Ever since March, when much of the country went into lockdown to contain the coronavirus, Donald Trump has tempted fate — ignoring his own administration’s advice on avoiding the virus, yet managing to avoid it all the same.

There was a June rally inside a Tulsa arena, and a convention speech to 2,500 people on the South Lawn of the White House in August. Then came de facto political rallies, which gave way to full outdoor rallies, which gave way to indoor ones. All gathered Trump supporters, largely maskless, tightly packed together, and yet the president — a habitual germophobe even before the pandemic — always emerged unscathed.

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But they all paled next to last weekend’s celebratory introduction of Supreme Court nominee Amy Coney Barrett, where roughly 150 guests sat shoulder-to-shoulder in the White House Rose Garden. Senators and other Republican luminaries worked the crowd, shaking hands, hugging and air-kissing, leaning in for conversation. There were indoor gatherings, too. And barely a mask in sight.

The triumphant event has turned into a public health nightmare. At least eight people who attended have since tested positive, including Trump himself, his wife, two Republican senators, former New Jersey Governor Chris Christie and the president of Notre Dame University, though it isn’t known where they contracted the virus.

In the aftermath, the White House said it is performing contract tracing, but several attendees told Bloomberg News that they haven’t been contacted. Some guests are quarantining while others are not, in apparent contradiction of Centers for Disease Control and Prevention guidelines.

“If you had to invent a way to transmit this virus, that’s the environment you would invent,” said Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “The only higher risk environment I can think of is the air in an ICU that is caring for lots of Covid patients.”

The response mirrors Trump’s inconsistent approach to the pandemic: only selectively, and rarely, following the advice of his own health professionals. Trump, in a statement from Walter Reed hospital on Saturday, chalked up his diagnosis to fate and his desire to be seen leading the country.

“I had no choice because I just didn’t want to stay in the White House,” he said. “I had to be out front, and this is America, this is the United States.”

Trump has made downplaying the risk of the virus and getting the country back to work a centerpiece of his re-election campaign. Now voters will judge how that approach has paid off for both the country and Trump personally, just a month before Election Day.

“We have a situation now where multiple people in the White House have Covid, as precautions were not being taken,” said Dr. Leana Wen, an emergency physician and public health professor at George Washington University who is a former health commissioner of Baltimore.

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Trump has often cited ubiquitous coronavirus testing within the White House as an excuse to not wear a mask. But testing is about detection, not prevention, Wen said.

It’s not known how, when or from whom Trump contracted the coronavirus. He conducted nearly a full week of public events and fundraisers after Saturday’s Rose Garden ceremony, including one on Thursday at his golf course in New Jersey after learning a close aide, Hope Hicks, had contracted the virus.

He was flown by helicopter to Walter Reed National Military Medical Center on Friday after testing positive for the virus and exhibiting symptoms. His staff say he’ll spend at least three days there.

The Barrett introduction has drawn criticism for what appears to be a flouting of CDC protocols. Images of the event show a relaxed crowd mingling freely — some with masks, but many without.

There was a giddy feel to the occasion, as guests gave fist bumps, posed for group pictures and shared hugs before and after Trump’s announcement. During his remarks, guests sat close together.

“I was not happy there were a lot of people not wearing masks,” despite signs asking attendees to do so, said John Malcolm, a legal scholar with the Heritage Foundation who attended the event.

Malcolm, who serves as director of the Meese Center for Legal & Judicial Studies, said he took a Covid test on Tuesday, which was negative. Malcolm said he has yet to hear from any White House officials following up on the spread of the virus at the event — though he added he didn’t think that was necessary.

“At this point anybody who attended the event is certainly on notice they ought to consider getting tested,” Malcolm said in a phone interview.

Temperature checks

White House guests were subject to temperature checks on their way in — though the screening is not foolproof, since some infected individuals may not have symptoms and others do not develop fever. And most attendees only participated in the outdoors event, where the risk of spread through aerosolized droplets is believed to be reduced.

No one was “being cavalier about Covid,” said Cleta Mitchell, a political law attorney and partner in the Washington, D.C. office of Foley & Lardner.

“Most of the people in the audience, including me, were outdoors the entire time,” Mitchell said by email. “Temperatures were taken as we went through the entry points and masks were required. Once outside, masks were optional — but we were outside.”

But the outdoor event was bookended by gatherings inside the White House, attended by at least some of the participants later found to be infected. Some who attended these indoor events were tested, but it’s not clear how many. Barrett and her family visited with Trump, the first lady and other White House staff in the Oval Office before the Rose Garden celebration.

And while the virus is generally spread less easily outside, the Centers for Disease Control and Prevention recommends people stay six feet apart from people they don’t live with and wear masks in those situations. The CDC also cautions that a mask is “not a substitute for social distancing.” Both recommendations were widely disregarded.

New Jersey event

Concerns have also been stoked by Trump’s Thursday afternoon roundtable with supporters and a fundraiser at his golf club in Bedminster, New Jersey. He would test positive hours later.

Organizers of the event sent a letter notifying attendees of the president and first lady’s positive test results. Health officials in the state have also begun attempting to reach participants. Likewise, organizers of the presidential debate in Cleveland on Tuesday have followed up with attendees.

There are no signs the White House itself is mounting its own comprehensive contact-tracing effort, the practice of piecing together chains of potential exposures and identifying individuals who may have come into contact with infected people.

Representatives of several people who were at other events with Trump in the past week, including Minnesota House Minority Leader Kurt Daudt, said they have not been formally notified of their potential exposure nor contacted by investigators seeking to learn about their actions in recent days.

The high-profile nature of these cases makes it likely people at recent events with Trump are already aware of their potential exposure. Contract-tracing efforts are often conducted by local health authorities as a way to help identify second- and third-order contacts that may have been near someone with an initial exposure — from acquaintances to store clerks.

Contract tracing

Trump’s physician, Sean Conley, said Saturday the White House Medical Unit was conducting contact tracing in conjunction with the CDC and local and state heath departments. LaToya Foster, a spokeswoman for the mayor of Washington, said the White House would do any contact tracing.

After his infection was made public early Friday, the White House scrambled to more closely follow some guidelines — senior aides suddenly began wearing masks, for one. But others were still dismissed, such as quarantine recommendations for those who’ve come in contact with a confirmed case.

On Friday, Trump’s campaign announced it would scrap all planned events involving the president, though some could be virtual. White House Press Secretary Kayleigh McEnany — who wore a mask outside, but also came to work on Friday despite being exposed to both Trump and Hicks — said officials were looking at ways for Trump to continue to speak to the American people.

Trump’s campaign initiated a reset on Saturday, launching “Operation MAGA” in a bid to keep things moving in the absence of both Trump and campaign manager Bill Stepien, who also has the disease.

Trump now faces the prospect of scrapping his signature rallies, a staple of both of his campaigns. Meanwhile, voting has already begun across much of the U.S., with polls showing Trump trailing former Vice President Joe Biden nationally and in key swing states.

In different times, voters have rallied around wounded presidents, as they did with Ronald Reagan after he survived an assassination attempt in 1981, or cheered on leaders in times of national crisis, as they did for George W. Bush after the September 11 terror attacks.

Trump’s own insistence on ignoring public health measures many Americans observed every day, like masks and social distancing, could diminish that reservoir of sympathy. His presidency has been so polarizing that there’s little clear precedent for how his illness might affect American sentiment. Polls already show Americans strongly disapprove of his handling of the pandemic.

“Presidents in trouble always experience a temporary bump in the numbers, said Craig Shirley, a presidential historian and biographer of Ronald Reagan. “It’s just the basic decency of the American people.”