COVID-19 Update: Re-opening Without Testing And Contact Tracing Is Irresponsible

Ken AshfordEbola/Zika/COVID-19 Viruses, Economy & Jobs & Deficit, Trump & AdministrationLeave a Comment



NC and local:

There’s still lots of talk about re-opening the economy, but research published in the medical journal Nature Medicine on Wednesday suggests we just can’t do that yet. The study shows people with the COVID-19 coronavirus were at their most infectious right when symptoms began, or even a few days before, presenting yet another hurdle for containing its spread.

The researchers inferred that infectiousness started about two or three days out and peaked right before and right when symptoms started, with infectiousness decreasing after illness sets in.

The researchers also estimated that 44% of secondary cases were infected during the presymptomatic stage.

A limitation of the study concerns patient bias in recalling when symptoms set in, but it’s indicative of the challenge of tracking the spread of the virus when it could begin three days out from symptoms appearing.

Contact tracing is a strategy used to identify people who have been in close contact with an infectious person in order to inform them to quarantine and hopefully prevent new clusters of the virus from emerging.

The report suggests mass contact tracing needs to include up to three days of tracking movement in order to more effectively contain the outbreaks.

While countries like Singapore and South Korea have slowed the spread of the virus with contact tracing via methods like cell phone tracking, how the U.S. may go about it could raise privacy concerns.

For his part, Trump created a commission for the re-opening. Yup, we’ve got the Great American Economic Revival Industry Groups watching out for us. Trump says GAERIG are going to advise him on when it’s safe to reopen the economy. Biggest question in the nation. So attention must be paid.

They’re mostly business leaders. From the head of Goldman Sachs to the head of Chick-fil-A. To the professional wrestling czar who Trump, in his announcement, called “the great Vince McMahon.” We are mentioning McMahon, a big Trump donor whose wife runs a pro-Trump super PAC, because the governor of Florida recently named World Wrestling Entertainment an “essential” business that was going to be allowed to continue staging matches during the economic lockdown.

Essential is in the eye of the beholder.

But about GAERIG. We’re talking nearly 200 people — at least one of whom told The Times that there was no White House contact or advance notice of the announcement. Their meetings, unfortunately, won’t be Mega-Zoom — just a bunch of phone calls.

The list of businesses invited looks like something Jorge Luis Borges would invent to demonstrate the addled mind of someone who doesn’t understand the American economy. It includes casinos, foreign-owned cruise lines,  Trump’s buddies who own sports teams, and top Reality TV chefs like Wolfgang Puck, Thomas Keller, and Daniel Boulud (h/t DJ for the Top Chef insight). While it includes some businesses that are part of critical supply chains, there are big gaps that we should expect to be the ones that will crash once the economy does reopen more broadly. And large populations of workers and small business owners are barely represented.

But participants in the calls — which took place in four rounds and included representatives from more than a dozen industries, including banking, sports, agriculture and health care — painted a picture of a chaotic approach by the White House.

“Trump made it very clear he was ready to go on May 1,” a person who was on one of the afternoon calls said. The person, who spoke on the condition of anonymity to describe the private call, added that Trump seemed to bask in the praise from CEOs, who repeatedly opened their comments with compliments for the president.

Public health experts — including several members of Trump’s administration — have said in recent days that a target date of May 1 is not realistic. In addition to the issue of mass testing, experts have argued that because the virus has an estimated incubation period of up to 14 days, states should refrain from moving toward relaxing their restrictions until they have seen a sustained reduction in new cases for at least that long.

One member of a group that participated in the calls, the AFL-CIO, was told in advance of being named to the outside advisory council. But a spokeswoman for the AFL-CIO said its leader, Richard Trumka, was not asked — rather, Trump just announced that the coalition of labor unions would be a part of the council, she said.

In another example of the apparent disorganization, the White House misspelled the name of Lockheed Martin chief executive Marillyn Hewson in its news release announcing the members of the advisory council.

On one of the morning calls, the point most emphasized by the chief executives was the need for massive testing, which they said would be necessary to create the psychological circumstances for the nation to feel comfortable returning to offices, restaurants and recreation, according to a person familiar with the call.

And so on we stumble.

But one thing strikes me as inevitable. As Ed Yong writes in The Atlantic:

The only viable endgame is to play whack-a-mole with the coronavirus, suppressing it until a vaccine can be produced. With luck, that will take 18 to 24 months. During that time, new outbreaks will probably arise. Much about that period is unclear, but the dozens of experts whom I have interviewed agree that life as most people knew it cannot fully return. “I think people haven’t understood that this isn’t about the next couple of weeks,” said Michael Osterholm, an infectious-disease epidemiologist at the University of Minnesota. “This is about the next two years.”

But we’re not there yet, In fat, there are some Republican governors who have refused to call for lockdowns. Theses states are Arkansas, Iowa, Nebraska, North Dakota, Oklahoma, South Dakota, Utah and Wyoming.

And what has happened? Second to NYC, the biggest hotspot ow is in South Dakota. A pork processing plant in Sioux Falls, South Dakota’s most populous city, was forced to close after about 240 employees contracted the virus. Republican Mayor Paul TenHaken asked Gov. Kristi Noem this week to issue a stay-at-home order in Minnehaha and Lincoln counties, where more than 800 of the state’s 988 positive cases have been confirmed.

Noem refused, prompting the city council to introduce a three-week lockdown ordinance on its own that members lament will take a week just to pass.

“Whatever we were doing wasn’t working, and it’s taking off like crazy now,” Pat Starr, a Sioux Falls City Council member, said of the virus.

Iowa on Tuesday reported its single largest daily jump in confirmed cases —roughly half stemming from an outbreak at the Tyson Foods plant in Columbus Junction. Company officials closed the facility, one of the nation’s largest pork processing plants, earlier this month.

Over the last five days, confirmed cases have increased more than 30 percent in North Dakota, 22 percent in Arkansas, 26 percent in Oklahoma, and 260 percent in South Dakota. That compares to roughly 26 percent over the same period in New York, the epicenter of the pandemic.

MAGA people are starting protests to re-open the economy, fed by right wing news. the most notorious (so far) is Operation Gridlock which took place in Michigan.

The governor is standing firm.

Oh, Trump’s miracle cure? More studies needed, but it looks like hokum, says one small study:

Hydroxychloroquine, the 65-year-old malaria drug that President Donald Trump has praised, appeared not to help patients get rid of the pathogen in a small study.

The pill didn’t help patients clear the virus better than standard care and was much more likely to cause side effects, according to a study of 150 hospitalized patients by doctors at 16 centers in China. The research, which hasn’t been peer-reviewed, was released Tuesday.

The drug did help alleviate some clinical symptoms of Covid-19, however, and the patients who took it showed a greater drop in C-reactive protein, a measure of inflammation.

“When testing new treatments, we are looking for signals that show that they might be effective before proceeding to larger studies,” said Allen Cheng, an infectious diseases physician and a professor of epidemiology at Melbourne’s Monash University. “This study doesn’t show any signal, so it is probably unlikely that it will be of clinical benefit.”

There were more side effects in the group of 75 people who took hydroxychloroquine, but they were mostly mild, the most common being diarrhea. The researchers, led by Wei Tang of Ruijin Hospital in Shanghai, wrote that the medicine’s anti-inflammatory effects probably helped alleviate patients’ symptoms.

More studies of hydroxychloroquine are underway after the medicine made headlines in recent weeks and was endorsed by Trump.

“The results of those studies will be of interest,” Cheng said.

On the economy side, another 5 million people filed jobless claims last week, bringing total to almost 22 million in one month. That wipes out all job growth of the past decade. Meanwhile, the White House says the new small business loan program is out of money, leaving many firms grasping for lifelines. Lawmakers can’t agree on how to update the $350 billion Paycheck Protection Program, which Republicans say ran out of money in just two weeks.