Let’s take a big, second bite at the mass testing apple
We made many mistakes in our response to the coronavirus over the past year. One of the most critical was our failure to massively expand our capacity to produce coronavirus tests and masks and other PPE. As many economists including Paul Romer noted last spring, mass testing and wide distribution of high quality masks would probably have allowed us to crush the virus and return to something close to normal life even in the absence of a vaccine. Given that it was far from clear when or even if an effective vaccine would arrive, a large investment in mass testing and PPE production seemed like a no-brainer, but we didn’t do it. This was one of the most serious and easily avoidable errors in our covid response.
But what about now? President Biden asked for $50 billion in his American Recovery Act to expand rapid testing, to help schools reopen. This investment is critical, although the rationale is much too limited. There is a real chance that the coronavirus will evolve in a way that lets it escape the current vaccines. I don’t know how likely this is. But even a small risk of viral escape would justify a large investment in testing and PPE production to let us keep a new variant of the virus under control while new vaccines are developed.
Congressional Democrats should make this a high priority in the covid package they are working on. A major investment in vaccine development and creation of accelerated vaccine testing procedures is also critical. A protracted outbreak of a new covid strain will be a disaster for the country – a health disaster first, then an economic disaster, and finally a political disaster when Democrats get blamed for the never-ending hardships.
(I looked for information on the status of the legislation but didn’t find anything on point. Anyone know of something?)
In part, because we don’t have National Health, but rather this hodgepodge of States, Cities, and Counties; what data we have may not be of much value. Data is so important.
Just in time means when a black swan hits, the item is out of stock. The military knows about the need for surge capacity.
China completing sequencing the genome for what would be known as Covid-19 on Jan 7, 2020. On Jan 8, the CDC was informed by China. On Jan 9, the Covid-19 genome was made public. On Jan 10, the primers for testing for the virus were distributed to WHO.
The CDC could have used the primers from China and WHO, but chose to develop its own test and that became a problem….
Germany, with the gene sequence and primers available, had developed a test by Jan 16.
The CDC had developed tests by Feb 7, as compared to Jan 16 for Germany, but the CDC tests proved contaminated causing further delay of a month to Mar. The CDC also would not allow for the early use of tests independently developed by research centers in Washington state….
https://www.nytimes.com/2020/04/18/health/cdc-coronavirus-lab-contamination-testing.htmlApril 18, 2020C.D.C. Labs Were Contaminated, Delaying Coronavirus Testing, Officials SayFallout from the agency’s failed rollout of national coronavirus kits two months ago continues to haunt U.S. efforts to combat the spread of the highly infectious virus.By Sheila Kaplan
As for PPE preparation, the private orientation of hospitals meant that inventory was long held at a minimum. Inventory lowers profits. China and WHO were urging hospitals to be prepared in the middle of Jan, but the urgings seemed significantly disregarded.
Another critical aspect, was that China was treated with disdain in the American press for its efforts to cope with the coronavirus. I knew of the finding of a different type of pneumonia on December 30-31, 1999 and followed and recorded findings every single day from there. The WHO was alerted; the CDC was alerted. There was an international press reported released on Dec 30-31. As China worked on the outbreak there was disdain in the American press, especially disdain in the New York Times.
I recorded the daily public records on what would soon be known as the coronavirus, from China, beginning on Dec 30-31, 1999. Telling and explaining what was happening however was and continues to be “difficult” because of the disdain that was cultivated for China. However, of the 4,636 coronavirus deaths in mainland China, there was a death on April 16, 2020 and since then there have been 2 more deaths. We have sorely needed to understand the approach taken by China.
Likely I have been fruitless, since my posts do not appear. I really have tried to be helpful here, but evidently to no avail.
February 15, 2021
Chinese mainland reports 9 new COVID-19 cases
The Chinese mainland recorded 9 new COVID-19 cases on Sunday, including 1 locally transmitted in Hebei Province, data from the National Health Commission (NHC) showed on Monday.
It’s the first local transmission reported since February 6. The case was found in Hebei’s capital city Shijiazhuang.
No suspected cases or deaths related to COVID-19 were newly reported, the commission said.
Ten new asymptomatic cases were also recorded on Sunday and a total of 396 asymptomatic patients remain under medical observation.
The total number of confirmed COVID-19 cases on the Chinese mainland has reached 89,772, and the death toll stands at 4,636.
Chinese mainland new locally transmitted cases
Chinese mainland new imported cases
Chinese mainland new asymptomatic cases
Reporting for clarity:
The CDC had developed tests by Feb 7, as compared to Jan 16 for Germany, but the CDC tests proved contaminated causing further delay of a month to Mar. The CDC also would not allow for the early use of tests independently developed by researchers in Washington state….https://www.nytimes.com/2020/04/18/health/cdc-coronavirus-lab-contamination-testing.htmlApril 18, 2020C.D.C. Labs Were Contaminated, Delaying Coronavirus Testing, Officials SayFallout from the agency’s failed rollout of national coronavirus kits two months ago continues to haunt U.S. efforts to combat the spread of the highly infectious virus.By Sheila Kaplan
I am sorry for the posts that are badly spaced, but I always try very very hard to get the spacing right often to no avail.
As for having inventory for the epidemic, there was ample time to prepare since WHO was formally urging hospitals all through the world to prepare in the middle of Jan. Of course, inventory is needed but there was enough time to gather inventory.
The Chinese made clear in the middle of Jan, that people who were older and people with compromised immune systems were especially vulnerable, but in New York coronavirus patients in hospitals were actually ordered to be moved to nursing homes:
July 8, 2020
Does Cuomo Share Blame for 6,200 Virus Deaths in N.Y. Nursing Homes?A state directive sent thousands of Covid-19 patients into nursing homes, but the Cuomo administration has given other reasons for the virus’s spread.By Luis Ferré-Sadurní and Amy Julia Harris
My view is that we have enough testing already at least in Wisconsin. Cases are well off peak of mid-November 2020. Test positivity remains above a 5% reference point mentioned a lot last year, but the reason for that sure seems to be that doctors and patients know a great deal more about when to go for a test. You could substitute the current test with faster ones, but you would not be increasing the number of tests administered. Can the medical community make good use of the reduced cycle time and are there any accuracy concerns are some good questions.
My doctor tells me the current turn time around here is about 2 days and that faster would not be much better for people with COVID illness, because their treatment starts from symptomatic criteria, not test results. There is the idea that positives who are asymptomatic might benefit – although their instructions tell them to isolate while waiting for the result. So faster may be a little better, provided that the tests are about as accurate. If they are accurate, faster and cheaper, it makes all the sense in the world to go to them.
Three of my 4 kids are in school 5 days a week since September. The other just wants to know where his fire truck toy is. Neither of the two schools has COVID testing apart from temperature checks and none of my kids has missed a day yet due to COVID or COVID exposure protocols. Testing is not an important part in opening schools beyond the testing that is available here to the whole community. Rapid tests would allow a district to pretend otherwise if saving some face is a consideration (and it often is).
Wisconsin ranks 15th in the nation for covid cases per million, 44th in tests per million, 20th in population, and 24th in population per square mile. You gotta a spike coming.