Category Archives: Public Safety

60% of Sturgis residents were against a motorcycle rally that brings in thousands but the city approved it. Here’s why

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Ethics, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Judgement, Mortality, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, Respect, Social Distancing, Superspreader, Superspreader Event, Superspreading Events • Leave a comment

https://www.cnn.com/2020/08/10/us/sturgis-motorcycle-rally-residents-decision

Steven J. Frisch on Twitter: "I'm fearful of what is to come, as ...

Before deciding on whether to hold the 80th annual motorcycle rally in Sturgis, South Dakota, the local city council turned to its residents to get their take.

“There was a significant amount of discussion that the council had with residents, businesses and state health officials as well as local health officials,” Daniel Ainslie, the city manager, told CNN Sunday.
The city, home to fewer than 7,000, sent a survey to all households asking if they wanted the rally to proceed on its scheduled date. The massive event usually brings in crowds of about 500,000 over 10 days of drag races, contests and concerts. On its 75th anniversary, nearly three quarters of a million people showed.
A little more than 60% of people in the city voted against holding the event this week. But the city council approved it anyway.

https://www.washingtonpost.com/arts-entertainment/2020/08/10/smash-mouth-coronavirus-concert/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR0EIjLLrhpAEXabcLb11uuVlYYSuluULzd13BPitPSQCW7m-KHfsL7ZNgE

 

 

 

The Health 202: Coronavirus keeps spreading. But at least we’ve learned more about it.

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Coronavirus, Crisis, Crisis Management, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, Quarantine, School Reopening, Social Distancing • Leave a comment

https://www.washingtonpost.com/politics/2020/08/11/health-202-coronavirus-keeps-spreading-least-we-learned-more-about-it/?utm_campaign=wp_the_health_202&utm_medium=email&utm_source=newsletter&wpisrc=nl_health202

Coronavirus: FI Strategy to Stop the Spread

Coronavirus infections are swelling in the United States, which hit 5 million cases over the weekend.

But so is the body of research on how the novel coronavirus spreads and affects people.

Dozens of studies have now been published in top medical journals, providing critical information to public health officials and medical professionals attempting to get a handle on the virus. More understanding of the virus is critical, as its aggressive spread around the country confounds President Trump’s efforts toward an economic rebound and threatens to keep schools and workplaces shuttered through the fall.

There’s a lot left to learn. But some of the blanks are starting to be filled in, now that researchers around the world have had six months to study it (check out The Post’s database of questions and answers about the pandemic).

Here are some things we learned about the virus over the summer — and some questions that persist:

 

Can asymptomatic people spread the virus?

Researchers are still trying to discover whether people without visible symptoms spread the virus at similar rates as those with symptoms. There’s been a considerable amount of confusion around this question, particularly after the World Health Organization appeared to suggest the virus isn’t spread asymptomatically — and then walked back its pronouncement the next day.

It seems clear that asymptomatic transmission does occur. People with no symptoms carry the same level of virus in their nose, throat and lungs as those with symptoms, according to a South Korean study of 303 people published last week in JAMA Internal Medicine.

The study was the first to distinguish between patients who didn’t develop symptoms initially and those who did develop symptoms later on — which can cause some confusion when looking at asymptomatic spread. Based on their observations, the researchers estimated that 30 percent of infected people never develop symptoms.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said last week he thinks the figure is closer to 40 percent.

“The good news about covid-19 is that about 40 percent of the population have no symptoms when they get infected,” Fauci said, but he added that asymptomatic people “are propagating the outbreak, which means that you’re going to infect someone, who will infect someone, who then will have a serious consequence.”

Are some people immune to the virus without ever getting it?

There is some very early, tentative evidence suggesting a segment of the world’s population may have partial protection thanks to the immune system’s “memory” T cells, which are trained to recognize specific invaders.

People may derive this protection from standard childhood vaccinations or from previous infections by other coronaviruses, such as those that cause the common cold, my colleague Ariana Eunjung Cha reported.

“This might potentially explain why some people seem to fend off the virus and may be less susceptible to becoming severely ill,” National Institutes of Health Director Francis Collins remarked in a blog post last week.

“On a population level, such findings, if validated, could be far-reaching,” Ariana wrote. “ … In communities in Boston, Barcelona, Wuhan and other major cities, the proportion of people estimated to have antibodies and therefore presumably be immune has mostly been in the single digits. But if others had partial protection from T cells, that would raise a community’s immunity level much higher.”

 

How many untested Americans have already had the virus?

The head of the Centers for Disease Control and Prevention estimated in June that there were roughly 10 times more coronavirus infections in the United States than had been confirmed through testing.

There were just 2.4 million confirmed cases when CDC Director Robert Redfield made that estimate — which, if accurate, would have translated to 24 million cases at the time. Confirmed cases have since doubled, to more than 5 million — meaning the virus may have swept through tens of millions of people.

Redfield based his estimate on the results of antibody tests, which examine a person’s blood for indicators that the body fought off an infection, Lena H. Sun and Joel Achenbach wrote.

 

How does the virus travel?

Scientists initially thought the virus easily spread on surfaces, similar to how other viruses operate. That’s why much of the initial public health advice centered around hand-washing and disinfecting surfaces.

Now public health experts think SARS-CoV-2 is primarily spread through person-to-person contact.

In May, the CDC updated guidance on its “How COVID-19 Spreads” website to say that “the virus spreads easily between people.” The agency also acknowledged the virus may spread other ways, such as through touching contaminated objects or surfaces, but clarified “this is not thought to be the main way the virus spreads.”

“The virus travels through the droplets a person produces when talking or coughing,” Ben Guarino and Joel wrote. “An individual does not need to feel sick or show symptoms to spread the submicroscopic virus. Close contact means within about six feet, the distance at which a sneeze flings heavy droplets. Example after example have shown the microbe’s affinity for density. The virus has spread easily in nursing homes, prisons, cruise ships and meatpacking plants — places where many people are living or working in proximity.”

 

Do children spread it?

Children only rarely get seriously ill or die of covid-19, the disease the virus causes; data on hospitalizations and deaths make that clear. But whether — and to what extent — they can spread the virus to others asymptomatically is still murky.

Studies are also conflicting on whether the age of children affects their likelihood of spreading the virus. One study conducted at a Chicago hospital found children younger than 5 with mild to moderate cases of covid-19 had much higher levels of virus in their noses than older children and adults — suggesting they could be more infectious, Ariana, Haisten Willis and Chelsea Janes reported.

But a study out of South Korea examining household transmission seemed to reach an opposite conclusion. It found children under age 10 did not appear to pass on the virus readily, while those between 10 and 19 appeared to transmit the virus almost as much as adults did, my colleagues wrote.

 

Which organs does Covid-19 attack?

The lungs appear most susceptible to the virus. Researchers have also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract, spleen and in the endothelial cells that line blood vessels, along with widespread clotting in many organs, Ariana and Lenny Bernstein reported.

But researchers have been surprised to discover little inflammation on the brain, despite previous reports about neurological symptoms related to the coronavirus. The same goes for the heart. While physicians warned for months about a cardiac complication they suspected was myocarditis, autopsy investigators found no evidence of the condition.

 

Dr. Anthony Fauci says chance of coronavirus vaccine being highly effective is ‘not great’

Posted on by • Posted in 2020 Election Issues, Clinical Research, Clinical Testing, Coronavirus, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expectations, False Hope, False Narrative, Food and Drug Administration (FDA), Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Public Health, Public Safety, School Reopening, Social Distancing, Vaccine, Wishful Thinking, World Health Organization (WHO) • Leave a comment

https://www.cnbc.com/amp/2020/08/07/coronavirus-vaccine-dr-fauci-says-chances-of-it-being-highly-effective-is-not-great.html?utm_source=&utm_medium=email&utm_campaign=32192

KEY POINTS
  • White House coronavirus advisor Dr. Anthony Fauci that the chances of scientists creating a highly effective vaccine — one that provides 98% or more guaranteed protection — for the virus are slim.
  • Scientists are hoping for a coronavirus vaccine that is at least 75% effective, but 50% or 60% effective would be acceptable, too, he said.
  • The FDA has said it would authorize a coronavirus vaccine so long as it is safe and at least 50% effective.

White House coronavirus advisor Dr. Anthony Fauci said Friday that the chances of scientists creating a highly effective vaccine — one that provides 98% or more guaranteed protection — for the virus are slim.

Scientists are hoping for a coronavirus vaccine that is at least 75% effective, but 50% or 60% effective would be acceptable, too, Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a Q&A with the Brown University School of Public Health. “The chances of it being 98% effective is not great, which means you must never abandon the public health approach.”

“You’ve got to think of the vaccine as a tool to be able to get the pandemic to no longer be a pandemic, but to be something that’s well controlled,” he said.

The Food and Drug Administration has said it would authorize a coronavirus vaccine so long as it is safe and at least 50% effective. Dr. Stephen Hahn, the FDA’s commissioner, said last month that the vaccine or vaccines that end up getting authorized will prove to be more than 50% effective, but it’s possible the U.S. could end up with a vaccine that, on average, reduces a person’s risk of a Covid-19 infection by just 50%.

“We really felt strongly that that had to be the floor,” Hahn said on July 30, adding that it’s “been batted around among medical groups.”

“But for the most part, I think, infectious disease experts have agreed that that’s a reasonable floor, of course hoping that the actual effectiveness will be higher.”

A 50% effective vaccine would be roughly on par with those for influenza, but below the effectiveness of one dose of a measles vaccination, which is about 93% effective, according to the Centers for Disease Control and Prevention.

Public health officials and scientists expect to know whether at least one of the numerous potential Covid-19 vaccines in development worldwide is safe and effective by the end of December or early next year, though there is never a guarantee. Drug companies Pfizer and Moderna both began late-stage trials for their potential vaccines last week and both expect to enroll about 30,000 participants.

Fauci has previously said he worries about the “durability” of a coronavirus vaccine, saying if Covid-19 acts like other coronaviruses, it may not provide long-term protection.

Health officials say there is no returning to “normal” until there is a vaccine. Fauci’s comment came a day after the World Health Organization cautioned about the development of vaccines, reiterating that there may never be a “silver bullet” for the virus, which continues to rapidly spread worldwide. The phase three trials underway do not necessarily mean that a vaccine is almost ready to be deployed to the public, the agency said.

“Phase three doesn’t mean nearly there,” Mike Ryan, executive director of the WHO’s emergencies health program, said during a virtual panel discussion with “NBC Nightly News” Anchor Lester Holt hosted by the Aspen Security Forum. “Phase three means this is the first time this vaccine has been put into the general population into otherwise healthy individuals to see if the vaccine will protect them against natural infection.”

While there is hope scientists will find a safe and effective vaccine, there is never a guarantee, WHO Director-General Tedros Adhanom Ghebreyesus said.

“We cannot say we have vaccines. We may or may not,” he said.

On Friday, Fauci reiterated that he is “cautiously optimistic” scientists will find a safe and effective vaccine. He also reiterated that the coronavirus may never be eliminated, but world leaders can work together to bring the virus down to “low levels.”

Some of Fauci’s comments have been at odds with President Donald Trump, who has repeatedly said the virus would “disappear.”

Trump, who is seeking reelection, said Thursday that it’s possible the United States could have a safe and effective vaccine for the coronavirus before the upcoming presidential election on Nov. 3.

 

 

 

 

 

THE BIG DEAL—Five takeaways from the July jobs report

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economic Stimulus, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, National Strategy, Pandemic, Paycheck Protection Program, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, Scientists, Unemployment, Unemployment Insurance • Leave a comment

https://thehill.com/policy/finance/510987-july-jobs-report-unemployment-economy-coronavirus

July U.S. Job Gains Top Expectations

The Friday release of the July jobs report gave a clearer view into a labor market clouded by mixed signals from real-time data and concerns about rising coronavirus cases across the country. The U.S. recovered another 1.8 million jobs last month—a bit above economists’ expectations, but well below the gains of May and June — and pushed the unemployment rate down to 10.2 percent.

While the U.S. economy is continuing to recover from the shock of pandemic, the report is a bit more complicated than the headline numbers indicate. Here are five key points to make sense of the July jobs report.

 

The recovery is still going, but slowing: The story of the coronavirus recession is a story of declines of record-breaking size and speed. Between March and April, the U.S. lost roughly 10 years of job gains and followed it up with a 32-percent annualized decline in economic growth in the second quarter.

The U.S. made solid progress recovering part of the more than 20 million jobs lost to the pandemic with gains of 2.7 million in May and 4.8 million in June. But the 1.8 million jobs gained in July marks a notable slowdown in the pace of recovery.

Economists have warned since coronavirus cases began spiking in mid-June that the resurgence would hinder the pace of growth, even if states don’t reimpose business closures. Those warnings bore out in the July jobs report, reinforcing the need to control the virus before the economy can fully recover.

 

The report gives both sides ammo in stimulus talks: The state of the economy rarely fits into a neat political narrative and the July jobs report is no exception.

Democrats can point to the slowing pace of job growth and the long road to recovery to support their calls for another $3 trillion in stimulus.

“The latest jobs report shows that the economic recovery spurred by the investments Congress has passed is losing steam and more investments are still urgently needed to protect the lives and livelihoods of the American people,” said House Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Charles Schumer (D-N.Y.) in a Friday statement.

But the White House and Republican lawmakers are seizing on the expectations-beating job gain and lack of increase in permanent layoffs to make the case behind a pared down bill focused on reopening the economy.

“The most responsible thing we can do is to take proactive measures to allow people to return to work safely, instead of continuing to lock down the economy,” said Rep. Kevin Brady (R-Texas), ranking member of the House Ways and Means Committee.

 

The job market is still a long way from recovery: Despite three months of seven-figure job gains, the U.S. economy is still in a deeply damaged state. The July unemployment rate of 10.2 percent is roughly even with the peak of joblessness during the Great Recession of 10 percent in October 2009. And the true level of U.S. unemployment may be higher given how the pandemic has made it harder to define and track who is truly in the labor force.

It took a decade of steady economic recovery— the longest in modern U.S. history — for unemployment to drop to a 50-year low of 3.5 percent in February, so the nation remains a long way from where it was before the pandemic.

“At the current pace, it would take well into 2021 to recoup the 12.9 million jobs lost since February,” wrote Diane Swonk, chief economist at Grant Thornton, in a Friday analysis of the jobs report.

 

The increase in government jobs is likely misleading: Employment in government — which includes public schools — rose by 301,000 in July.

At first glance, that’s a welcome sign of resilience as state and local governments face severe budget crunches driven by falling tax revenues and staggering unemployment claims. But economists warn that the rise is likely the result of a seasonal adjustment designed to account for the large numbers of teachers and school employees that roll off of payrolls during the summer before coming back to work in the fall.

Elise Gould, senior economist at the left-leaning Economic Policy Institute, noted that public sector employment is still 1 million jobs below its February level after loads of layoffs during the beginning of the pandemic.

“We’ve seen large reductions in state and local public sector employment — a sector which disproportionately employs women and Black workers — over the last few months,” Gould wrote.

“I’d warn data watchers to consider those gains with a grain of salt, and to look at the overall changes from February (pre-COVID-19) to July.”

Aid to state and local governments is one of the biggest obstacles to gathering GOP support behind another stimulus bill, so this rise could factor into the rhetoric around the negotiations.

 

The report poses hard questions for negotiators: Every monthly jobs report has about two weeks of lag between the time the data was compiled — around the 12th of that month — and the report’s release.

While economic conditions don’t typically change drastically in that time, July was an exception. The $600 weekly boost to jobless benefits and the federal eviction and foreclosure ban enacted in March both lapsed in between the jobs report survey period and release, and much of the money lent through the Paycheck Protection Program had been spent by the end of the month. That means lawmakers are looking at a glimpse of the economy with much more fiscal support than it currently has, posing tough choices about how much more is needed to keep the economy afloat.

Even so, economists are urging  lawmakers not to rest on their laurels as the U.S. faces a difficult road ahead.

“Any notion that the improvement in the top line provides a convenient excuse for policymakers to avoid hard decisions around a fifth round of fiscal aid aimed at the unemployed should be summarily dismissed,” wrote Joe Brusuelas, chief economist at tax and audit firm RSM, in a Friday analysis.

Talks on a new coronavirus relief package were going poorly before the report and collapsed hours after it was released. 

 

LEADING THE DAY

Trump embraces jobs report signaling slowdown: The White House is trying to capitalize on the latest jobs numbers, arguing they point to a strong economic recovery under President Trump even as millions remain out of work and states grapple with increases in coronavirus infections.

But the data nevertheless point to an economic slowdown, challenging the White House’s bullish predictions for a speedy V-shaped recovery. The figures also come amid collapsed talks between the Trump administration and Democratic leaders on a coronavirus relief package, which economists say is desperately needed to prevent a deeper recession.

“This is not a rocket ship,” said Martha Gimbel, senior manager of economic research at Schmidt Futures. “It’s really unclear if the economy is going to achieve escape velocity before the lack of government spending crashes down or before … we have to shut down again, which is a total possibility.”

The Hill’s Morgan Chalfant and I explain why here.

The White House view: White House economic adviser Larry Kudlow, who did the rounds on cable news Friday morning, declared that the numbers evidenced a “self-sustaining recovery” and predicted that the United States would see unemployment head into the single digits in the fall months.

“The worries that some partial shutdowns or some pausing shutdowns would wreck the jobs numbers did not pan out. I think that shows signs of strength,” Kudlow said on Fox Business.

The economists’ take: Economic analysts say that despite the jobs report, there remains a need for additional fiscal stimulus. Many point to an extension of the expanded unemployment benefits and additional aid to states as necessary steps to shepherd the economy through recovery until there is a vaccine for the coronavirus.

“This jobs number doesn’t change the undeniable need for additional federal support,” said Isaac Boltansky, director of policy research at investment bank Compass Point Research & Trading.

 

 

 

 

97,000 children reportedly test positive for coronavirus in two weeks as schools gear up for instruction

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, 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, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Wishful Thinking • Leave a comment

https://www.cbsnews.com/news/covid-19-kids-school-children-positive-tests-coronavirus-reopening/?utm_source=nl&utm_brand=wired&utm_mailing=WIR_Science_081020&utm_campaign=aud-dev&utm_medium=email&utm_term=WIR_Science&bxid=5db707423f92a422eaeaf234&cndid=&esrc=bounceX&source=EDT_WIR_NEWSLETTER_0_SCIENCE_ZZ

97,000 children reportedly test positive for coronavirus in two ...

Nearly 100,000 children tested positive for the coronavirus in the last two weeks of July, a new report from the American Academy of Pediatrics finds. Just over 97,000 children tested positive for the coronavirus from July 16 to July 30, according to the association.

Out of almost 5 million reported COVID-19 cases in the U.S., CBS News’ Michael George reports that the group found that more than 338,000 were children.

Vanderbilt University’s Dr. Tina Hartert hopes increased testing of children will help determine what role they play in transmission, as school districts around the country return to some form of school. She is leading a government-funded study that saw DIY testing kits sent to some 2,000 families.

“The kits are shipped to the families, they are taught how to collect these samples, and then the samples are sent back by the families to a central repository,” she said.

In New York City, home to the nation’s largest school district, Mayor Bill de Blasio announced a return to in-person schooling in the fall and pledged officials “have worked incessantly to get this right.”

“They’ve looked at examples from all over the world of what will keep the school community safe, and they’ve made a series of choices of how to do things from the health and safety lens first, while also making sure we can educate our kids,” he said in a Friday press conference.

De Blasio gave parents until Friday night to register students for in-person instruction, remote learning or a hybrid.

More than 25 children died of the coronavirus in July alone. Pressure to get kids back into the classroom has left superintendents in more than 13,000 different school districts across the country to figure out how to keep children safe amid a myriad of public health advisories, and handle learning differences.

Niles, Michigan Superintendent Dan Applegate is hoping Plexiglas could be a solution for children with speech impediments to be able to participate in class.

He demonstrated by speaking behind a transparent slate at a press conference.

“As I’m sitting here and I can articulate,” Applegate said. “The student on the other side will be wearing a mask. Then I can put my mask on, and that student can drop their mask and articulate as well.”

Indiana’s Lawrence Township is cleaning school buses with a hospital-grade disinfectant spray for students still needing rides to school.

“You’re going to see a very clean and disinfected bus,” Transportation Director Matt Miles said. “We actually have fogging machines.”

However, they are not expecting many students to get on the bus — 35% of children in the area are expected to learn remotely, while other school districts in the U.S. will not open at all.

 

 

 

 

2005 chloroquine study had nothing to do with COVID-19 and the drug wasn’t given to humans

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Chloroquine, Coronavirus, Coronavirus Treatment, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, False Hope, False Narrative, Food and Drug Administration (FDA), Hydroxychloroquine, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, National Institute of Health (NIH), Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Wishful Thinking, World Health Organization (WHO) • Leave a comment

https://www.politifact.com/factchecks/2020/jul/29/facebook-posts/2005-chloroquine-study-had-nothing-do-covid-19-and/?fbclid=IwAR2e4j_lb10FWa5Cyuokzo3pbjlty_ffvwsEfVT_2iQ6ki8a9z-TpzDm9DQ

PolitiFact | 2005 chloroquine study had nothing to do with COVID ...

IF YOUR TIME IS SHORT

  • The 2005 study wasn’t published by the NIH and didn’t prove chloroquine was effective against “COVID-1” because that’s not a real disease.
  • The study found that chloroquine could inhibit the spread of Severe Acute Respiratory Syndrome in animal cell culture, and the authors said more research was needed.
  • There are currently no approved medications or treatments for COVID-19.

 

Chloroquine is back.

The anti-malarial drug first showed up as a possible COVID-19 treatment around May 2020, when President Donald Trump said he had been taking its chemical cousin, hydroxychloroquine, to prevent getting infected with the virus.

Since then, some studies have found that the drugs could help alleviate symptoms associated with COVID-19, but the research is not conclusive. There are currently no FDA-approved medicines specifically for COVID-19. (Chloroquine is chemically similar to hydroxychloroquine, but it is a different drug that’s primarily used to treat malaria. Both carry a particular risk for people with heart problems, plus other possible side effects.)

Now, hydroxychloroquine and chloroquine have been thrust back into the spotlight as misinformation about the drugs’ effectiveness and safety recently reappeared online.

One such post on Facebook falsely claims that Americans have been deceived because health officials at the National Institutes of Health have known all along that chloroquine is effective against “COVID.”

The post reads:

“N.I.H. 15 years ago published a study on chloroquine. It is effective against COVID-(1). We are being lied to America!”

The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.) 

 

This is flawed. 

First, there’s no such thing as “COVID-1.” COVID-19 was named for the year it was discovered, not because it’s the 19th iteration. 

Second, the 2005 study found that chloroquine was effective on primate cells infected with severe acute respiratory syndrome, known as SARS, which is caused by a coronavirus. But while the two share similarities, SARS-CoV and COVID-19 are different diseases, and primate cells are far from human patients.

Third, the study was indexed by the NIH’s National Library of Medicine, but the NIH was not involved. It was published in the peer-reviewed Virology Journal and conducted by researchers from the Centers for Disease Control and Prevention and the Montreal Clinical Research Institute.

 

What the study says

The study was published in August 2005 and found that chloroquine has “strong antiviral effects on SARS-CoV infection of primate cells” and that it was effective on cells treated with the drug before and after exposure to the virus.

The drug was not administered to actual SARS patients, and the study’s authors wrote that more research was needed on how the drug interacts with SARS in animal test subjects.

“Cell culture testing of an antiviral drug against the virus is only the first step, of many steps, necessary to develop an antiviral drug,” Kate Fowlie, a spokesperson for the CDC previously told PolitiFact in an email. “It is important to realize that most antivirals that pass this cell culture test hurdle fail at later steps in the development process.”

Dr. Alex Greninger, assistant director of clinical virology at the University of Washington School of Medicine, told us that a problem in virology is trying to determine the difference of how drugs work in cell culture in comparison to humans.

“Data on chloroquine is largely taken from these cell culture studies, but we now have trials in people on hydroxychloroquine that show it’s not as effective,” Greninger said, “and there’s new data out in the last week that suggests that some of the reasons could be because of the cell types that SARS coronaviruses grow in, and this original experiment was done on African green monkey kidney cells, which is not the tissue we are really worried about.”

 

What officials say about the drugs now

The Food and Drug Administration granted emergency use authorizations for some medicines to be used for certain patients hospitalized with COVID-19, but it revoked the authorization for hydroxychloroquine and chloroquine in mid-June due to concerns over the drugs’ serious side effects. There are currently no FDA-approved medicines for COVID-19.

“It is no longer reasonable to believe that oral formulations of HCQ and CQ may be effective in treating COVID-19, nor is it reasonable to believe that the known and potential benefits of these products outweigh their known and potential risks,” FDA Chief Scientist Denise M. Hinton wrote.

The NIH’s COVID-19 treatment guidelines, which were developed to inform clinicians on how to care for patients with COVID-19, also currently recommend against the use of chloroquine or hydroxychloroquine for COVID-19 treatment, except in a clinical trial.

But even those trials have been halted. The World Health Organization and the NIH announced in mid-June that they would stop hydroxychloroquine patient trials, citing safety concerns that include serious heart rhythm problems, blood and lymph system disorders, kidney injuries, and liver problems and failure.

 

Our ruling

A Facebook post says that the NIH published a study 15 years ago that showed chloroquine was effective against “COVID-(1)” and that health officials have been lying to the American people.

This is wrong. There’s no such thing as “COVID-1” and the study cited was not published by the NIH and had to do with animal cells infected with SARS, not COVID-19. The drug was not given to human patients and the study’s authors said more research was needed.

Health officials caution against the use of chloroquine or hydroxychloroquine to treat COVID-19 patients, citing the possibility of serious side effects. There are currently no approved treatments for the virus.

We rate this False. 

 

 

 

 

Covid-19 Data in the US Is an ‘Information Catastrophe’

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Data, Data Analytics, Data Control, Data Gathering, Data Governance, Data Integrity, Data Interpretation, Data Management, Data Ownership, Data Quality, Dept of Health and Human Services (HHS), Infection Control, Infection Control Plan, Infectious Virus, KPI Dashboards, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, School Reopening, Screwing, Social Distancing • Leave a comment

https://www.wired.com/story/covid-19-data-in-the-us-is-an-information-catastrophe/#intcid=recommendations_wired-bottom-recirc-personalized_31e95638-88d6-439c-85a2-db8f6235da26_text2vec1-mab

Covid-19 Data in the US Is an 'Information Catastrophe' | WIRED

The order to reroute CDC hospitalization figures raised accuracy concerns. But that’s just one of the problems with how the country collects health data.

TWO WEEKS AGO, the Department of Health and Human Services stripped the Centers for Disease Control and Prevention of control of national data on Covid-19 infections in hospitalized patients. Instead of sending the data to the CDC’s public National Healthcare Safety Network (NHSN), the department ordered hospitals to send it to a new data system, run for the agency by a little-known firm in Tennessee.

The change took effect immediately. First, the hospitalization data collected up until July 13 vanished from the CDC’s site. One day later, it was republished—but topped by a note that the NHSN Covid-19 dashboard would no longer be updated.

Fury over the move was immediate. All the major organizations that represent US public health professionals objected vociferously. A quickly written protest letter addressed to Vice President Mike Pence, HHS secretary Alex Azar, and Deborah Birx, the coordinator of the White House’s Coronavirus Task Force, garnered signatures from more than 100 health associations and research groups. The reactions made visible the groups’ concerns that data could be lost or duplicated, and underlined their continual worry that the CDC is being undercut and sidelined. But it had no other effect. The new HHS portal, called HHS Protect, is up and running.

Behind the crisis lies a difficult reality: Covid-19 data in the US—in fact, almost all public health data—is chaotic: not one pipe, but a tangle. If the nation had a single, seamless system for collecting, storing, and analyzing health data, HHS and the Coronavirus Task Force would have had a much harder time prying the CDC’s Covid-19 data loose. Not having a comprehensive system made the HHS move possible, and however well or badly the department handles the data it will now receive, the lack of a comprehensive data system is harming the US coronavirus response.

“Every health system, every public health department, every jurisdiction really has their own ways of going about things,” says Caitlin Rivers, a senior scholar at the Johns Hopkins Center for Health Security. “It’s very difficult to get an accurate and timely and geographically resolved picture of what’s happening in the US, because there’s such a jumble of data.”

Data systems are wonky objects, so it may help to step back and explain a little history. First, there’s a reason why hospitalization data is important: Knowing whether the demand for beds is rising or falling can help illuminate how hard-hit any area is, and whether reopening in that region is safe.

Second, what the NHSN does is important too. It’s a 15-year-old database, organized in 2005 out of several streams of information that were already flowing to the CDC, which receives data from hospitals and other health care facilities about anything that affects the occurrence of infections once someone is admitted. That includes rates of pneumonia from use of ventilators, infections after surgery, and urinary tract infections from catheters, for instance—but also statistics about usage of antibiotics, adherence to hand hygiene, complications from dialysis, occurrence of the ravaging intestinal infection C. difficile, and rates of health care workers getting flu shots. Broadly, it assembles a portrait of the safety of hospitals, nursing homes, and chronic care institutions in the US, and it shares that data with researchers and with other statistical dashboards published by other HHS agencies such as the Center for Medicare and Medicaid Services.

Because NHSN only collects institutional data, and Covid-19 infections occur both inside institutions such as nursing homes and hospitals, and in the outside world, HHS officials claimed the database was a bad fit for the coronavirus pandemic. But people who have worked with it argue that since the network had already devised channels for receiving all that data from health care systems, it ought to continue to do so—especially since that data isn’t easy to abstract.

“If you are lucky enough to work in a large health care system that has a sophisticated electronic medical record, then possibly you can push one button and have all the data flow up to NHSN,” says Angela Vassallo, an epidemiologist who formerly worked at HHS and is now chief clinical adviser to the infection-prevention firm Covid Smart. “But that’s a rare experience. Most hospitals have an infection preventionist, usually an entire team, responsible for transferring that data by hand.”

There lies the core problem. Despite big efforts back during the Obama administration to funnel all US health care data into one large-bore pipeline, what exists now resembles what you’d find behind the walls of an old house: pipes going everywhere, patched at improbable angles, some of them leaky, and some of them dead ends. To take some examples from the coronavirus response: Covid-19 hospital admissions were measured by the NHSN (before HHS intervened), but cases coming to emergency departments were reported in a different database, and test results were reported first to local or state health departments, and then sent up to the CDC.

Covid-19 data in particular has been so messy that volunteer efforts have sprung up to fix it. These include the COVID Tracking Project—compiled from multiple sources and currently the most comprehensive set of statistics, used by media organizations and apparently by the White House—and Covid Exit Strategy, which uses data from the COVID Tracking Project and the CDC.

Last week, the American Public Health Association, the Johns Hopkins Center, and Resolve to Save Lives, a nonprofit led by former CDC director Tom Frieden, released a comprehensive report on Covid-19 data collection. Pulling no punches, they called the current situation an “information catastrophe.”

The US, they found, does not have national-, state-, county-, or city-level standards for Covid-19 data. Every state maintains some form of coronavirus dashboard (and some have several), but every dashboard is different; no two states present the same data categories, nor visualize them the same way. The data presented by states is “inconsistent, incomplete, and inaccessible,” the group found: Out of 15 key pieces of data that each state should be presenting—things such as new confirmed and probable cases, new tests performed, and percentage of tests that are positive—only 38 percent of the indicators are reported in some way, with limitations, and 60 percent are not reported at all.

“This is not the fault of the states—there was no federal leadership,” Frieden emphasized in an interview with WIRED. “And this is legitimately difficult. But it’s not impossible. It just requires commitment.”

But the problem of incomplete, messy data is older and deeper than this pandemic. Four scholars from the health-policy think tank the Commonwealth Fund called out the broader problem just last week in an essay in The New England Journal of Medicine, naming health data as one of four interlocking health care crises exposed by Covid-19. (The others were reliance on employer-provided health care, financial losses in rural and primary-care practices, and the effect of the pandemic on racial and ethinic minorities.)

“There is no national public health information system—electronic or otherwise—that enables authorities to identify regional variation in the demand for, and supply of, resources critical to managing Covid-19,” they wrote. The fix they recommended: a national public health information system that would record diagnoses in real time, monitor the materials hospitals need, and link hospitals and outpatient care, state and local health departments, and laboratories and manufacturers to maintain real-time reporting on disease occurrence, preventive measures, and equipment production.

They are not the first to say this is needed. In February, 2019, the Council of State and Territorial Epidemiologists launched a campaign to get Congress to appropriate $1 billion in new federal funding over 10 years specifically to improve data flows. “The nation’s public health data systems are antiquated, rely on obsolete surveillance methods, and are in dire need of security upgrades,” the group wrote in its launch statement. “Sluggish, manual processes—paper records, spreadsheets, faxes, and phone calls—still in widespread use, have consequences, most notably delayed detection and response to public health threats.”

Defenders of the HHS decision to switch data away from the CDC say that improving problems like that is what the department was aiming for. (“The CDC’s old hospital data-gathering operation once worked well monitoring hospital information across the country, but it’s an inadequate system today,” HHS assistant secretary for public affairs Michael Caputo told CNN.) If that’s an accurate claim, during a global pandemic is a challenging time to do it.

“We were opposed to this, because trying to do this in the middle of a disaster is not the time,” says Georges Benjamin, a physician and executive director of the American Public Health Association, which was a signatory to the letter protesting moving data from the NHSN. “It was just clearly done without a lot of foresight. I don’t think they understand the way data moves into and through the system.”

The past week has shown how correct that concern was. Immediately after the switch, according to CNBC, states were blacked out from receiving data on their own hospitals, because the hospitals were not able to manage the changeover from the CDC to the HHS system. On Tuesday, Ryan Panchadsaram, cofounder of Covid Exit Strategy and former deputy chief technology officer for the US, highlighted on Twitter that data on the HHS dashboard, advertised as updating daily, was five days old. And Tuesday night, the COVID Tracking Project staff warned in a long analysis: “Hospitalization data from states that was highly stable a few weeks ago is currently fragmented, and appears to be a significant undercount.”

When the Covid-19 crisis is over, as everyone hopes it will be someday, the US will still have to wrestle with the questions it raised. One of those will be how the richest country on the planet, with some of the best clinical care in the world, was content with a health information system that left it so uninformed about a disease affecting so many of its citizens. The answer could involve tearing the public-health data system down and building it again from scratch.

“This is a deeply entrenched problem, where there is no single person who has not done their job,” Rivers says. “Our systems are old. They were not updated. We haven’t invested in them. If you’re trying to imagine a system where everyone reports the same information in the same way and we can push a button and have all the information we might want, that will take a complete overhaul of what we have.”

 

 

 

 

Winter is coming: Why America’s window of opportunity to beat back Covid-19 is closing

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Pandemic Fatigue, Public Health, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, World Health Organization (WHO) • Leave a comment

Winter is coming: Why America’s window of opportunity to beat back Covid-19 is closing

Winter is coming: Why America's window of opportunity to beat back ...

The good news: The United States has a window of opportunity to beat back Covid-19 before things get much, much worse.

The bad news: That window is rapidly closing. And the country seems unwilling or unable to seize the moment.

Winter is coming. Winter means cold and flu season, which is all but sure to complicate the task of figuring out who is sick with Covid-19 and who is suffering from a less threatening respiratory tract infection. It also means that cherished outdoor freedoms that link us to pre-Covid life — pop-up restaurant patios, picnics in parks, trips to the beach — will soon be out of reach, at least in northern parts of the country.

Unless Americans use the dwindling weeks between now and the onset of “indoor weather” to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn.

“I think November, December, January, February are going to be tough months in this country without a vaccine,” said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

It is possible, of course, that some vaccines could be approved by then, thanks to historically rapid scientific work. But there is little prospect that vast numbers of Americans will be vaccinated in time to forestall the grim winter Osterholm and others foresee.

Human coronaviruses, the distant cold-causing cousins of the virus that causes Covid-19, circulate year-round. Now is typically the low season for transmission. But in this summer of America’s failed Covid-19 response, the SARS-CoV-2 virus is widespread across the country, and pandemic-weary Americans seem more interested in resuming pre-Covid lifestyles than in suppressing the virus to the point where schools can be reopened, and stay open, and restaurants, movie theaters, and gyms can function with some restrictions.

“We should be aiming for no transmission before we open the schools and we put kids in harm’s way — kids and teachers and their caregivers. And so, if that means no gym, no movie theaters, so be it,” said Caroline Buckee, associate director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health.

“We seem to be choosing leisure activities now over children’s safety in a month’s time. And I cannot understand that tradeoff.”

While many countries managed to suppress spread of SARS-CoV-2, the United States has failed miserably. Countries in Europe and Asia are worrying about a second wave. Here, the first wave rages on, engulfing rural as well as urban parts of the country. Though there’s been a slight decline in cases in the past couple of weeks, more than 50,000 Americans a day are being diagnosed with Covid-19. And those are just the confirmed cases.

To put that in perspective, at this rate the U.S. is racking up more cases in a week than Britain has accumulated since the start of the pandemic.

Public health officials had hoped transmission of the virus would abate with the warm temperatures of summer and the tendency — heightened this year — of people to take their recreational activities outdoors. Experts do believe people are less likely to transmit the virus outside, especially if they are wearing face coverings and keeping a safe distance apart.

But in some places, people have been throwing Covid cautions to the wind, flouting public health orders in the process. Kristen Ehresmann, director of infectious disease epidemiology, prevention, and control for the Minnesota Department of Health, points to a large, three-day rodeo that was held recently in her state. Organizers knew they were supposed to limit the number of attendees to 250 but refused; thousands attended. In Sturgis, S.D., an estimated quarter of a million motorcyclists were expected to descend on the city this past weekend for an annual rally that spans 10 days.

Even on smaller scales, public health authorities know some people are letting down their guard. Others have never embraced the need to try to prevent spread of the virus. Ehresmann’s father was recently invited to visit some friends; he went, she said, but wore his mask, elbow bumping instead of shaking proffered hands. “And the people kind of acted like, … ‘Oh, you drank that Kool-Aid,’ rather than, ‘We all need to be doing this.’”

Ehresmann and others in public health are flummoxed by the phenomenon of people refusing to acknowledge the risk the virus poses.

“Just this idea of, ‘I just don’t want to believe it so therefore it’s not going to be true’ — honestly, I have not really dealt with that as it relates to disease before,” she said.

Buckee, the Harvard expert, wonders if the magical thinking that seems to have infected swaths of the country is due to the fact many of the people who have died were elderly. For many Americans, she said, the disease has not yet touched their lives — but the movement restrictions and other response measures have.

“I think if children were dying, this would be … a different situation, quite honestly,” she said.

Epidemiologist Michael Mina despairs that an important chance to wrestle the virus under control is being lost, as Americans ignore the realities of the pandemic in favor of trying to resume pre-Covid life.

“We just continue to squander every bit of opportunity we get with this epidemic to get it under control,’’ said Mina, an assistant professor in Harvard’s T.H. Chan School of Public Health and associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital.

“The best time to squash a pandemic is when the environmental characteristics slow transmission. It’s your one opportunity in the year, really, to leverage that extra assistance and get transmission under control,” he said, his frustration audible.

Driving back transmission would require people to continue to make sacrifices, to accept the fact that life post-Covid cannot proceed as normal, not while so many people remain vulnerable to the virus. Instead, people are giddily throwing off the shackles of coronavirus suppression efforts, seemingly convinced that a few weeks of sacrifice during the spring was a one-time solution.

Osterholm has for months warned that people were being misled about how long the restrictions on daily life would need to be in place. He now thinks the time has come for another lockdown. “What we did before and more,” he said.

The country has fallen into a dangerous pattern, Osterholm said, where a spike in cases in a location leads to some temporary restraint from people who eventually become alarmed enough to start to take precautions. But as soon as cases start to plateau or decline a little, victory over the virus is declared and people think it’s safe to resume normal life.

“It’s like an all or nothing phenomenon, right?” said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. “You all locked down or you get so discouraged with being lockdown that you decide you’re going to be in crowded bars … you can have indoor parties with no masks. You can do all the things that are going to get you in trouble.”

Osterholm said with the K-12 school year resuming in some parts of the country or set to start — along with universities — in a few weeks, transmission will take off and cases will start to climb again. He predicted the next peaks will “exceed by far the peak we have just experienced. Winter is only going to reinforce that. Indoor air,” he said.

Buckee thinks that if the country doesn’t alter the trajectory it is on, more shutdowns are inevitable. “I can’t see a way that we’re going to have restaurants and bars open in the winter, frankly. We’ll have resurgence. Everything will get shut down again.”

Fauci favors a reset of the reopening measures, with a strong messaging component aimed at explaining to people why driving down transmission now will pay off later. Young people in particular need to understand that even if they are less likely to die from Covid-19, statistically speaking, transmission among 20-somethings will eventually lead to infections among their parents and grandparents, where the risk of severe infections and fatal outcomes is higher. (Young people can also develop long-term health problems as a result of the virus.)

“It’s not them alone in a vacuum,” Fauci said. “They are spreading it to the people who are going to wind up in the hospital.”

Everyone has to work together to get cases down to more manageable levels, if the country hopes to avoid “a disastrous winter,” he said.

“I think we can get it under much better control, between now and the mid-to-late fall when we get influenza or we get whatever it is we get in the fall and the winter. I’m not giving up,” said Fauci.

But without an all-in effort “the cases are not going to come down,” he warned. “They’re not. They’re just not.”

 

 

 

 

 

Indoor air is the next coronavirus frontline

Posted on by • Posted in Coronavirus, Coronavirus Airborne Transmission, Infection Control, Infection Control Plan, Infectious Virus, Pandemic, Public Health, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, World Health Organization (WHO) • Leave a comment

https://www.axios.com/airborne-transmission-coronavirus-covid-indoor-c47e2763-a62d-4861-84e7-fc19feace3fc.html

Indoor air is the next coronavirus frontline - Axios

A growing body of research has made it clear that airborne transmission of the coronavirus is possible.

Why it matters: That fact means indoor spaces can become hot spots. Those spaces also happen to be where most business and schooling takes place, so any hope for a return to normality will require better ways of filtering indoor air.

What’s happening: After a concerted campaign by scientists, the WHO last month updated its guidelines on COVID-19 to include the possibility that the coronavirus could be airborne.

  • That marked a shift from initial assumptions that the virus was mostly transmitted via contaminated surfaces and respiratory droplets emitted at close range, like an infected person coughing near someone susceptible.
  • More evidence was added to the airborne hypothesis last week, when researchers at the University of Nebraska Medical Center reported in a paper published in Nature that they had found coronavirus-filled aerosols — small airborne particles of fluid — in the air of COVID-19 patients’ hospital rooms.
  • It’s still not clear just how much or how often the airborne transmission happens, a question Anthony Fauci has said the White House coronavirus task force will examine.

Context: If coronavirus-contaminated aerosols can indeed hang in the air, perhaps for hours, then “mitigating airborne transmission should be at the front of our disease-control strategies for COVID-19,” Joseph Allen of Harvard’s Healthy Building program wrote in the Washington Post.

  • Schools in particular “definitely present a challenge,” says Barry Po, president of connected solutions for mCloud Technologies, a provider of cloud-based remote HVAC management. Many school buildings in the U.S. are old and poorly ventilated, which makes them prime locations for indoor transmission.

The good news is there are existing technologies that can filter out or destroy coronavirus trapped in indoor air.

  • The easiest way is simply opening windows whenever possible, which dilutes the amount of virus in the air. In Japan windows are kept open in subway trains, which has helped prevent outbreaks in the country’s crowded transit system.
  • Portable HEPA filters, which can cost as little as a few hundred dollars, are capable of capturing particles as small as the novel coronavirus and could be used to clean individual classrooms.
  • Commercial HVAC systems can be adjusted to increase the number of times they exchange air per hour, analysts from McKinsey said in a report last month.

The catch: Increasing ventilation decreases energy efficiency, and Po estimates that net energy costs for buildings could increase by at least 10% in the COVID-19 era.

A more high-tech solution involves the use of specialized UV light to deactivate coronavirus in the air or on surfaces.

  • Fred Maxik, the founder of Healthe Lighting, developed Far UVC 222, a short-wave UV light spectrum that the company reports can neutralize 99.9% of coronavirus in a space. The UV light breaks the chemical bonds in the virus, Maxik says, making it incapable of replicating.
  • Unlike the UVB rays in sunlight that can damage DNA and cause skin cancer, Far UVC 222 doesn’t penetrate the human body.
  • The Healthe system has been installed in Seattle’s reopening Space Needle, as well as the practice facilities of the Miami Dolphins. “This is one of the only methodologies where we can continually clean a space in real time,” says Maxik.

The bottom line: Despite the runs early in the pandemic on Clorox wipes, it may be the air we breathe more than the surfaces we touch that need to be kept clean.

 

 

 

 

How to do smarter coronavirus testing

Posted on by • Posted in Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Deferred Healthcare, Health Insurance Coverage Adequacy, Infection Control, Infection Control Plan, Infectious Virus, National Strategy, Out of Pocket Expenses, Pandemic, Public Health, Public Safety, Underinsured, Uninsured • Leave a comment

https://www.axios.com/smarter-coronavirus-testing-69c9042c-f9d4-4dc2-b4c9-84106b3c33e0.html

I got a positive COVID-19 antibody test. What do I do with that ...

 

With testing once again a huge vulnerability to America’s coronavirus response, public health officials are calling for a revamped strategy that features the use of more tests, even if they’re imperfect.

Why it matters: The system is overwhelmed by the demand for tests, and yet prolific testing is key to identifying asymptomatic or pre-symptomatic coronavirus cases. Experts say the solution is smarter testing — which doesn’t require perfect accuracy.

The big picture: Most coronavirus diagnostic tests right now are PCR tests, which are highly accurate, but relatively slow and expensive. But other kinds of tests exist; they just carry the risk of more false negatives.

  • Some experts argue that, when doing mass testing, the tests don’t need to be 100% accurate. Catching, for example, even 50% of unidentified cases is better than the much-lower percentage that we’re catching today.

Between the lines: Strategy is key, and who gets which test matters.

  • In a white paper calling for a national testing strategy, former FDA Commissioner Mark McClellan, Johns Hopkins’ Caitlin Rivers and Duke’s Christina Silcox last week wrote that symptomatic patients and people who are close contacts of known cases should still receive PCR or other highly-accurate diagnostic tests.
  • But “for people without symptoms, we also need broad availability of more rapid but sometimes less accurate screening tests … to detect outbreaks sooner and give people more confidence in their workplaces and schools,” they write.

Details: There are several alternative testing options. Antigen tests are faster and cheaper than PCR tests, but less accurate. The FDA has already authorized two companies to sell antigen tests, per Science, and others are in the pipeline.

  • Pool testing is another way to stretch limited resources.

Yes, but: Many insurers don’t pay for tests that aren’t “medically necessary,” which generally includes screening or surveillance testing.

  • The absence of a guaranteed demand could be depressing the creation and mass production of these alternative tests.
  • “Without clear funding or screening protocols, test manufacturers are not getting a clear signal for investing in much larger testing capacity for the months ahead,” McClellan, Rivers and Silcox write.

What we’re watching: Six states announced last week that, in the absence of a national testing strategy, they’re banding together in partnership with the Rockefeller Foundation to buy 3 million rapid point-of-care antigen tests.

  • If this goes well, it could provide a model for how states — or even the federal government — can evolve their testing strategies.