Category Archives: Clinical Testing

Test positivity rate: How this one figure explains that the US isn’t doing enough testing yet

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Positivity Rate - High, Positivity Rate - Low, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, World Health Organization (WHO) • Leave a comment

https://theconversation.com/test-positivity-rate-how-this-one-figure-explains-that-the-us-isnt-doing-enough-testing-yet-143340

Test positivity rate: How this one figure explains that the US isn ...

The U.S. has performed more coronavirus tests than any other country in the world. Yet, at the same time, the U.S. is notably underperforming in terms of suppressing COVID-19. Confirmed cases – as well as deaths – are surging in many parts of the country. Some people have argued that the increase in cases is solely due to increased testing.

I am a statistician who studies how mathematics and statistics can be used to track diseases. The claim that the increase in cases is only caused by increases in testing is just not true. But how do public health officials know this?

Testing, confirmed cases and total cases

COVID-19 testing has two purposes. The first is to confirm a diagnosis so that medical treatment can be appropriately rendered. The second is to do surveillance for tracking and disease suppression – including finding those who may be asymptomatic or only have mild symptoms – so that individuals and public health officials can take actions to slow the spread of the virus.

At a White House briefing on July 13, the president said, “When you test, you create cases.”

The problem with this statement is that anyone who is infected with the coronavirus is, by definition, a case. Since taking a COVID-19 test does not cause a person to get coronavirus, just like taking a pregnancy test does not cause one to become pregnant, the president’s claim is false. Testing does not create cases.

However, because many COVID-19 cases are asymptomatic, many people are infected and don’t know it. What COVID-19 testing does do is identify unknown cases. And thus it does increase the number of cases that are known, or otherwise called the confirmed case count.

Finding unknown cases is good, not bad, because identifying those who are COVID-19-positive allows individuals and public health officials to take actions that slow the spread of the disease. When public health officials find cases, they can begin contract tracing. When a person finds out they are infected, they will know to quarantine.

Since the beginning of the pandemic, the U.S. has performed more total tests and more tests per capita than any other country, though as of late July the U.K., Russia and Qatar were performing more tests per capita per day. But counting the total number of tests or the tests per capita is not the right way to judge success of a testing program.

As it says on the Johns Hopkins testing comparison page, a country’s “testing program should be scaled to the size of their epidemic, not the size of the population.” Sure, the U.S. might have a big testing program, but it has a massive epidemic. The U.S. needs an equally massive testing program if health officials want to have an accurate picture of what’s really going on.

Test positivity rate

So how do public health officials know if they are doing enough testing?

Better than simply counting total number of tests, the test positivity rate is a useful measure of whether enough tests are being done. The test positivity rate is simply the fraction of tests that come back positive. It is calculated by dividing the number of positive tests by the total number of tests. Generally, a lower test positivity rate is good.

A good way to think about test positivity is to think about fishing with a net. If you catch a fish almost every time you send the net down – high test positivity – that tells you there are probably a lot of fish around that you haven’t caught – there are a lot of undetected cases. On the other hand, if you use a huge net – more testing – and only catch a fish every once in a while – low test positivity – you can be pretty sure that you’ve caught most of the fish in the area.

According to the World Health Organization, before a region can relax restrictions or begin reopening, the test positivity rate from a comprehensive testing program should be at or below 5% for at least 14 days.

There are two ways to lower a test positivity rate: either by decreasing the number of positive tests or by increasing the total number of tests. A comprehensive testing program does both. By conducting a large number of tests, most cases in the community are detected. Then, individual and government actions can be taken that contain the virus. This results in a declining number of positive tests.

Returning to the fishing metaphor, the goal of a comprehensive testing program is to use a huge net to overfish in the coronavirus lake until there are very few COVID-19 cases left. Using the test positivity rate as a measure of success helps ensure that a testing program is appropriately scaled to the size of an epidemic.

As of July 27, the U.S. as a whole had a test positivity rate of 10%. States where testing programs are robust and the virus is fairly well controlled have test positivity rates well below 5%, like Massachusetts at 2.68% and New York at 1.09%. In places like Mississippi and Arizona that are experiencing large outbreaks, test positivity rates are above 20%.

The right amount of testing

The increases in confirmed cases aren’t occurring just because there is more testing. The high test positivity rates in some locations show that the virus is in fact spreading and growing so testing needs to grow with it. I believe that if the U.S. wants to beat back this virus, one of the first things that needs to happen is to increase testing. We need to deploy larger nets to catch more fish. Yes, we’ll find more cases, but that’s the point.

 

 

 

 

How COVID-19 might increase risk of memory loss and cognitive decline

Posted on by • Posted in 2020 Election Issues, Brain Care, Chronic Care Management, Chronic Conditions, Chronic Diseases, Clinical Testing, Contact Tracing, Coronavirus, Coronavirus Long-Term Complications, Coronavirus Treatment, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Immune System Response, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Preexisting Conditions, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://theconversation.com/how-covid-19-might-increase-risk-of-memory-loss-and-cognitive-decline-141940?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20August%207%202020%20-%201698416388&utm_content=Latest%20from%20The%20Conversation%20for%20August%207%202020%20-%201698416388+Version+A+CID_8af0fc3134205f68bf387b5096319fb1&utm_source=campaign_monitor_us&utm_term=How%20COVID-19%20might%20increase%20risk%20of%20memory%20loss%20and%20cognitive%20decline

Of all frightening ways that the SARS-COV-2 virus affects the body, one of the more insidious is the effect of COVID-19 on the brain.

It is now clear that many patients suffering from COVID-19 exhibit neurological symptoms, from loss of smell, to delirium, to an increased risk of stroke. There are also longer-lasting consequences for the brain, including myalgic encephalomyelitis /chronic fatigue syndrome and Guillain-Barre syndrome.

These effects may be caused by direct viral infection of brain tissue. But growing evidence suggests additional indirect actions triggered via the virus’s infection of epithelial cells and the cardiovascular system, or through the immune system and inflammation, contribute to lasting neurological changes after COVID-19.

I am a neuroscientist specializing in how memories are formed, the role of immune cells in the brain and how memory is persistently disrupted after illness and immune activation. As I survey the emerging scientific literature, my question is: Will there be a COVID-19-related wave of memory deficits, cognitive decline and dementia cases in the future?

The immune system and the brain

Many of the symptoms we attribute to an infection are really due to the protective responses of the immune system. A runny nose during a cold is not a direct effect of the virus, but a result of the immune system’s response to the cold virus. This is also true when it comes to feeling sick. The general malaise, tiredness, fever and social withdrawal are caused by activation of specialized immune cells in the brain, called neuroimmune cells, and signals in the brain.

These changes in brain and behavior, although annoying for our everyday lives, are highly adaptive and immensely beneficial. By resting, you allow the energy-demanding immune response to do its thing. A fever makes the body less hospitable to viruses and increases the efficiency of the immune system. Social withdrawal may help decrease spread of the virus.

In addition to changing behavior and regulating physiological responses during illness, the specialized immune system in the brain also plays a number of other roles. It has recently become clear that the neuroimmune cells that sit at the connections between brain cells (synapses), which provide energy and minute quantities of inflammatory signals, are essential for normal memory formation.

Unfortunately, this also provides a way in which illnesses like COVID-19 can cause both acute neurological symptoms and long-lasting issues in the brain.

Microglia are specialized immune cells in the brain. In healthy states, they use their arms to test the environment. During an immune response, microglia change shape to engulf pathogens. But they can also damage neurons and their connections that store memory.

During illness and inflammation, the specialized immune cells in the brain become activated, spewing vast quantities of inflammatory signals, and modifying how they communicate with neurons. For one type of cell, microglia, this means changing shape, withdrawing the spindly arms and becoming blobby, mobile cells that envelop potential pathogens or cell debris in their path. But, in doing so, they also destroy and eat the neuronal connections that are so important for memory storage.

Another type of neuroimmune cell called an astrocyte, typically wraps around the connection between neurons during illness-evoked activation and dumps inflammatory signals on these junctions, effectively preventing the changes in connections between neurons that store memories.

Because COVID-19 involves a massive release of inflammatory signals, the impact of this disease on memory is particularly interesting to me. That is because there are both short-term effects on cognition (delirium), and the potential for long-lasting changes in memory, attention and cognition. There is also an increased risk for cognitive decline and dementia, including Alzheimer’s disease, during aging.

 

How does inflammation exert long-lasting effects on memory?

If activation of neuroimmune cells is limited to the duration of the illness, then how can inflammation cause long-lasting memory deficits or increase the risk of cognitive decline?

Both the brain and the immune system have specifically evolved to change as a consequence of experience, in order to neutralize danger and maximize survival. In the brain, changes in connections between neurons allows us to store memories and rapidly change behavior to escape threat, or seek food or social opportunities. The immune system has evolved to fine-tune the inflammatory response and antibody production against previously encountered pathogens.

Yet long-lasting changes in the brain after illness are also closely linked to increased risk for age-related cognitive decline and Alzheimer’s disease. The disruptive and destructive actions of neuroimmune cells and inflammatory signaling can permanently impair memory. This can occur through permanent damage to the neuronal connections or neurons themselves and also via more subtle changes in how neurons function.

The potential connection between COVID-19 and persistent effects on memory are based on observations of other illnesses. For example, many patients who recover from heart attack or bypass surgery report lasting cognitive deficits that become exaggerated during aging.

Another major illness with a similar cognitive complications is sepsis – multi-organ dysfunction triggered by inflammation. In animal models of these diseases, we also see impairments of memory, and changes in neuroimmune and neuronal function that persist weeks and months after illness.

Even mild inflammation, including chronic stress, are now recognized as risk factors for dementias and cognitive decline during aging.

In my own laboratory, I and my colleagues have also observed that even without bacterial or viral infection, triggering inflammatory signaling over a short-term period results in long-lasting changes in neuronal function in memory-related brain regions and memory impairments.

 

Does COVID-19 increase risk for cognitive decline?

It will be many years before we know whether the COVID-19 infection causes an increased risk for cognitive decline or Alzheimer’s disease. But this risk may be decreased or mitigated through prevention and treatment of COVID-19.

Prevention and treatment both rely on the ability to decrease the severity and duration of illness and inflammation. Intriguingly, very new research suggests that common vaccines, including the flu shot and pneumonia vaccines, may reduce risk for Alzheimer’s.

Additionally, several emerging treatments for COVID-19 are drugs that suppress excessive immune activation and inflammatory state. Potentially, these treatments will also reduce the impact of inflammation on the brain, and decrease the impact on long-term brain health.

COVID-19 will continue to impact health and well-being long after the pandemic is over. As such, it will be critical to continue to assess the effects of COVID-19 illness in vulnerability to later cognitive decline and dementias.

In doing so, researchers will likely gain critical new insight into the role of inflammation across the life-span in age-related cognitive decline. This will aid in the development of more effective strategies for prevention and treatment of these debilitating illnesses.

 

 

 

 

Most Americans Still Aren’t Wearing Face Masks Outdoors, Poll Finds

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Opinion, Public Perception, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing • Leave a comment

https://www.forbes.com/sites/alisondurkee/2020/08/07/most-americans-still-arent-wearing-face-masks-outdoors-poll-finds/#16327ed43349

Why do so many Americans refuse to wear face masks? Politics is ...

TOPLINE

Even as the surging Covid-19 pandemic has inspired a broad majority of Americans to start wearing face masks indoors, the practice still remains rare outside, with a new Gallup poll finding that fewer than half of Americans wear face masks outside in non-socially distanced settings, despite many mask-wearing mandates now requiring them to do so.

KEY FACTS

While 81% of poll respondents say they always or usually wear a mask indoors when social distancing isn’t possible, only 47% say they wear a face mask outdoors when they cannot socially distance.

29% say they “always” wear a mask outdoors and 18% say they “usually” do.

The practice is more common among Democrats, with 64% saying they wear a mask outdoors as compared with 43% of Independents and only 23% of Republicans.

Midwesterners are the least likely to wear masks outside; only 37% in the Midwest region wear masks outside, versus 55% in the Northeast, 47% in the South and 49% in the West.

Research has shown that Covid-19 appears to be more easily transmitted indoors, though outdoor settings still pose some risk, and Gallup notes the poll findings “could indicate a potential for increased spread of the disease” in outdoor venues like beaches.

Many state or local mask-wearing mandates include outdoor settings where social distancing isn’t possible, and multiple areas, including New Jersey and Oregon, have also imposed additional orders specifying masks must be worn outdoors in many circumstances.

CRUCIAL QUOTE

“We know this virus is a lot less lethal outdoors than indoors, but that does not mean it is not lethal,” New Jersey Gov. Phil Murphy said in a statement about his July executive order requiring masks outdoors. “The hotspots we’re seeing across the nation and certain worrisome transmission trends in New Jersey require us to do more.”

BIG NUMBER

66,740: The number of lives that could be saved in the U.S. by December 1 if 95% of people “were to wear masks when leaving their homes,” as projected Thursday by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine. The IMHE’s model projects 295,011 deaths by December, which would drop by 49% to 228,271 with “consistent mask-wearing.”

KEY BACKGROUND

Mask wearing has become a major point of contention as Covid-19 has rapidly spread across the U.S. Though many states and localities have imposed mask-wearing mandates, the orders have been resisted by many GOP governors, including in states like Florida that have been particularly hard-hit by the virus. While President Donald Trump initially made mask-wearing a partisan debate through his refusal to don a mask, the president has shifted to promoting the practice in recent weeks, tweeting a photo of himself in a mask that called mask-wearing “patriotic” and urging supporters to wear a mask in a recent campaign email. Prominent Republicans including Senate Majority Leader Mitch McConnell have also vocally advocated for mask-wearing, with McConnell saying Thursday on CNBC that wearing a mask is “the single most significant thing everybody in the country can do to help prevent the spread.”

 

 

 

 

69% Of Americans Are Concerned That The U.S. Is Reopening Too Quickly Amid The Coronavirus Pandemic

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Case, Economic Recovery, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, Wishful Thinking • Leave a comment

https://www.forbes.com/sites/mattperez/2020/08/06/69-of-americans-are-concerned-that-the-us-is-reopening-too-quickly-amid-the-coronavirus-pandemic/#719b3e2523f3

69% Of Americans Are Concerned That The U.S. Is Reopening Too ...

TOPLINE

Some 69% of Americans believe that state governments have eased restrictions too soon amid the Covid-19 pandemic, as opposed to opening too slowly, according to a new Pew Research study published on Thursday, as the U.S. grapples with a still-uncontrolled outbreak of the coronavirus.

KEY FACTS

While the Trump administration pushed for states to lift stay-at-home orders throughout the spring to help the battered economy, governors are now being forced to pause or restore some restrictions after a surge in cases this summer.

Around seven-in-ten people believe the most effective way to help economic recovery is to significantly reduce infections across the country, according to the study, and while Trump continues his argument that the U.S. leads the world in cases due to an increase in testing, 60% of Americans believe it’s primarily due to more new infections.

A majority of Democrats and Republicans believe the main reason the outbreak in the U.S. has continued is due to the lack of social distancing and mask wearing, while 58% of adults surveyed believe it’s due to early lifting of restrictions.

A number of wealthy nations that experienced severe outbreaks early in the pandemic have exited their first waves and have less cases than states like California and Florida, with 62% of Americans believing the U.S. response to the coronavirus trails other affluent countries.

The survey comes as the Trump administration continues to pressure Democratic-led states to ease restrictions and demand schools reopen for in-person instruction, even threatening to withhold federal funding if they don’t.

CRUCIAL QUOTE

Dr. Anthony Fauci, the government’s lead infectious disease expert, commented on the rise of infections across the nation: “In the attempt to reopen in some situations states did not abide strictly by the guidelines that the task force and the White House has put out. And others that even did abide by it, the people in the state actually were congregating in crowds and not wearing masks.”

KEY BACKGROUND

While initial hotspots like New York and New Jersey were able to lower the infection rate throughout the spring, cases began exploding in southern and western states before the country as a whole could exit the first wave of its outbreak. Cases are now trending down after a record high of 74,818 on July 24, according to the Centers for Disease Control and Prevention, though deaths have been over 1,000 daily the past week and there are still tens of thousands of cases each day. The U.S. leads all other countries in cases with 4.87 million, as well as reported deaths with 159,864.

 

 

 

 

Virus testing in the US is dropping, even as deaths mount

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Deferred Healthcare, Denial, Economic Crisis, Economic Recovery, Economic Stimulus, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Expert, Expert Opinion, Food and Drug Administration (FDA), Health Insurance Coverage Adequacy, High Deductible Health Plans, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Network, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Public Health, Public Perception, Public Safety, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://apnews.com/aebdc0978de958f20ab3f398cdf6f769

Virus testing in the US is dropping, even as deaths mount

U.S. testing for the coronavirus is dropping even as infections remain high and the death toll rises by more than 1,000 a day, a worrisome trend that officials attribute largely to Americans getting discouraged over having to wait hours to get a test and days or weeks to learn the results.

An Associated Press analysis found that the number of tests per day slid 3.6% over the past two weeks to 750,000, with the count falling in 22 states. That includes places like Alabama, Mississippi, Missouri and Iowa where the percentage of positive tests is high and continuing to climb, an indicator that the virus is still spreading uncontrolled.

Amid the crisis, some health experts are calling for the introduction of a different type of test that would yield results in a matter of minutes and would be cheap and simple enough for millions of Americans to test themselves — but would also be less accurate.

“There’s a sense of desperation that we need to do something else,” said Dr. Ashish Jha, director of Harvard’s Global Health Institute.

Widespread testing is considered essential to managing the outbreak as the U.S. approaches a mammoth 5 million confirmed infections and more than 157,000 deaths out of over 700,000 worldwide.

Testing demand is expected to surge again this fall, when schools reopen and flu season hits, most likely outstripping supplies and leading to new delays and bottlenecks.

Some of the decline in testing over the past few weeks was expected after backlogged commercial labs urged doctors to concentrate on their highest-risk patients. But some health and government officials are seeing growing public frustration and waning demand.

In Iowa, state officials are reporting less interest in testing, despite ample supplies. The state’s daily testing rate peaked in mid-July but has declined 20% in the last two weeks.

“We have the capacity. Iowans just need to test,” Gov. Kim Reynolds said last week.

Jessica Moore of rural Newberry, South Carolina, said that after a private lab lost her COVID-19 test results in mid-July, she had to get re-tested at a pop-up site organized by the state.

Moore and her husband arrived early on a Saturday morning at the site, a community center, where they waited for two hours for her test. Moore watched in the rear-view mirror as people drove up, saw the long line of cars, and then turned around and left.

“If people have something to do on a Saturday and they want to get tested, they’re not going to wait for two hours in the South Carolina heat for a test, especially if they’re not symptomatic,” Moore said.

Before traveling from Florida to Delaware last month, Laura DuBose Schumacher signed up to go to a drive-up testing site in Orlando with her husband. They were given a one-hour window in which to arrive.

They got there at the start of the window, but after 50 minutes it looked as if the wait would be another hour. Others who had gone through the line told them that they wouldn’t get their results until five days later, a Monday, at the earliest. They were planning to travel the next day, so they gave up.

“Monday would have been pointless, so we left the line,” Schumacher said.

The number of confirmed infections in the U.S. has topped 4.7 million, with new cases running at nearly 60,000 a day on average, down from more than 70,000 in the second half of July.

U.S. testing is built primarily on highly sensitive molecular tests that detect the genetic code of the coronavirus. Although the test is considered the gold standard for accuracy, experts increasingly say the country’s overburdened lab system is incapable of keeping pace with the outbreak and producing results within two or three days, the time frame crucial to isolating patients and containing the virus.

“They’re doing as good a job as they possibly can do, but the current system will not allow them to keep up with the demand,” said Mara Aspinall of Arizona State University’s College of Health Solutions.

Testing delays have led researchers at Harvard and elsewhere to propose a new approach using so-called antigen tests — rapid technology already used to screen for flu, strep throat and other common infections. Instead of detecting the virus itself, such tests look for viral proteins, or antigens, which are generally considered a less accurate measure of infection.

A number of companies are studying COVID-19 antigen tests in which you spit on a specially coated strip of paper, and if you are infected, it changes color. Experts say the speed and widespread availability of such tests would more than make up for their lower precision.

While no such tests for the coronavirus are on the U.S. market, experts say the technology is simple and the hurdles are more regulatory than technical. The Harvard researchers say production could quickly be scaled into the millions.

A proposal from the Harvard researchers calls for the federal government to distribute $1 saliva-based antigen tests to all Americans so that they can test themselves regularly, perhaps even daily.

Even with accuracy as low as 50%, researchers estimate the paper strip tests would uncover five times more COVID-19 cases than the current laboratory-based approach, which federal officials estimate catches just 1 in 10 infections.

But the approach faces resistance in Washington, where federal regulators have required at least 80% accuracy for new COVID-19 tests.

To date, the Food and Drug Administration has allowed only two COVID-19 antigen tests to enter the market. Those tests require a nasal swab supervised by a health professional and can only be run on specialized machines found at hospitals, doctor’s offices, nursing homes and clinics.

Also, because of the risk of false negatives, doctors may need to confirm a negative result with a genetic test when patients have possible symptoms of COVID-19.

On Tuesday, the governors of Maryland, Virginia, Louisiana and three other states announced an agreement with the Rockefeller Foundation to purchase more than 3 million of the FDA-cleared antigen tests, underscoring the growing interest in the technology.

When asked about introducing cheaper, paper-based tests, the government’s “testing czar,” Adm. Brett Giroir, warned that their accuracy could fall as low as 20% to 30%.

“I don’t think that would do a service to the American public of having something that is wrong seven out of 10 times,” Giroir said last week. “I think that could be catastrophic.”

___

This story has been corrected to show that Iowa’s daily testing rate has declined 20%, not 40%.

 

 

 

The Misguided Rush to Throw the School Doors Open

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Guinea Pigs, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Threat, Threats, Wishful Thinking • Leave a comment

https://www.governing.com/now/The-Misguided-Rush-to-Throw-the-School-Doors-Open.html?utm_term=READ%20MORE&utm_campaign=The%20Misguided%20Rush%20to%20Throw%20the%20School%20Doors%20Open&utm_content=email&utm_source=Act-On+Software&utm_medium=email

With the COVID-19 pandemic raging across much of America, a return to full-scale classroom instruction poses too grave a risk to students, teachers, school staff, parents and their communities.

Across the country, many of the public schools that are scheduled to open their doors within the next few weeks are still in limbo as to whether they should open on time and how they should operate — with full-scale in-person classroom instruction, with online learning only, or with some hybrid of the two. But the right call is becoming clearer by the day: It’s too soon to bring students and teachers back into the classroom.

Most communities are not ready to reopen their schools for traditional classes because neither government leaders nor the public have done nearly enough to curb the spread of the coronavirus or make the necessary preparations that would be required to operate schools safely.

Tens of thousands of new cases of COVID-19 are being reported every day and the death toll is averaging more than a thousand daily, with Sun Belt states seeing most of the biggest surges. It’s becoming ever clearer that this grim tally will continue until an effective vaccine is available. Until then, the possibility that students, their parents, teachers and school staff could become infected with the coronavirus and spread it widely to their communities should gravely concern every public official. The danger is hardly speculative: Schools that are among the earliest to reopen are already seeing positive cases.

The arguments that students learn better in a classroom setting, that they are suffering psychologically from social isolation, and that school closures have been particularly hard on working families are all legitimate. But are we really prepared to further risk the health of our children and of our communities by putting them in an environment where most of the practices to curb the virus will be difficult, if not impossible, to consistently follow?

And the danger to school staff members if they are forced to return to work should not be underestimated. According to the Kaiser Family Foundation, 25 percent of teachers are at risk of serious illness if they become infected with COVID-19, either because of their age — 65 or older — or their underlying health conditions.

The rush to reopen fully for in-person instruction has been driven in part by President Trump and Education Secretary Betsy DeVos, whose demands have been accompanied with threats of losing federal funds. Those demands appear to run afoul of guidelines issued by the Centers for Disease Control and Prevention a few weeks ago: Among other things, the CDC counseled going with small, socially distanced class sizes, emphasizing hand hygiene and respiratory etiquette, and requiring cloth face coverings — common-sense precautions the president said were too strict and many school officials say will be difficult to implement.

The political pressure has been so intense that the CDC issued a new set of “resources and tools” for school reopening, with CDC Director Robert Redfield saying that “the goal line is to get the majority of these students back to face-to-face learning,” a stance that was seen by many as a capitulation after the president criticized the earlier guidelines. Clearly this is not what most Americans expect of our top health officials. The public must feel confident that decisions to reopen schools are based on the best scientific evidence available and the professional advice of educators.

Despite the threats and pressure, many school officials are still doing the right thing by listening to local health experts and deciding for themselves when and how best to reopen. I see this in my own state of Georgia, where, according to a recent Atlanta Journal-Constitution article on how Georgia schools plan to start the school year, most school official are delaying opening and say that when they do open they plan to implement a hybrid approach to instruction. “Teachers will check in virtually — via some video conferencing software allowing them to see the dozens of children they would normally engage with through rows or groups of desks,” the newspaper reported.

The larger school districts in metropolitan Atlanta recently reversed themselves from offering parents an option to send their children to school traditionally or attend virtually, opting to go all-virtual because of the spikes in the virus. Other schools in the state plan to meet on campus a few days a week and do virtual learning on other days. Then there are superintendents who plan to prioritize on-campus learning but restrict it to students with special learning needs, such as those who have autism. Many of these options are complex and carry with them implications difficult to foresee, but they all prioritize the health of students.

The ultimate decider of when schools will fully reopen will undoubtedly be parents, at least those who have the freedom and budgets to stay home and monitor their children’s academic progress and assist with their homework. As a caring society, we must ensure that the option to telework is given to as many parents as possible, so that the decision to send one’s children to school and possibly expose them to the coronavirus is not based on family income and social status.

We are still in an existential fight with the coronavirus, and we do not know precisely how or when this battle will end. We do know the virus is apolitical and knows no local or state boundaries. There are no quick or easy solutions. One can only pray that public officials learned something from reopening our economy too soon. We do not want this to happen again by prematurely reopening schools.

Much of what our children lose in a semester or two of distance learning can be made up in time, but a lost life is forever.

 

 

 

 

A Mississippi town welcomed students back to school last week. Now 116 are home in quarantine.

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Over 100 students quarantined in Mississippi school district after ...

Last week, schools in Corinth, Miss., welcomed back hundreds of students. By Friday, one high-schooler tested positive for the novel coronavirus. By early this week, the count rose to six students and one staff member infected. Now, 116 students have been sent home to quarantine, a spokeswoman for the school district confirmed.

Despite the quick fallout, the district’s superintendent said he has no plans to change course.

As districts around the country debate the merits of in-person classes vs. remote learning amid an escalating novel coronavirus pandemic, the Corinth School District’s early experience shows how quickly positive tests can lead to larger quarantines.

Other districts that have welcomed teachers or students back have faced similar challenges. After teachers returned to plan lessons in Georgia’s largest district, 260 district employees were barred from reentering schools because of either testing positive for the coronavirus or being in close contact with someone who had. In southeast Kansas, six school administrators tested positive after attending a three-day retreat. And within hours of opening, a school in Greenfield, Ind., was informed by the health department that a student had the virus.

Some health officials in the Trump administration, which has pushed for schools to fully reopen, are now urging communities with high rates of the virus to rethink in-person classes. On Sunday, Deborah Birx, the White House’s top coronavirus coordinator, said on CNN’s “State of the Union” that in hard-hit areas, “we are asking people to distance-learn at this moment so we can get this epidemic under control.”

Mississippi has been among the hardest-hit states in the South and could overtake Florida as the top state for cases per capita, according to researchers at Harvard University. The state has had more than 63,000 coronavirus cases and more than 1,800 deaths to date.

On Tuesday, Gov. Tate Reeves (R) said in a Facebook post that he would delay school opening for seventh to 12th grades in hot spots. The governor also mandated masks in schools and ordered a two-week mask requirement for public gatherings.

In Corinth, the school district gave families an option of either sending their children to school buildings or doing distance learning from home.

“We made the decision that even though we had seen a spike in those numbers, that schools needed to reopen and at the same time, schools need to remain open,” Childress said in the Facebook Live broadcast.

According to the district’s reopening plan, students and teachers are screened daily, with their temperatures taken upon arrival at school and checked for symptoms including coughing, difficulty breathing, and loss of taste and smell. Childress said that the district will start midday temperature checks.

When the schools learned of positive coronavirus cases, they used contact tracing and notified students who had been “within 6 feet of an infected person for 15 minutes or more,” said a memo posted Wednesday on Facebook informing the community of the cases. Seating charts helped the school determine who needed to quarantine, Childress said in the Facebook Live broadcast.

Those students will have to self-quarantine for 14 days and continue school online.

Despite the positive tests and quarantines, Childress said he remained optimistic about the school district’s plans. He encouraged the families to wear masks, and he urged everyone with children in quarantine to stay home until getting their test results.

“We’ve had a good start of school,” Childress said. “We’re going to have some more positive cases. We know that. We know it will happen. We’re going to have to deal with it, and I can assure that we will deal with it and when we impose quarantines on students and staff, we are doing that for a reason.”

 

 

 

 

Fauci says family has faced threats, harassment amid pandemic

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Fauci says family has faced threats, harassment amid pandemic

Fauci says family has faced threats, harassment amid pandemic ...

Dr. Anthony Fauci, the nation’s top infectious disease expert, said he and his family are getting death threats because people don’t like what he says about COVID-19.

“Getting death threats for me, and my family, and harassing my daughters, to the point where I have to get security is just — I mean, it’s amazing,” Fauci said during an interview with CNN’s Sanjay Gupta on Wednesday.

“I wouldn’t have imagined in my wildest dreams that people who object to things that are pure public health principles, are so set against it and don’t like what you and I say, namely in the world of science, that they actually threaten you.”

He noted that crises like COVID-19 has brought out the best of people but also the worst of people.

Fauci’s notoriety has been elevated by COVID-19, as he is often on TV offering a blunt portrayal of the state of the pandemic in the U.S.

Fauci, 79, is one of the world’s most respected infectious disease experts, having advised six presidents on HIV/AIDS, Ebola, Zika and other health crises. He has earned a reputation for being blunt and willing to correct the president.

Fauci has had a security detail since at least April.

Fauci also reflected on what he says is a degree of “anti-science” sentiment in the U.S. that is making it difficult to get people to do things to slow the spread of COVID-19 like wearing masks.

“There is a degree of anti-science feeling in this country, and I think it is not just related to science. It’s almost related to authority and a mistrust in authority that spills over,” he told Gupta.

“Because in some respects, scientists, because they’re trying to present data, may be looked upon as being an authoritative figure, and the pushing back on authority, the pushing back on government is the same as pushing back on science.”

He said the scientific community should be more transparent and reach out to people to underscore the importance of science and evidence-based policy.

“I know when I say that if we follow these five or six principles, we can open up we don’t have to stay shut…There are some people that just don’t believe me or don’t pay attention to that. And that’s unfortunate because that is the way out of this,” he said.

President Trump has repeatedly undermined Fauci, questioning the White House coronavirus task force member on Twitter and in interviews with the media.

Over the weekend, Trump tweeted out a video of a portion of Fauci’s testimony explaining why the U.S. has recorded more cases than European cases and called it “wrong.” Trump has falsely claimed several times that the U.S. has more cases because it is doing more testing.

Trump has also retweeted multiple messages that question Fauci’s expertise, including one last week that said he had “misled the American public.”

 

40% of Americans still putting off care

Posted on by • Posted in 2020 Election Issues, Chronic Care Management, Chronic Conditions, Chronic Diseases, Clinical Testing, Coronavirus, Crisis, Crisis Management, Deferred Healthcare, Economic Crisis, Economy Reopening, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Control, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Public Health, Public Perception, Public Safety, Public Trust, Quarantine, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninformed • Leave a comment

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40% of Americans continue to put off medical care - Axios

Roughly 40% of Americans have postponed getting medical care due to the coronavirus outbreak. That number has stayed around 40% in all 12 weeks of the Census Bureau’s Household Pulse Survey.

Why it matters: Hospitals and doctors started rescheduling surgeries and other appointments as early as mid-May, and many patient volumes are mostly back to pre-pandemic numbers, Axios’ Bob Herman writes.

  • But this data suggests there is still a major backlog of Americans who need care — a phenomenon that existed well before the pandemic.

 

 

 

 

Admininstration believes Coronavirus is “under control”

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Cares, Leadership Culture, Leadership Decentralized, Leadership Messaging, Leadership Political, Leadership Trust, Leadership Vision, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Control, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Public Good, Public Health, Public Perception, Public Safety, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Uncertainty, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Wishful Thinking • Leave a comment

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Daily confirmed COVID-19 cases, rolling 3-day average - Our World ...

President Trump said in an interview with “Axios on HBO” that he thinks the coronavirus is as well-controlled in the U.S. as it can be, despite dramatic surges in new infections over the course of the summer and more than 150,000 American deaths.

  • “They are dying, that’s true. And you have — it is what it is. But that doesn’t mean we aren’t doing everything we can. It’s under control as much as you can control it. This is a horrible plague,” he told Axios’ Jonathan Swan.

Reality check: The U.S. is averaging roughly 65,000 new cases and 1,000 deaths per day, Axios’ Sam Baker writes. The virus has already killed nearly 150,000 Americans, and it spread largely unchecked through almost the entire country throughout June and July.

The big picture: In the interview, which took place last Tuesday, Trump returned to familiar themes and areas where the U.S. really has made significant progress. He cited the dramatic increase in ventilator production, the ramp-up in testing and treatment that has reduced the overall fatality rate from the virus.

  • Yes, but: He painted a far rosier picture of the pandemic than most data would support.

On testing, Trump said, “You know there are those that say you can test too much” — a view that no experts have advocated.

  • The U.S. is experiencing long turnaround times for coronavirus testing, as Trump acknowledged, because of the high demand for testing. But that is largely a function of the country’s high caseload and the number of people at risk of infection.

He also returned to his mantra that “because we’ve done more tests, we have more cases.”

  • The cases the U.S. has, we would have had with or without testing. We know we have them because of testing, but the massive outbreak here would be a massive outbreak whether we chose to know about it (through testing) or ignore it by not testing.