Modeling the ominous impact of testing delays

https://mailchi.mp/da2dd0911f99/the-weekly-gist-july-17-2020?e=d1e747d2d8

Sponsors Delay Trials and Shift Toward Using Remote Procedures ...

With delays in getting test results growing in many areas of the country, a new analysis in the Lancet shows just how destructive increased turnaround times for COVID tests can be.

Researchers modeled the impact of the timeliness and completeness of contact tracing, finding that minimizing testing delay—shortening the time between symptom onset and a positive test result—had the greatest impact on reducing future spread of the disease.

Digging into the details, if infected individuals who develop symptoms are isolated within one day of symptom onset, the R0 (“R-naught”) can be reduced to 1—each existing infection seeds one new case—stabilizing the level of infection in a population. With contact tracing, the R0 can be reduced to 0.8, meaning the disease will decline.

And researchers found with a testing delay of three days or more, even the most efficient isolation and contact tracing is essentially futile, powerless to bend the curve of transmission rates.

Ominous findings for many states, where average test turnaround times are again approaching one week, showing just how far we are from being able to implement the basic public health strategy of “test, trace and isolate”, which has proven effective for so many countries around the world.

 

 

U.S. Coronavirus Pandemic Status: It’s about to get a lot worse

https://www.axios.com/coronavirus-pain-getting-worse-cd329f4c-9962-4f40-b401-7a7ac1a393cf.html

The pain of the coronavirus is about to get a lot worse - Axios

For months now, American workers, families and small businesses have been saying they can’t keep up their socially distanced lives for much longer. We’ve now arrived at “much longer” — and the pandemic isn’t going away anytime soon.

The big picture: The relief policies and stopgap measures that we cobbled together to get us through the toughest weeks worked for a while, but they’re starting to crumble just as cases are spiking in the majority of states.

Next week, the extra $600 per week in expanded unemployment benefits will expire. And there’s no indication that Congress has reached a consensus on extending this assistance or providing anything in its place.

  • But nearly half of the U.S. population is still jobless, and millions will remain jobless for the foreseeable future. There are 14 million more unemployed people than there are jobs, per the Economic Policy Institute.
  • Nearly a third of Americans missed a housing payment in July — and that was with the additional $600. Plus, most Americans have already spent the stimulus checks they received at the beginning of the pandemic.
  • “We should be very concerned about what’s going to happen in August and beyond” — starting with a spike in evictions, Mathieu Despard, who leads the Social Policy Institute at the Washington University in St. Louis, tells Axios.

Expect more furloughs and layoffs as more small businesses are pushed off the pandemic cliff.

  • By economists’ estimates, more than 100,000 small businesses have permanently closed since the pandemic began.
  • For those that are hanging on, loans from the Paycheck Protection Program (PPP) have not been enough, and the back and forth between re-opening and then closing again as states deal with new case waves has been devastating. In fact, rates of closure have started increasing, the New York Times reports, citing Yelp data.
  • The big firms aren’t immune either. Just last week, behemoths like United Airlines, Wells Fargo, Walgreens and Levi’s either cut jobs or told workers their jobs were at risk, Axios’ Dion Rabouin writes.

And the question of whether schools will reopen looms.

  • Since schools sent kids home in March, and most summer camps didn’t open their doors for the summer, working parents have been dealing with a child care crisis — attempting to do their jobs, care for their kids and homeschool all at once — and hoping that the stress will be temporary.
  • The situation is more dire for low-income families with kids who rely on school lunches or for single parents who are juggling work and parenting without any help.
  • Now the public heath crisis hasn’t abated, and school districts are running out of time to figure out what the fall will look like. Some, starting with Los Angeles, have already decided to go online.

The bottom line: “It’s the uncertainty that is anxiety-inducing,” says Despard. “If you give people a time horizon and say, ‘Look you have to get through these next 8 weeks of extreme shutdown,’ they’ll do it. Now it’s like, ‘How much longer?'”

 

 

 

 

 

U.S. Coronavirus Response: We blew it

https://www.axios.com/coronavirus-america-blew-it-b3d84ea3-78b3-4fe0-8dce-1c4ed0ec0a4c.html

We blew it: Why America still hasn't gotten the coronavirus under ...

America spent the spring building a bridge to August, spending trillions and shutting down major parts of society. The expanse was to be a bent coronavirus curve, and the other side some semblance of normal, where kids would go to school and their parents to work.

The bottom line: We blew it, building a pier instead.

There will be books written about America’s lost five months of 2020, but here’s what we know:

We blew testing. President Trump regularly brags and complains about the number of COVID-19 tests conducted in the U.S., but America hasn’t built the infrastructure necessary to process and trace the results.

  • Quest Diagnostics says its average turnaround time for a COVID-19 test has lengthened to “seven or more days” — thus decreasing the chance that asymptomatic or mildly symptomatic carriers will self-quarantine.
  • The testing delays also make it harder for public health officials to understand current conditions, let alone implement effective contact tracing.
  • Speaking of contact tracing, it remains a haphazard and uncoordinated process in many parts of the country.

We blew schools. Congress allocated $150 billion for state and local governments as part of the CARES Act, but that was aimed at maintaining status quo services in the face of plummeting tax revenue.

There was no money earmarked for schools to buy new safety equipment, nor to hire additional teachers who might be needed to staff smaller class sizes and hybrid learning days.

  • U.S. Education Secretary Betsy DeVos was not among the 27 officials included in the White House Coronavirus Task Force.
  • The administration insists that schools should reopen this fall because kids are less likely to get very sick from the virus, but it has not yet offered detailed plans to protect older teachers, at-risk family members, or students with pre-existing respiratory or immune conditions.
  • Silicon Valley provided some free services to schools, but there was no coordinated effort to create a streamlined virtual learning platform. There also continue to be millions of schoolkids without access to broadband and/or Internet-connected devices.

We blew economics. The CARES Act was bold and bipartisan, a massive stimulus to meet the moment.

  • It’s running out, without an extension plan not yet in place.
  • Expanded unemployment benefits expire in days. Many small businesses have already exhausted their Paycheck Protection Program loans, including some that reopened but have been forced to close again.
  • There has been no national effort to pause residential or commercial evictions, nor to give landlords breathing room on their mortgage payments.

We blew public health. There’s obviously a lot here, but just stick with face masks. Had we all been directed to wear them in March — and done so, even makeshift ones while manufacturing ramped up — you might not be reading this post.

We blew goodwill. Millions of Americans sheltered in place, pausing their social lives for the common good.

  • But many millions of other Americans didn’t. Some were essential workers. Some were deemed essential workers but really weren’t. Some just didn’t care, or didn’t believe the threat. Some ultimately decided that protesting centuries of racial injustice was a worthy trade-off.
  • All of this was complicated by mixed messages from federal and state leaders. Top of that list was President Trump, who claimed to adopt a wartime footing without clearly asking Americans to make sacrifices necessary to defeat the enemy.
  • Five months later, many of those who followed the “rules” are furious at what they perceive to be the selfishness of others.

The bottom line: America has gotten many things right since March, including the development of more effective hospital treatments for COVID-19 patients.

  • But we’re hitting daily infection records, daily deaths hover around 900, and many ICUs reports more patients than beds. It didn’t have to be this way.

 

 

 

 

The surge in coronavirus hospitalizations is severe

https://www.axios.com/newsletters/axios-vitals-b0ebd340-d76f-49c3-8f02-cb2896ae2e8d.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

Share of hospital beds occupied
by COVID-19 hospitalizations

States shown from first date of reported data, from March 17 to July 19, 2020

  • In the last two weeks hospitalizations are:

The coronavirus surge is real, and it's everywhere - Axios

 

Coronavirus hospitalizations are skyrocketing, even beyond the high-profile hotspots of Arizona, Florida and Texas, Axios’ Bob Herman and Andrew Witherspoon report.

Why it matters: The U.S. made it through the spring without realizing one of experts’ worst fears — overwhelming hospitals’ capacity to treat infected people. But that fear is re-emerging as the virus spreads rapidly throughout almost every region of the country.

Where things stand: Arizona remains in the worst shape; 27.1% of all hospital beds in the state are occupied by COVID-19 patients as of July 15, according to an analysis combining data from the COVID Tracking Project and the Harvard Global Health Institute. Texas is second at 18.8%.

  • Nevada is the next worst, with COVID-19 patients taking up 18.7% of all hospital beds. That’s up significantly from 11.2% at the start of July.
  • Florida just started tallying current hospitalization data, showing more than 16% of all hospital beds occupied.

It gets worse: Many other states are showing significant upticks in coronavirus hospitalizations during the first half of July, including Alabama, California, Louisiana, Mississippi, South Carolina and Tennessee.

  • Many of these states, which reopened a lot of their economies in May, do not have mask mandates.

Between the lines: Intensive-care unit beds, reserved for the sickest patients, are completely full in parts of ArizonaFloridaMississippi and Texas.

  • Hospitals can convert other areas into ICUs, but that’s not all that useful if hospitals don’t have enough staff and supplies.

The bottom line: Cases have soared over the past 45 days, and hospitalizations naturally follow many of those cases.

  • Rising hospitalizations mean the outbreaks in many areas are not close to being controlled, and some percentage of those hospitalizations will end as deaths.

 

 

U.S. blows past coronavirus record with more than 70,000 new cases in one day

https://www.washingtonpost.com/nation/2020/07/17/coronavirus-live-updates-us/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most

FirstFT: Today's top stories | Financial Times

There was a time in the United States when 40,000 coronavirus cases in a day seemed like an alarming milestone. That was less than three weeks ago.

Now, the number of new infections reported each day is reaching dizzying new heights. On Thursday, the daily U.S. caseload topped 70,000 for the first time, according to data tracked by The Washington Post.

Record numbers of covid-19 fatalities were reported in Florida, Texas and South Carolina on Thursday, and officials throughout the Sun Belt are worried that hospitals could soon reach a breaking point.

Here are some significant developments:

  • Masks are now mandatory in more than half of U.S. states — with the governors of Arkansas and Colorado the latest to issue face-covering orders. Major retailers phased in new mask policies, and Maryland Gov. Larry Hogan (R), chairman of the National Governors Association, said that masks should be mandated in states across the country.
  • Larry Fink, the chief executive of investment firm BlackRock, said that if states moving forward with reopening plans required masks, the economy would recover much sooner.
  • Atlanta Mayor Keisha Lance Bottoms (D) blasted Georgia’s Republican governor, Brian Kemp (R), for suing to stop block her city’s mask ordinance, accusing him of “putting politics over people.”
  • An unpublished report from the White House Coronavirus Task Force suggests that nearly 20 hard-hit states should enact tougher public health measures.
  • Real-time coronavirus tracking data temporarily disappeared from the Centers for Disease Control and Prevention’s website, sparking an outcry.
  • President Trump faces rising disapproval and widespread distrust on coronavirusaccording to a new Post-ABC poll.
  • India on Friday surpassed 1 million confirmed coronavirus cases, becoming the third country to cross that threshold, behind the United States and Brazil..

 

 

 

 

Florida And Texas Both Set Coronavirus Death Records Thursday

https://www.forbes.com/sites/nicholasreimann/2020/07/16/florida-and-texas-both-set-coronavirus-death-records-thursday/?utm_source=newsletter&utm_medium=email&utm_campaign=dailydozen&cdlcid=5d2c97df953109375e4d8b68#226e63bb720a

Florida coronavirus: State marks Covid-19 case record as July ...

TOPLINE

Coronavirus deaths are again on the rise in the U.S., with all three of the nation’s largest states setting new highs for daily death tolls Thursday following weeks of record increases in new cases and hospitalizations, even as President Donald Trump and other conservatives have touted death statistics as a sign the U.S. is handling the pandemic well.

KEY FACTS

California, Texas and Florida all reported new record daily highs for deaths Thursday.

California reported 149 deaths, while Florida reported 120 and Texas set a new record for the third-straight day, with 105.

Deaths are rising rapidly in Texas, with the 105 deaths breaking Wednesday’s record of 98, which shattered the record of 60 that was set on Tuesday.

Coronavirus deaths in the U.S. declined from early May through mid-June, but have picked up recently, and are now pacing at just under 1,000 per day.

The rise is being driven by record new death tolls in the nation’s largest states—the same states that have in large part contributed to the U.S.’s record rise in new cases recently.

Experts have said that deaths lag behind increases in cases and hospitalizations, with former FDA Commissioner Scott Gottlieb saying in an interview Sunday that “the total number of deaths is going to start going up again.”

KEY BACKGROUND

Coronavirus deaths reached a peak nationally in April through early May with over 2,000 a day on many days, largely driven by the severe outbreak in New York. Now the pandemic has eased in the Northeast while states in the South and West are the new national epicenters for coronavirus.

CHIEF CRITICS

Trump and Republican politicians had used the decline in deaths and a decrease in mortality rates to argue that the U.S. response to coronavirus has worked. However, there has also been a massive increase in testing, meaning that many less severe cases are now being identified.

BIG NUMBER

4.3%. According to Johns Hopkins University, that’s what the current mortality rate is among confirmed coronavirus cases in the U.S., a number that’s continually dropped as testing has increased. However, health experts like Dr. Anthony Fauci said early on in the pandemic that they believe the actual mortality rate is around 1%, which is still at least 10 times the lethality of the seasonal flu. And Gottlieb noted that even if the reported death rate continues to drop, if there is an increase in infections, the amount of deaths will ultimately rise, as well.

CRITICAL QUOTE

“It’s a false narrative to take comfort in a lower rate of death,” Fauci said on Tuesday, adding “There’s so many other things that are very dangerous and bad about this virus, don’t get yourself into false complacency.”

 

 

 

Unpublished White House Coronavirus Task Force Report – 18 States in Red Zone

https://mailchi.mp/publicintegrity/exclusive-white-house-docs-shows-18-states-in-coronavirus-red-zone?e=4539e77864

An unpublished document prepared for the White House Coronavirus Task Force and obtained by the Center for Public Integrity suggests more than a dozen states should revert to more stringent protective measures, limiting social gatherings to 10 people or fewer, closing bars and gyms and asking residents to wear masks at all times.

The document, dated July 14, says 18 states are in the “red zone” for COVID-19 cases, meaning they had more than 100 new cases per 100,000 population last week. Eleven states are in the “red zone” for test positivity, meaning more than 10 percent of diagnostic test results came back positive. 

It includes county-level data and reflects the insistence of the Trump administration that states and counties should take the lead in responding to the coronavirus. The document has been shared within the federal government but does not appear to be posted publicly.

It’s clear some states are not following the task force’s advice. For instance, the document recommends that Georgia, in the red zone for both cases and test positivity, “mandate statewide wearing of cloth face coverings outside the home.” But Gov. Brian Kemp signed an order Wednesday banning localities from requiring masks.

 

 

 

 

Administration’s war on the public health experts

https://www.axios.com/trump-public-health-experts-cdc-fauci-e1509d14-0cf1-4b1c-b107-7753bf95395d.html

Trump's war on the public health experts - Axios

A pandemic would normally be a time when public health expertise and data are in urgent demand — yet President Trump and his administration have been going all out to undermine them.

Why it matters: There’s a new example almost every day of this administration trying to marginalize the experts and data that most administrations lean on and defer to in the middle of a global crisis.

Here’s how it has been happening just in the past few weeks:

  • The administration has repeatedly undermined the Centers for Disease Control and Prevention. Most recently, Trump has criticized the CDC’s school reopening guidelines, Education Secretary Betsy DeVos declared that “kids need to be in school,” and the administration has reportedly ordered hospitals to bypass the CDC in reporting coronavirus patient information.
  • It has repeatedly undermined Anthony Fauci. Trump distanced himself on Wednesday from an op-ed attack by White House trade adviser Peter Navarro, but longtime Trump aide Dan Scavino also called the infectious diseases specialist “Dr. Faucet” in a Facebook post accusing him of leaking his disagreements. And the White House gave a opposition research-style list of the times Fauci “has been wrong” to the Washington Post and other media outlets.
  • Trump himself undermined public health experts generally with his retweet of former game show host Chuck Woolery’s “everyone is lying” tweet — which blamed “The CDC, Media, Democrats, our Doctors, not all but most, that we are told to trust.”
  • Trump has made numerous statements suggesting, over and over again, that we wouldn’t have as many COVID cases if we just tested less. (From his Tuesday press conference at the White House: “If we did half the testing we would have half the cases.”)

The impact: The result is that the CDC — which is supposed to be the go-to agency in a public health crisis — is distracted by constant public critiques from the highest levels. And Fauci, “America’s Doctor,” is the subject of yet another round of stories about whether Trump is freezing him out.

  • “The way to make Americans safer is to build on, not bypass, our public health system,” Tom Frieden, a former CDC director under Barack Obama, said in a statement to Axios about the efforts to sideline the agency.
  • “Unfortunately, as with mask-up recommendations and schools reopening guidance, the administration has chosen to sideline and undermine our nation’s premier disease fighting agency in the middle of the worst pandemic in 100 years,” Frieden said.
  • And Fauci, in an interview with The Atlantic, said of the efforts to discredit him: “Ultimately, it hurts the president to do that … It doesn’t do anything but reflect poorly on them.”

The other side: The White House insists there’s no problem. “President Trump has always acted on the science and valued the input of public health experts throughout this crisis,” said White House deputy press secretary Sarah Matthews.

  • Trump campaign communications director Tim Murtaugh closed ranks with the experts as well. “President Trump has said repeatedly that he has a strong relationship with Dr. Fauci, and Dr. Fauci has always said that the President listens to his advice,” he said.
  • And Department of Health and Human Services spokesman Michael Caputo declared that “the scientists and doctors speak openly, they are listened to closely, and their advice and counsel helps guide the response.”
  • “Frankly, when it comes to this tempest in a teapot over Dr. Fauci, I blame the media and their unending search for a ‘Resistance’ hero, for turning half a century of a brilliant scientist’s hard work into a clickbait headline that helps reporters undermine the president’s coronavirus response,” Caputo said.

Between the lines: Murtaugh deflected several times when asked whether there was a deliberate strategy to marginalize the CDC and the experts: “The President and the White House have consistently advised Americans to follow CDC guidelines. The President also believes we can open schools safely on time and that we must do so.”

  • However, one administration official said there were parts of the CDC school reopening guidelines that were impractical, and noted that kids can also suffer long-term harm by staying out of school too long.

Our thought bubble, by Axios White House reporter Alayna Treene: The responses make it clear that the White House and the Trump campaign don’t want to advance the narrative that they’re deliberately battling with America’s health experts, or that there’s any kind of strategy behind it.

The bottom line: When the history of this pandemic is written, it will show that the public health experts who were trying to fight it also had to deal with political fights that made their jobs harder.

 

 

 

 

 

Cartoon – False Narratives Today

Cartoon – Unethical vs. Ethical Advertising | HENRY KOTULA

Cartoon – We’re way beyond Rational Thinking

Management Cartoon # 7684: We're way beyond rational thinking. You ...