an alert strategy,” Popescu says. Trump, who is in contact with so many people day after day, has “really not shown a propensity for wearing his mask.”

In recent days, Trump has been in contact with a wide array of people ranging from Supreme Court nominee Amy Coney Barrett to his financial backers in New Jersey. He also met Biden and Fox News host Chris Wallace for a 90-plus-minute, rancor-filled, televised debate. The Centers for Disease Control and Prevention defines an exposure as when someone is within six feet of a COVID-19 positive person for 15 minutes or longer. Although the candidates were far apart from one another at the debate, Popescu says that because it lasted so long and involved a lot of heated talking, “I don’t think you can say that there’s not risk there.”

“Anytime you’re indoors for a prolonged period of time with a lot of other people, especially unmasked, that is concerning,” Popescu says. “ And we know there’s certain high-risk activities that increase that: yelling, shouting, singing. The six-foot rule is in a good minimum, but it’s not this invisible force field that means no particles pass through it.”

Biden’s campaign announced Friday that the candidate and his wife had tested negative for the virus. Wallace says he will get tested.

Although the natural inclination is to immediately get tested after learning one may have been exposed to COVID-19,  Popescu recommends people wait until the coronavirus has had a chance to incubate before testing and remember that tests are not 100 percent accurate: “I would say, you know, err on the side of caution and quarantine for 14 days even if it [a test] was negative on day six.”