Rising COVID-19 cases raise worries about Trump rallies

The Trump campaign is facing criticism for holding packed outdoor rallies and some indoor events where people don’t wear masks, even as cases of COVID-19 increase in most states ahead of an anticipated winter surge.

Outbreaks are particularly bad in midwestern states like Wisconsin, where the Trump campaign has ramped up its efforts as he seeks to win a second term. Wisconsin is one of the key states the president needs to win to secure four more years.

Trump’s decision to go ahead with the rallies, which still pose transmission risks even though they are outdoors, illustrates his desire to move on from the pandemic despite experts’ warnings that the worst is yet to come this winter.

“People are tired of COVID. I have these huge rallies. People are saying ‘Whatever, just leave us alone,’” Trump said Monday in a call with supporters.

“They’re tired of it. People are tired of hearing Fauci and all these idiots.”

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Anthony FauciAnthony FauciCampaign spokesman on Trump calling Fauci an ‘idiot’: There’s ‘competing science’ The Hill’s Morning Report – Sponsored by Goldman Sachs – Two weeks out, Trump attempts to rally the base McConnell aims for unity amid growing divisions with Trump MORE, the nation’s top infectious diseases expert, has said those rallies are “asking for trouble” and people should instead double down on public health measures to bring the number of COVID-19 cases down by the winter, when the virus spreads more easily.

But Trump, who is less than three weeks removed from his own case of COVID-19, sees the rallies as a key part of his election win in 2016 and thinks they could carry him to a second surprise victory in 2020 despite polls that show he’s trailing Democratic presidential nominee Joe BidenJoe BidenBiden holds massive cash advantage over Trump ahead of Election Day Tax records show Trump maintains a Chinese bank account: NYT Trump plays video of Biden, Harris talking about fracking at Pennsylvania rally MORE.

Yet the contrast with Biden’s safety-conscious campaign style risks underlining complaints that Trump has mismanaged the pandemic. Polls routinely show disapproval of how Trump has handled the coronavirus, and Biden’s campaign believes it is the issue that will cost Trump the White House.

Biden has decided against holding rallies, instead holding small events outside, speaking at “drive-in” rallies where people stay in their cars and virtual fundraisers.

“It’s a striking contrast between the Biden campaign taking very strict measures and not choosing to do these rallies based upon the recommendations of scientists and public health experts,” said Josh Michaud, associated director for global health policy at the Kaiser Family Foundation and an infectious diseases epidemiologist.

The contrasting styles and positions of Trump and Biden are certain to be voiced at the final presidential debate, set to take place on Thursday.

The Centers for Disease Control and Prevention (CDC) lists “large in-person gatherings” without social distancing where attendees travel from outside the local area as the “highest risk” settings for events during the pandemic. It recommends people prioritize outdoor activities over indoor ones but to stay six feet or more from people outside your households and wear masks, especially when people might be shouting, chanting or singing.

Since Oct. 12, Trump has held rallies in Georgia, North Carolina, Iowa, Pennsylvania, Nevada, Michigan, Wisconsin and Florida twice. All were outdoors.

His tour of the country comes at a pivotal and possibly dangerous point, given the fall surge of COVID-19 cases that began in September. The U.S. has averaged 59,000 new cases per day, a 34 percent increase from the average two weeks ago. And there’s no sign the curve will flatten anytime soon.

In 34 states, the percentage of tests coming back positive is 5 percent or higher, an indicator of growing community spread.

“When you’re packed closely together for a long period of time, and you’re in a setting where the community rate of infection has increased, this is very concerning,” said Preeti Malani, professor of medicine in the Division of Infectious Diseases at the University of Michigan. Trump held a rally last week in Muskegon, Mich. While it’s too soon to know whether the rally is tied to any COVID-19 cases, Malani is worried about transmission and people traveling from all over the state and seeding outbreaks in rural communities.

“There’s nothing wrong with having an event, but you can do it in a way that’s responsible and require masks and have fewer people,” she said.

Even though Trump’s rallies have been held outdoors, where the virus has a harder time spreading because of the increased ventilation compared to indoor spaces, some experts are concerned about the transmission risks posed by maskless people being closely packed together for hours at a time.

The campaign hands out masks, but attendees aren’t required to wear them. Temperatures are checked at the door, but not everyone with COVID-19 has a temperature, including the 40 to 45 percent of people who are thought to be asymptomatic.

“People have talked about this as if just being outside is a magical thing that can that can eliminate the risk of transmission, and that’s simply not true,” said Angela Rasmussen, a virologist at Columbia Mailman School of Public Health.

“When you have enough people together in close proximity, not wearing masks, potentially shouting, and you know, singing and being loud and making a lot of particles from their respiratory tract in the same space, even if it’s outdoors, that’s still a significant transmission risk.”

She added that Trump is sending the wrong message to the public, encouraging behavior that “puts people at higher risk, even when they’re not at the rally anymore.”

“I think that that is only going to help amplify the surge in cases that we’re now seeing and that we probably will continue to see as the weather gets colder and people are spending more time indoors with each other,” she said.

The Minnesota Department of Public Health has traced 16 cases to Trump’s Sept. 18 rally in Bemidji and four cases to a protest outside; three cases to a Trump rally in Duluth on Sept. 30 and one case to Biden’s campaign stop at a union training center in Duluth.

“Clearly, you can’t write off the risk entirely, even if it’s outside, but getting together in an outdoor situation is much, much lower risk of you getting together in an indoor situation,” Michaud said.

He wondered if people became sick through activities associated with the events, like going out to eat before or after or taking public transportation or rideshares.

Trump and Vice President Pence mainly hold their large rallies and events outdoors, while their surrogates are more likely to hold events indoors at hotels or campaign offices. But last week, Trump spoke at a 500-person, indoor event in Florida for an event focused on “protecting” seniors, who are most at risk for severe COVID-19 illness and are advised by the CDC to stay out of large crowds during the pandemic.

Tiffany Trump spoke at an indoor event Monday at a hotel ballroom where people were not wearing masks.

“Indoor gatherings where people get together, even a small number of people, you can easily see transmission,” Michaud said.