U.S. doing a lot less coronavirus testing

https://www.axios.com/newsletters/axios-vitals-32689a40-e409-4547-8468-b03dc589c082.html

The two sides of America's coronavirus response - Axios

The U.S. is cutting back on coronavirus testing. Nationally, the number of tests performed each day is about 17% lower than it was at the end of July, and testing is also declining in hard-hit states.

Why it matters: This big reduction in testing has helped clear away delays that undermined the response to the pandemic. But doing fewer tests can also undermine the response to the pandemic.

By the numbers: At the end of July, America was doing more than 800,000 tests a day. This week, it’s hovered around 715,000.

  • Even as states with particularly bad outbreaks pull back on their testing, the proportion of tests coming back positive is still high — which would normally be an indication that they need to be doing more tests.
  • In Texas, 19% of tests are coming back positive, according to Nephron Research. In Florida, the rate of positive tests is 18%, and in Nevada, 17%.

Yes, but: Experts have said reducing the demand for testing may be the best way to alleviate long delays, which made tests all but useless. And that appears to be working.

Driving the news: The Department of Health and Human Services estimated this week that nearly 90% of all tests are being completed within three days — a big improvement from turnaround times that had been stretching well over a week.

  • Quest Diagnostics says its expected turnaround time is now 2–3 days, and less for priority patients. LabCorp announced a similar turnaround time last week.

The bottom line: The U.S. is averaging 50,000 new cases a day, and that high caseload is ultimately why the demand for testing is more than the system can handle.

  • We can’t get our caseload under control without fast, widespread testing, but we can’t achieve fast, widespread testing with such a high caseload.

 

 

 

 

The Misguided Rush to Throw the School Doors Open

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.

 

 

 

 

Schools are essential. Don’t rule them out.

Schools are essential. Don’t rule them out.

Teach Your Children Well - Crosby Stills Nash and Young (Ukulele ...

It remains to be seen just how much President Trump’s extension of social distancing guidelines in the United States until April 30 defers the debate over when to safely restart the economy, allowing policymakers to focus on how to ramp up the testing and PPE availability to do so. When the time comes, they also need to contemplate the question asked by Aaron Carroll in the March 17th New York Times, “Is closing the schools a good idea?”

The question was not rhetorical. It cited the food insecurity addressed by school lunch and breakfast programs as well as the physical safety provided, particularly for homeless children. While New York City schools are providing 3 meals/day for children who need, child protective services in many regions are already seeing 50% declines in reporting of child abuse and neglect. With families stressed economically and confined to home without supervision, that is not good news since neglected or abused children are often only identified at school. In this week’s New Yorker Peter Hessler writes anecdotally about 2 suicides in youth attributed to the lockdown in China, matching that country’s total number of pediatric deaths thus far due to SARS-CoV-2 in the literature.

When we think of flattening the curve to protect the most vulnerable in society, our minds jump to the very old and the very young. Evidence from previous influenza pandemics supports our instincts. But SARS-CoV-2 appears different. Not only has critical illness in children in China and Italy been extremely rare, in both countries children make up only 1% all cases.

Even in New York state, where younger age groups seem to have been hit harder than in Italy, children still only represent 2% of cases. Finally, in a country like Iceland, which has tested a large proportion of its population, including many without any symptoms at all, children under 10 years old make up only 2% of the cases. It is these numbers that beg examination of one of Dr. Fauci’s hypotheses in the New England Journal of Medicine – that “children are less likely to become infected.”

The first SARS-CoV pandemic in 2002-2003 documented 135 pediatric cases, or only 1.7% of the 8098 reported worldwide to the World Health Organization (WHO) by the time it was declared contained, with no deaths and only 1 reported case of transmission of the virus from a pediatric patient. The WHO January 2020 Situation Update for the Middle East respiratory syndrome (MERS), another coronavirus, shows children and adolescents to be similarly disproportionally unaffected. A Japanese study of transmission in close contacts of known positive coronavirus 2019 (COVID-19) patients demonstrated a much lower attack rate amongst children than adults.

And according to the Report of the WHO-China Joint Mission on COVID-19, no one performing case tracing on the ground in China could “recall episodes in which transmission occurred from a child to an adult.”

Singapore has been lauded for its ability to mitigate the COVID-19 outbreak. Its rigorous implementation of control measures has included opening (and re-closing, next on April 8th) schools concurrently with other activities. Perhaps, as speculated by Dr. Dale Fisher, an infectious diseases specialist from Singapore who served as a member of the WHO-China Joint Mission, “children… don’t amplify the transmission. They are kind of bystanders while it goes on.”

If true, schools should be among the first US institutions re-opened, not the last. They are at least as essential as liquor stores and gun shops.