ML: How hard is it to do this? Who owns the genome of the virus? Is it an invasion of privacy to sequence the genomes of a virus that comes out of somebody?

JD: The sequencing of your own genome and your own information — we would consider that private health information. But a virus such as Covid-19 is RNA, it’s not even DNA, it’s not part of your genome and no one owns it. You don’t own it. The president doesn’t own it. It’s part of nature. And, in fact, after you clear it from your immune system, you won’t have it in your body anymore. And so, when you sequence just the viral genome, you’re not sequencing any human information. There’s no private health information contained within the virus genome, with the exception of the concept that there’s epidemiological information in there.

ML: Are there any kind of legal impediments to getting the positive samples from in and around the White House and sequencing them?

JD: To my knowledge, there shouldn’t be since we’re not violating protected personal health information. I think that actually sequencing the viral genomes, not just for the president but nationwide, is a good idea because it informs us on strategies we would use to intervene and stop transmission chains where they may be occurring, where you didn’t think they were occurring.

ML: To what extent are we doing it now? What percentage of the positives in this country get sequenced?

JD: A very small amount of the total.

ML: Back to Trump. Explain to me how if Hope Hicks gave it to Donald Trump, how you’d be able to figure that out. If they have an identical virus, if it hasn’t mutated, you couldn’t really tell whether Donald Trump gave it to Hope Hicks or Hope Hicks gave it to Donald Trump, right?

JD: In this hypothetical situation, if Hope Hicks and the president’s viral genome were identical, then all you could conclude is that they’re as closely related as two viruses can be, and they either likely transmitted it to each other, or there was no more than one extra person between them.

ML: Now, if the president had one extra mutation on top of all the mutations that were in Hope Hicks’s viral genome, you would know that he was downstream of Hope Hicks. And you could sequence them in time —Hope Hicks first, then the president. In the other situation, it might be the president first and then Hope Hicks if they’re identical and you wouldn’t know which direction the virus went.

JD: Yes, exactly.

ML: If you had whatever the passel of positives end up being — 100 people from rallies, from Rose Garden ceremonies and so on — would it allow you to figure out the conditions in which it was transmitted?

JD: If you were able to sequence as many of the positives as you could, you’d likely be able to link the transmission events to particular environments. A closed office. A rally. A Rose Garden event. From a public health standpoint, you could identify which of those environments need intervention.

ML: So you might be able to show that nothing happened in the Rose Garden, but it all happened on Air Force One.

JD: Correct. It could have happened on the plane, it could have happened in a limousine. Those are the kinds of connections and contact tracing combined with the genomic epidemiology that would really be a precision-mapping tool for knowing the situations in which the virus is transmitted, and how you intervene to stop it.

ML: I understand that maybe we don’t have the firepower or the energy to do this for the whole country — but we have this unbelievably high-profile event. It seems strange to me that we’re not using the technology to figure out what happened.

JD: If there was an armed assailant who somehow hopped the fence at the White House and went in through an open window and roamed the halls freely, you can guarantee that somebody in the Secret Service would lose their job.

ML: There would be videotape of the guy running around and no one would think: “Oh, don't consult the videotape.” And the analogy of the genomic sequencing is sort of like — it's a version of the videotape. It can describe what happened.

JD: The security tapes could tell you who might have assisted the assailant, who opened the window and let that person in. In the same way, the genomic sequencing can tell you who was at the scene, who might have transmitted the virus to whom and who could not have been at the scene. So I find it really striking that not only does there not appear to be any use of the genomic sequencing to understand how this occurred, but they're not even doing basic contact tracing.