'‘This Is Not the Hunger Games’: National Testing Strategy Draws Concerns' diff viewer (7/8)

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‘This Is Not the Hunger Games’: National Testing Strategy Draws Concerns	‘This Is Not the Hunger Games’: National Testing Strategy Draws Concerns
2020-06-13 03:44:40 UTC	2020-06-15 20:10:27 UTC (3 days later)
The Trump administration’s new testing strategy, released Sunday to Congress, holds individual states responsible for planning and carrying out all coronavirus testing, while planning to provide some supplies needed for the tests.	The Trump administration’s new testing strategy, released Sunday to Congress, holds individual states responsible for planning and carrying out all coronavirus testing, while planning to provide some supplies needed for the tests.
The proposal also says existing testing capacity, if properly targeted, is sufficient to contain the outbreak. But epidemiologists say that amount of testing is orders of magnitude lower than many of them believe the country needs.	The proposal also says existing testing capacity, if properly targeted, is sufficient to contain the outbreak. But epidemiologists say that amount of testing is orders of magnitude lower than many of them believe the country needs.
The report cements a stance that has frustrated governors in both parties, following the administration’s announcement last month that the federal government should be considered “the supplier of last resort” and that states should develop their own testing plans.	The report cements a stance that has frustrated governors in both parties, following the administration’s announcement last month that the federal government should be considered “the supplier of last resort” and that states should develop their own testing plans.
“For months, it was a tennis game, it was going back and forth between the feds and the states, and it’s now landed with the states,” said Scott Becker, executive director of the Association of Public Health Laboratories.	“For months, it was a tennis game, it was going back and forth between the feds and the states, and it’s now landed with the states,” said Scott Becker, executive director of the Association of Public Health Laboratories.
Mr. Becker noted that the federal government plans to distribute some testing supplies, including swabs and viral transport media, and to store test kits in the strategic national stockpile. “That’s actually quite significant,” he said. “That’s a positive step.”	Mr. Becker noted that the federal government plans to distribute some testing supplies, including swabs and viral transport media, and to store test kits in the strategic national stockpile. “That’s actually quite significant,” he said. “That’s a positive step.”
The Department of Health and Human Services prepared the strategy, which meets requirements under the Paycheck Protection Program and Health Care Enhancement Act, signed into law by President Trump on April 24, that federal agencies come up with a strategic testing plan within 30 days. It was reported earlier by The Washington Post.	The Department of Health and Human Services prepared the strategy, which meets requirements under the Paycheck Protection Program and Health Care Enhancement Act, signed into law by President Trump on April 24, that federal agencies come up with a strategic testing plan within 30 days. It was reported earlier by The Washington Post.
Mr. Becker, public health experts and Democratic leaders panned the proposal, saying the strategy runs the risk of states competing with one another and may create deep inequities among them.	Mr. Becker, public health experts and Democratic leaders panned the proposal, saying the strategy runs the risk of states competing with one another and may create deep inequities among them.
The strategy mirrors a divide that has played out in Congress for months. As they negotiated the virus relief bill in March, Democratic lawmakers pushed to require the administration to submit this national testing plan to Congress. Republicans resisted, saying those decisions belonged to each state.	The strategy mirrors a divide that has played out in Congress for months. As they negotiated the virus relief bill in March, Democratic lawmakers pushed to require the administration to submit this national testing plan to Congress. Republicans resisted, saying those decisions belonged to each state.
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Mr. Becker and others said it’s reasonable to expect states to implement some aspects of the testing, such as designating test sites. But acquiring tests involves reliance on national and international supply chains — which are challenging for many states to navigate.	Mr. Becker and others said it’s reasonable to expect states to implement some aspects of the testing, such as designating test sites. But acquiring tests involves reliance on national and international supply chains — which are challenging for many states to navigate.
“That’s our biggest question, that’s our biggest concern, is the robustness of the supply chain, which is critical,” Mr. Becker said. “You can’t leave it up to the states to do it for themselves. This is not the Hunger Games.”	“That’s our biggest question, that’s our biggest concern, is the robustness of the supply chain, which is critical,” Mr. Becker said. “You can’t leave it up to the states to do it for themselves. This is not the Hunger Games.”
In a joint statement on Monday, Speaker Nancy Pelosi; Senator Chuck Schumer, the Democratic leader; Representative Frank Pallone, Democratic chairman of the House Energy and Commerce Committee; and Senator Patty Murray, the ranking Democrat on the Senate’s health committee, said the Trump administration was not taking responsibility for ramping up national testing capacity.	In a joint statement on Monday, Speaker Nancy Pelosi; Senator Chuck Schumer, the Democratic leader; Representative Frank Pallone, Democratic chairman of the House Energy and Commerce Committee; and Senator Patty Murray, the ranking Democrat on the Senate’s health committee, said the Trump administration was not taking responsibility for ramping up national testing capacity.
“This disappointing report confirms that President Trump’s national testing strategy is to deny the truth that there aren’t enough tests and supplies, reject responsibility and dump the burden onto the states,” the lawmakers said. “In this document, the Trump administration again attempts to paint a rosy picture about testing while experts continue to warn the country is far short of what we need.”	“This disappointing report confirms that President Trump’s national testing strategy is to deny the truth that there aren’t enough tests and supplies, reject responsibility and dump the burden onto the states,” the lawmakers said. “In this document, the Trump administration again attempts to paint a rosy picture about testing while experts continue to warn the country is far short of what we need.”
Experts also took issue with the report’s assertion that continuing to test only about 300,000 people a day, by targeting only those likely to be positive, would be enough to contain the outbreak.	Experts also took issue with the report’s assertion that continuing to test only about 300,000 people a day, by targeting only those likely to be positive, would be enough to contain the outbreak.
“On the face of it, the idea that 300,000 tests a day is enough for America is absurd,” said Dr. Ashish Jha, director of the Harvard Global Health Institute.	“On the face of it, the idea that 300,000 tests a day is enough for America is absurd,” said Dr. Ashish Jha, director of the Harvard Global Health Institute.
He offered a quick rundown of the numbers to illustrate the estimate’s inadequacy. Most hospitals nationwide now test everyone who is admitted for any reason, roughly 100,000 tests each day, fearing that they may be asymptomatic and yet still spreading the virus. Testing the 1.6 million residents of nursing homes — known to be at high risk of coronavirus infection — and workers every two weeks would require 150,000 more tests each day. Add high-risk places like meatpacking plants that need regular testing, and the numbers rapidly build.	He offered a quick rundown of the numbers to illustrate the estimate’s inadequacy. Most hospitals nationwide now test everyone who is admitted for any reason, roughly 100,000 tests each day, fearing that they may be asymptomatic and yet still spreading the virus. Testing the 1.6 million residents of nursing homes — known to be at high risk of coronavirus infection — and workers every two weeks would require 150,000 more tests each day. Add high-risk places like meatpacking plants that need regular testing, and the numbers rapidly build.
“Without having tested a single person for symptoms of Covid, we would quickly exhaust our entire national supply of testing if all we have is 300,000 tests per day,” he said.	“Without having tested a single person for symptoms of Covid, we would quickly exhaust our entire national supply of testing if all we have is 300,000 tests per day,” he said.
The H.H.S. report noted that an analysis by the Safra Center at Harvard estimated the need at more than three million tests per day. But the federal report said that estimate was based on faulty assumptions.	The H.H.S. report noted that an analysis by the Safra Center at Harvard estimated the need at more than three million tests per day. But the federal report said that estimate was based on faulty assumptions.
The Safra authors who crafted the estimate said that the federal report had cherry-picked one simple example from their analysis without considering other evidence.	The Safra authors who crafted the estimate said that the federal report had cherry-picked one simple example from their analysis without considering other evidence.
Updated June 12, 2020	Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“We ran multiple models, all of which pointed to the same order of magnitude,” said Danielle Allen, director of the Safra Center. “They’ve selected one non-primary model in an appendix and selectively adjusted assumptions to generate a different number.”	“We ran multiple models, all of which pointed to the same order of magnitude,” said Danielle Allen, director of the Safra Center. “They’ve selected one non-primary model in an appendix and selectively adjusted assumptions to generate a different number.”
Dr. Allen said millions of daily tests would be required to have 4 percent of people test positive with the coronavirus — the level they say is needed to halt the spread of the virus. The administration’s target, 10 percent, would allow only for mitigation.	Dr. Allen said millions of daily tests would be required to have 4 percent of people test positive with the coronavirus — the level they say is needed to halt the spread of the virus. The administration’s target, 10 percent, would allow only for mitigation.
“There is not a single country that I’m aware of that achieved disease suppression with a positivity rate of 10 percent,” she said.	“There is not a single country that I’m aware of that achieved disease suppression with a positivity rate of 10 percent,” she said.
And 300,000 daily tests would be insufficient even for mitigation, Dr. Jha said, estimating that would require at least 900,000 tests per day.	And 300,000 daily tests would be insufficient even for mitigation, Dr. Jha said, estimating that would require at least 900,000 tests per day.