The Superspreading Presidency of Donald Trump

So does that mean…? “I would say the president is a superspreader,” Scarpino says. “I’m happy to say that.”

Things didn’t have to be this way. Have tight lockdowns, keep everybody from coming into contact with anybody, and R0 goes down. Even the people who are better at transmitting (they’re carrying more virus, they’re at the peak time in their infection, they’re loud talkers, whatever) don’t have anybody to transmit to. No more infections.

Or, you know, do the opposite of that. Foster social conditions in which the virus spreads (cold, dry, noisy, crowded, no ventilation). Don’t wear masks and make fun of people who do. Result: lots of infections. A virus has biology, and so does its host, but it spreads in an environment, in a context. This is where biology meets policy. “You can decompose the transmission of a pathogen into the biological features of the individual pathogens themselves, the biological features of the host, the sociological aspects of the host—and when we’re talking about humans, we think about policies, the sociotechnical systems embedded in the defective behaviors. All of those things have to interact for transmission,” Scarpino says. “What we see in the United States time and again is this confluence of reckless policy, poor guidance from federal public health agencies around what people need to do to keep themselves safe, and then the biology of the pathogen and the humans.”

Scarpino is part of a team of researchers that has been working on a slightly different characterization of how the virus moves through populations. Their construction looks at a particular form of crowdedness, of how closely packed together people are at different spatial scales—in a building, in a neighborhood, in a city. The specific mathematical term they’re interested in is called Lloyd’s “mean crowding,” basically the number of contacts you might expect from random chance transmissions in a given area divided by the population of that area. What they’ve found is that more densely-packed places are more “bursty” when it comes to Covid-19. When the virus gets there, it burns through the susceptible population hotter and faster, a sudden, sharp peak of sick people all in one place at one time.

The burstier places might seem isolated at first, and that can make it look like they’re protected. Until they aren’t. That’s what happens in meat-packing plants and elder-care facilities. It happened in Manaus, a city in the heart of the Amazon rainforest where officials didn’t detect any Covid-19 cases until March. Over the next four months, the virus went on to infect up to two-thirds of the population and killed one out of every 500 people. To Scarpino, the White House looks bursty, too. “It’s really tightly connected, nobody’s really wearing masks, lots of social connections. It was really a matter of when. When the virus shows up, it’s going to sweep through. You’re going to have superspreading. It’s just going to take a while,” Scarpino says. “Really it was just inevitable, because it’s really a microcosm of what we see playing out over the US: a combination of risky behavior, crappy policy, low testing, and in the White House’s case the exact right—or wrong, depending on how you think about it—connectivity and social network structure.”

And not to sound like a Twitter reply-guy here, but—that surprises you because why, exactly? This is the same White House that couldn’t institute widespread testing for the disease, or nationwide contact tracing. It’s the same White House that promoted untested treatments, and spread informational smog like saying disinfectants and ultraviolet light might work inside people’s bodies. It’s the White House that mostly failed to establish reliable clinical trials. It’s the same White House that tried to bend the data in the unimpeachable Morbidity and Mortality Weekly Report. It’s the same White House with a president who mocked mask-wearing right up until his own hospitalization, and in fact blocked the distribution of 650 million masks to Americans. It’s the same White House that rushed the reopening of restaurants and other businesses. It’s the same White House that attempted to block more stringent requirements for new vaccines. It’s the same White House that had staff and a president show up to a debate after exposure to a deadly pandemic disease and didn’t tell anyone. It’s the same White House that derided wearing masks as a way to reduce the spread of virus from people without symptoms—both in the world generally and in the White House itself, as a matter of “personal choice,” even with multiple staffers ill. It’s the White House—the president—that told people not to let the virus “dominate” their lives, who went home from the hospital when he was still sick and almost certainly still infectious. These are all, in their way, superspreading behaviors, as sure as doing a bar crawl when you’re sick.