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The last time President Trump and Joseph R. Biden Jr. debated each other, the nation was left grappling with Trump’s attack on electoral integrity, his refusal to outright condemn white supremacists, and bitter exchanges of a kind that it is rarely seen in American presidential politics.
That was last week.
Now, in a stark reminder of the tumultuous nature of the 2020 race, all of those issues, which are of great importance to American voters, have been overshadowed in the political dialogue by a fight for health precautions and transparency. which is established to define the next presidential debate, scheduled for October 15.
Trump, who tested positive for the coronavirus, has insisted who is “waiting” for the debate in Miami, despite the great uncertainties about what his condition will be then. Biden and his team, for their part, are trying to put the responsibility for a safe debate on the president, the Presidential Debate Committee and officials from the Cleveland Clinic, who advise on health and safety for the clashes.
“If you still have Covid, we shouldn’t have a debate,” Biden told reporters Tuesday night after delivering a campaign speech in Gettysburg, Pennsylvania. “I’ll be guided by the Cleveland Clinic guidelines and what the docs say is the right thing to do.”
Biden’s advisers have emphasized that he intends to participate in any debate that takes place, noting that the scheduled format is town hall-style, and they have said that the former vice president wants a chance to interact with voters. But they and other allies have also said that Trump must show that he is not contagious, and that the responsibility lies with the organizers of the debate and the president himself to show that he meets those standards.
“This is your obligation to meet,” Kate Bedingfield, Biden’s deputy campaign manager, told CNN Wednesday morning. “You need to show that it is not contagious.”
In a follow-up statement, a spokesperson for Mr. Biden, TJ Ducklo, said: “The Presidential Debate Commission and the Cleveland Clinic will determine the health and safety protocols for next week’s debate. This is your responsibility and we hope you take it seriously. “
For Trump, proving that he is not contagious will not be easy. The Centers for Disease Control and Prevention asks people with mild symptoms to isolate themselves at home for 10 days, at which point they should stop being infectious. But some people with moderate or severe illnesses can remain infected for 20 days or perhaps even longer.
If the president gets worse, “then that whole 10-day window is screwed up,” said Dr. Esther K. Choo, an emergency physician at Oregon Health and Science University. “We want to feel really good that we are not creating a second super spreader event.”
Early in the pandemic, the CDC recommended two negative tests to indicate that a patient was no longer infectious. Since then, studies have shown that people with the disease can spread the killed virus for weeks even if they are no longer contagious. That can result in a false positive result.
“Certainly a negative PCR test of some kind will be really helpful,” said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston, referring to a laboratory test that can detect the virus. “But a positive PCR test would be difficult to interpret.”
If the president gets a PCR test, doctors might see a value called a “cycle threshold,” an indicator of how much virus is in a body, said Dr. Céline Gounder, infectious diseases physician at Bellevue. Hospital Center in New York. . Or they could use antigen tests, which are less sensitive and detect the virus only if people have enough to be contagious.
A negative test may also have nothing to do with Trump’s health or fitness on the day of the debate. But doctors said it was difficult to predict his progress without a precise chronology of his illness. So far, the White House has declined to say when Trump last tested negative.
“The catch here is, when was the president ‘symptomatic’?” Dr. Gounder said. “Because all they tell us is that he feels great, but we are never given a very objective reading of what his symptoms were and when.”
Many patients do well in the first week and suddenly get worse sometime during the second or third week after symptoms appear. White House physician Dr. Sean Conley said Wednesday that the president had developed antibodies that could clear the virus from his system. But that may not mean much in terms of your symptoms for the next week, Dr. Faust said.
“As of day 21, you could be fighting for your life in ICU, and you don’t really necessarily have that much live virus in your body,” said Dr. Faust. “At that point, it’s just your immune system, the inflammatory part of the disease.”
Even if Trump is feeling fine, a man his age, weight and general health is likely to feel extreme fatigue, as many people with Covid-19 do, doctors said.
“We know that as of Monday, he seemed out of breath walking up a flight of stairs,” said Dr. Uché Blackstock, an urgent care physician in Brooklyn, NY. “For the debate, you will have to stand up for 90 minutes and engage in a dynamic conversation, from what I saw on Monday, I don’t know if I would be prepared for that.”
Biden’s campaign has not publicly set detailed criteria that it wants the president to meet before a debate, saying only that it will be referred to medical experts. And the plans and possible rules for the debate are changing.
“I don’t think President Donald Trump should come to Miami when he’s been infected with the coronavirus,” said Rep. Debbie Mucarsel-Powell, a Democrat from South Florida.
Biden and his campaign have for months sought to make the race a referendum on Trump and, in particular, his administration of the virus response. Biden’s team believes the president’s conduct around his diagnosis has further highlighted the contrasts between the two campaigns and his approaches to a virus that has killed 211,000 people in the United States and led to staggering economic consequences.
“I think it is a tragedy that the president deals with Covid as if it is something not to worry about when 210,000 people have already died,” Biden told reporters Wednesday night, according to a report from the group.
Trump has mocked the masks, held large-scale demonstrations and downplayed the risks of the virus even after contracting it. “Don’t be afraid of Covid” he tweeted Monday. After taking a walk with Secret Service agents to greet supporters on Sunday, which alarmed some medical experts, he returned to the White House from the hospital Monday and removed his mask, even as positive cases among his staff they kept increasing.
Biden had moved to remove negative ads after news of Trump’s positive test last week, but with the president out of the hospital, Biden’s campaign confirmed Wednesday that it was resuming “points of contrast and negatives” along with press affirmatively. case of the former vice president. The president had already resumed his attacks in recent days against Democrats, including Biden.
Representatives for Trump’s campaign did not respond to questions about the president’s plans for the debates and tests.
Former Representative Sean Duffy of Wisconsin, a Republican who attended Trump rallies during the pandemic, dismissed any idea that Trump’s approach to the virus was a bad example or was reckless.
“Everybody is making decisions,” he said. “They assess the risk and make the right decisions for themselves, their families. Some say they will wear masks, others choose not to. In a free society, that’s what we allow. “
Biden, by contrast, has called for mask mandates and has chosen to wear a mask as a patriotic duty. He faced criticism for months, from Republicans and some Democrats, for running an exceptionally cautious campaign with very little in-person campaigning. Even now he’s just holding tightly controlled and socially distanced events. But in a sea change from campaign activities, it is now Biden who remains on the track, while Trump is at home.
Thomas Kaplan contributed reporting.
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