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President Trump could be contagious 20 days after COVID-19 diagnosis, doctor says

"You can't tell based on symptoms. You can't tell based on how you feel," Washington University Infectious Disease Specialist Dr. Steven Lawrence said

ST. LOUIS — The Commission on Presidential Debates announced its intent for the second debate to go virtual Thursday morning. The commission cited COVID-19 safety concerns. 

President Trump responded to the change when he called into Fox Business News and said he feels better than he has in a long time. He said he even wanted to hold a rally Wednesday night. 

But does "feeling better" mean the president isn't contagious? 

"You can't tell based on symptoms. You can't tell based on how you feel," Washington University Infectious Disease Specialist Dr. Steven Lawrence said, "Any one person is not able to determine if they are still contagious or not."

"You never really know when you are not contagious. So that's why the CDC came up with the guideline of 10 days," SSM Chief Community Health Officer Dr. Alex Garza added.

Contact tracing and clinical testing shows that most infected people do not pass the virus to others after that length of time. An infected person may feel better before their 10 days is up, but they could still be contagious. 

Doctors have also found that some people stay contagious longer than the CDC threshold of 10 days.

"If patients have had more severe or critical illness and traditionally those are the patients that end up in the hospital or require oxygen. We know that the sicker patients can be contagious for longer," explained Mercy Hospital South Chief Medical Officer Dr. Aamina Akhtar.

Dr. Akhtar and Dr. Lawrence told 5 On Your Side patients in the "severe or critical" subgroup should isolate for 20 days after the onset of their symptoms. 

President Trump announced last Friday he had COVID-19 and was hospitalized the same day. The debate is next Thursday, which is beyond the standard 10 day waiting period. The President's case could be considered severe and thus doctors say 20 days would be a safer time to isolate. 

"If somebody is still in a period where they are still shedding, they could be contagious," Dr. Lawrence tells 5 On Your Side, "it's really necessary to remain in isolation and not be in spaces with other people, particularly indoor spaces when they are unmasked."  

Dr. Lawrence, Dr. Akhtar and Dr. Garza agreed a virtual debate would be a safer alternative. 

"I believe it's reasonable out of an abundance of caution to go to that virtual debate set up that they are advocating for right now," Dr. Garza said, "especially because both of the candidates are in high risk groups because of their age."

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