Folks—WH’s defense strategy failed miserably—we epidemiologists think it was a silent asymptotical carrier who evaded the WH testing fence around Trump. But they relied on just that one single fence to their peril. Good oped by @j_g_allen. #COVID19 https://www.washingtonpost.com/opinions/2020/10/03/white-house-coronavirus-outbreak-shows-that-testing-alone-is-not-enough/

2) Does the Secret Service rely on just the fence around WH alone? Of course not—lot of other security. WH needed to have a multilayered castle defense instead of relying on a single wall of testing, which is important but not enough because of the pre/asymptotical window.

3) and during this infected-but-no-symptom window, we know cases are hard to pick up. We know this from testing performance analysis — it’s not that test is bad — it’s the TIMING — too early and early viral load buildup just harder to pickup before symptoms onset (if any).

4) Ive described this all previously (and WH experts should have known this weakness in their testing fence approach). This brings us to @j_g_allen’s oped: he is a building expert for this “castle” and lays out the multilayered approach we should have had from beginning:

5) “Not a single one — whether finance, biotech or arts organizations, or universities or other schools — relies on testing alone. Instead, many use a layered defense strategy rooted in the “hierarchy of controls,” a decades-old framework from field of worker health and safety.”

6) “Applied to #COVID19, it looks like:

Elimination: Prioritize work-from-home strategies.

Substitution: Identify the core people who need to be physically present together and allow only them on-site.
...

7) Engineering: Implement “healthy” building strategies, such as higher ventilation rates and enhanced filtration.

Administrative: Maintain physical distancing.

Personal Protective Equipment: Enforce universal masking.

8) BOTTOMLINE: I believe it was sheer arrogance and blatant science ignorance that allowed whoever designed the WH defense strategy to only rely on just one leaky testing fence strategy alone to test negative and then allowed to go no mask inside WH.

9) Bottomline cont’d: Secret Service guards Trump physically with multiple fences, interior alarms, outer guards, inside monitoring, and interior physical guards—but WH clearly also need to protect the president better against pernicious insidious threats like #COVID19 better too