Testing NOW

 

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Marko Djurica/Reuters

The United States has a restless population straining against limitations on social meetings ranging from family gatherings to public education to basic transportation to business operations to public elections to religious observances to restaurant meals to sports events and musical concerts.

That it came to us from China reflects badly on that country.

That we cannot rally a sufficient and timely response reflects badly on us.

What is worst is that we cannot ramp up two basic testing programs that would be the most effective ways to start to dig ourselves out of this hole.


Testing for Antibodies

Three interesting but isolated news items were released this week.

1) All the residents of a homeless shelter in South Boston were tested for Covid-19.  Among the 397 men tested, 146, or more than a third, were experiencing coronavirus.  None had any symptoms.

2) A small-scale serological blood test for Covid-19 antibodies in Santa Clara, California, suggested that many, many more than the number of residents reported sick with the illness already had been infected and were done with it.
         (Experts are pissing all over this test based on who was sampled and statistical grounds, but in general, false positives are far less common on antibody tests than false negatives.)

3) A random testing of 200 persons in Chelsea, a dense Boston suburb, found that one-third had Covid antibodies and, again, no previously reported symptoms.

Tests like these are anecdotal and, yes, too limited.  BUT they suggest that what researchers long have suspected:  A significant portion of persons who become infected with Covid-19, perhaps one-third, experience no symptoms.  (I heard this most recently from a friend who is a professor of pharmacology.) Another number of those infected, also uncounted, have mild symptoms and take care of themselves at home.

In Southern California, word is that doctors and nurses (and, one hopes, other workers in medical facilities) are being given serological blood tests only now.

Antibody tests require less intensive production and analysis than tests for active infections.  Why not make them broadly available, starting in the hot spots like New York, northern New Jersey and Boston?

If you had antibodies to Covid-19, wouldn’t you like to know?  Wouldn’t you want to help your relatives with shopping or home schooling?  Wouldn’t you like to get back to work at some job, even if your old one had been eliminated for the duration of this period?


Testing for Infection

At present, the US is doing more testing for Covid-19 than ever:  about 150,000 tests per day.

Also at present, unless you are symptomatic, you cannot get a Covid test unless you are an NBA player or some kind of celebrity influencer.

“Experts” tell us we need 500,000 to 700,000 tests per day to better manage the situation.

I say the experts are wrong. We need millions of tests per day, starting three weeks ago.

Here is why:  People are agitating for a lifting of some of the quarantine restrictions.

In some states, they are demonstrating in crowds that don’t do social distancing.

In Southern California, the resistance is milder — a tripling of road and pedestrian traffic in recent weeks, but with social distancing maintained — but every park has been closed and fenced off.  The parking lots by the beach have been closed. People who walk on the all-but-empty beach boardwalks are yelled at by police bullhorns and threatened with $1,000 citations.   Last week I saw a police helicopter hover for 10 minutes over two sailboats to hector the sailors back to port.

I’m sure the enforcement is well-intentioned, but it is reaching a straining point. There is no way we can keep 327 million people and most of the economy shut down until autumn 2021, the most hopeful date for an approved vaccine and broad-scale immunizations.

The problem with even the most limited opening now is that it will be accompanied by a new rise of infections, one that probably will be smaller but that could be ameliorated by making tests much more broadly available.

It’s time to test people who don’t have symptoms.  Infected people can spread the disease before they get sick; identifying even a few of those BEFORE they get sick or acquire antibodies would prevent further infections.

Anyone who wants to be tested should be able to get tested, period.

This must be done sooner and not later.


Why

My first argument for testing is that a nation that can commit $2.2 trillion for subsistence payments to people and small businesses — more than $8,000 for every single person in the US — should damn well be able to provide infection AND antibody tests for every one of those persons.

But, pathetically, the problem is not one of cost.

Unfortunately, we do not have the manufacturing or staffing capacity to administer such tests.  Rich as we are, we have insufficient “supply chains.”

Shame on us.

The limits we face at this moment are hinted at in this part of a broader commentary by Marc Andreeson.

   “Part of the problem is clearly foresight, a failure of imagination. But the other part of the problem is what we didn’t *do* in advance, and what we’re failing to do now. And that is a failure of action, and specifically our widespread inability to *build*.

    “We see this today with the things we urgently need but don’t have. We don’t have enough coronavirus tests, or test materials — including, amazingly, cotton swabs and common reagents. We don’t have enough ventilators, negative pressure rooms, and ICU beds. And we don’t have enough surgical masks, eye shields, and medical gowns — as I write this, New York City has put out a desperate call for rain ponchos to be used as medical gowns. Rain ponchos! In 2020! In America!

     “We also don’t have therapies or a vaccine — despite, again, years of advance warning about bat-borne coronaviruses. Our scientists will hopefully invent therapies and a vaccine, but then we may not have the manufacturing factories required to scale their production. And even then, we’ll see if we can deploy therapies or a vaccine fast enough to matter — it took scientists 5 years to get regulatory testing approval for the new Ebola vaccine after that scourge’s 2014 outbreak, at the cost of many lives.”


 I recommend reading the whole piece.

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