After months of crowded events and often maskless encounters, a growing number of top government officials, including President Trump, and their close contacts have tested positive for the coronavirus.
The fault for the outbreak lies in no small part with an ill-conceived disease-prevention strategy at the White House, health experts said: From the early days of the pandemic, federal officials have relied too heavily on one company’s rapid tests, with little or no mechanism to identify and contain cases that fell through the diagnostic cracks.
“It seems the White House put all their eggs in one basket: testing,” said Dr. Megan Ranney, an emergency medicine physician at Brown University. “But there is no single strategy, no single thing we can do to be safe. It has to be multimodal.”
Other health experts noted that the tests deployed by the White House, manufactured by Abbott Laboratories, were given emergency clearance by the Food and Drug Administration only for people “within the first seven days of the onset of symptoms.” But they were used incorrectly, to screen people who were not showing any signs of illness. Such off-label use, experts said, further compromised a strategy that presumably was designed to keep leading officials safe from a pandemic that so far has killed more than 210,000 Americans.
“It’s not being used for the intended purpose,” said Syra Madad, an infectious disease epidemiologist based in New York. “So there will be potentially a lot of false negatives and false positives.”
Dr. Scott Gottlieb, the former commissioner of the F.D.A., described these procedures as a misguided attempt at a “zero-fail testing protocol” in an interview on CBS’ “Face the Nation” on Sunday, saying that officials “weren’t taking any precautions beyond testing people who are going to be in contact with the president.”
Although Abbott’s products are not cleared for asymptomatic testing, the company has told experts that it thinks such use is likely to pan out.
On Saturday evening, Andrea Wainer, Abbott’s executive vice president of rapid and molecular diagnostics, emailed a document to several public health experts containing preliminary results outlining the test’s performance in people without symptoms. Among an unspecified number of individuals, the test picked up about 88 percent of the infections found by laboratory P.C.R. tests, the company statement said.
“By studying the test in the asymptomatic people, Abbott knows it works in that population,” the document said. “It can’t say that for itself, because the test isn’t approved for that, but that data has been shared with others and the F.D.A. too.”