Monday, August 31, 2020

POLITICO NIGHTLY: Soon: Anyone who wants a test, can get a test

 


 
POLITICO Nightly: Coronavirus Special Edition

BY RENUKA RAYASAM

With help from Myah Ward

WHICH TEST IS BEST — The country crossed 6 million Covid confirmed infections today, and President Donald Trump often complains that the country tests too much. His newest Covid adviser said today that healthy people shouldn’t get tested. Top administration officials pressured the CDC into issuing similar guidance against testing asymptomatic people who have been exposed.

The problem throughout the pandemic, however, is that the country hasn’t always been testing enough, according to most scientific experts, and that test results are too slow to be useful. Trump’s own administration seems to want to test more, too: Health agencies are paying Abbott Labs $750 million for 150 million new rapid tests to be deployed in high risk areas like nursing homes. The FDA has approved dozens of different Covid tests.

The proliferation of new tests is making ubiquitous testing a possibility in the near future, but we’re not there yet.

There are two broad types of diagnostic tests that have received emergency authorization from the FDA: PCR tests, which detect a virus’ genetic material, and antigen tests, which detect proteins on the virus’ surface. (There are also antibody tests, which tell whether someone was infected with a virus, but let’s focus on detecting a current infection.)

PCR tests are highly accurate, but require a central lab to analyze the sample, whether a nasal swab or saliva.

The spit test the NBA used in its bubble is a PCR test that needs to be sent to a lab. But it doesn’t require swabs and uses fewer reagents, sidestepping supply chain problems that have dogged labs. It’s also potentially easier to collect saliva than nasal swabs.

Accuracy is the tradeoff for speed. Antigen tests can be analyzed wherever the sample, a nasal or throat swab, is taken, usually within an hour or less.

Some studies have shown up to 50 percent false negatives for antigen tests. (Remember when Ohio Gov. Mike DeWine falsely tested positive for Covid and had to skip a meeting with Trump?)

Faster, less accurate tests should be the first line of defense against Covid-19, says Daniel Larremore, a computer scientist at the University of Colorado Boulder who has been modeling Covid . An accurate PCR test that delivers results weeks after infection isn’t useful for an asymptomatic patient. Catching half of those infections with a quick antigen or spit test would do a lot of good, and preserve more reliable tests for those who have already tested positive or have symptoms, he said.

The $5 Abbott test the administration is buying is an antigen test. Unlike two other antigen tests that have received FDA approval, it doesn’t require a specialized machine, which should make it more widely accessible.

The at-home pregnancy test model for coronavirus isn’t here yet, though the Abbott test is a step in that direction. The FDA-approved tests for Covid all require a doctor's note and a trained professional to carry them out.

Ongoing studies are trying to figure out how accurate the tests are if there’s some kind of user error, like a person who leaves the sample in their hot car for a couple of hours. And one company, e25, is working on a paper-strip spit test that would pretty much be the pandemic’s version of a home pregnancy test. It has yet to receive FDA approval.

The Abbott test — or any other rapid test — has other drawbacks aside from inaccuracy: Not all results will get reported to authorities, though the administration is still requiring results to be reported. And the cost, even of $5, could further widen testing disparities between wealthy and poor communities.

Welcome to POLITICO Nightly: Coronavirus Special Edition. Finally caught up on this excellent podcast and might be convinced that the CIA wrote the Scorpions’ “Wind of Change.” Reach out rrayasam@politico.com or on Twitter at @renurayasam.

 

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FIRST IN NIGHTLY

RNC TRUMP V. TWITTER TRUMP  For one week, the Republican Party sent out a parade of people to make the case that the president, insulter-in-chief, has a heart. Within days, Twitter Trump had returned.

At the RNC, everyone from little-known Americans to first lady Melania Trump insisted the Trump who lashes out on social media and in press conferences is not the compassionate man they see “when the cameras are off,” as Vice President Mike Pence put it. But over the weekend, Trump went right back to his bare-knuckle approach, White House reporter Meridith McGraw writes. He insulted his niece and boosted a video from a white nationalist user who falsely blamed “Black Lives Matter/Antifa” for a violent 2019 incident. He mocked and retweeted profane jokes about the Portland mayor and retweeted a video of Trump supporters in Portland shooting paintball guns and pepper spray at racial justice protesters in the city, saying it “cannot be unexpected.”

And at a briefing this evening, Trump dished out numerous incendiary claims about violence in “Democrat-run cities” for nearly 30 minutes. He alleged the violence is caused by “left-wing indoctrination,” insisted “the violent rioters share Biden talking points” and proclaimed “paint is not bullets” when asked about the protesting Trump supporters in Portland, where one Trump supporter was shot and killed over the weekend.

The dichotomy highlights the challenge facing the GOP with nine weeks left in the campaign: How to make Trump seem more palatable to voters who may largely agree with his policies but are turned off by his tactics, while still letting Trump rile up his base.

Democratic presidential candidate former Vice President Joe Biden waves as he arrives at New Castle Airport in Delaware. Biden traveled to Pittsburgh today and spoke on the protests against racism and police violence in Kenosha, Wis., and Portland, Ore.

Joe Biden waves as he arrives at New Castle Airport in Delaware. Biden traveled to Pittsburgh today and spoke on the protests against racism and police violence in Kenosha, Wis., and Portland, Ore. | Getty Images

FROM THE HEALTH DESK

DEMS RED OVER RED ZONES — Senior Trump administration officials privately warned seven states in June about dangerous coronavirus outbreaks that put them in the highest risk “red zone” while publicly dismissing concerns about a second wave of Covid-19, according to White House documents House Democrats released today.

The House Select Subcommittee on the Coronavirus Crisis released eight weeks of previously confidential reports obtained from the White House coronavirus task force that Democrats said showed the administration acting over the summer to willfully cover up public health risks for political gain, health care reporter Alice Miranda Ollstein writes.

“Rather than being straight with the American people and creating a national plan to fix the problem, the president and his enablers kept these alarming reports private,” Rep. Jim Clyburn (D-S.C.), the subcommittee’s chair, said in a statement. “As a result of the president’s failures, more than 58,000 additional Americans have died since the Task Force first started issuing private warnings, and many of the Task Force’s recommendations still have not been implemented.”

White House Communications Director Alyssa Farah said the administration began a public health messaging campaign in July to states with large outbreaks “to warn the public to follow mitigation practices to bring down the number of cases.”

“The notion that we are trying to hide information from the public is absurd,” she said.

TALKING TO THE EXPERTS

PICKING THE LOCKDOWN — A second lockdown, which some economists and epidemiologists have argued for in recent weeks, is a bad idea, argues Harvard’s James Stock, an economist who is working with a team that includes epidemiologist Michael Mina to model how to avoid a surge in deaths without another economic shutdown.

Nightly’s Myah Ward talked with Stock about why he believes stringent adoption of measures like face masks, social distancing and limits on group gatherings, as well as other mitigation efforts like testing and contact tracing, are enough to suppress the virus. This conversation has been edited.

What were the economic costs of the first lockdown?

Because we failed to pursue a strategy where we actually fully suppressed the virus, people are just afraid. And as long as people are afraid, we’re going to see slow economic activity. And that’s exacerbated by the lockdown. The lockdowns are part of the story, but really it’s our failure so far to suppress the virus that prevents people from wanting to go out and engage in economic activity.

We’re big supporters of opening up almost all of the economy, but the key word there is almost. You can’t just open up bars. You can’t open up sporting events and things like that. The really high-contact activities have to be shut down until we have this thing totally under control.

What would you say to the economists and epidemiologists who advocate for another lockdown?

To me, that just sounds like giving up. To say it’s easier somehow for the politicians to tell everybody that you have to stay at home than to tell them that you need to wear masks. Or to tell Congress that it’s easier to shut down the economy again and see the unemployment rate go up to 15 percent or 18 percent, or whatever it is, than it is for you to pass a measure where you support $100 billion in testing. I don't see that as being an effective solution. It’s not a realistic solution, and it’s an extremely costly solution.

How does your research apply to school reopenings?

Some districts have schools where you can get more social distancing, and others are in these old buildings, virtually crammed together with bad ventilation. But by and large, if the virus level is low and you have these other measures in place, then you don’t need to have school closings. I view that as a really costly lockdown. That’s kind of like closing malls and people not flying, but this is even more costly in ways that are difficult to measure. And it's not necessary if you do the other things.

Right now, I am on the side of, I really would like the kids through grade six to be in school in-person. I understand why people are hesitant about that.

ASK THE AUDIENCE

Nightly asks you: Send us pictures of your Covid-19 work or study space. Send your photo to nightly@politico.com. We'll include select photos in our Friday edition.

COVID-2020

‘DO I LOOK LIKE A RADICAL SOCIALIST?’ Biden today blamed Trump for the violence that has accompanied mass protests for racial justice, accusing the president of “long ago” forfeiting “any moral leadership in this country.” In a speech in Pittsburgh, the Democratic presidential nominee portrayed Trump as having lost control of a country rocked by a series of converging crises and being guilty “for years” of fomenting racial tensions that have led to violence, which he also denounced.

“Ask yourself: Do I look like a radical socialist with a soft spot for rioters? Really?” Biden said. “I want a safe America, safe from Covid, safe from crime and looting, safe from racially motivated violence, safe from bad cops. And let me be crystal clear: safe from four more years of Donald Trump.” The speech came a little more than a week after a police officer in Kenosha, Wis., shot Jacob Blake, a Black man, seven times in the back as he leaned over into his car, sparking protests and violence in the city.

Nightly video player of former Vice President Joe Biden

Partisan goggles  Are we a country that’s failed disastrously to respond to a global pandemic, or a country that’s overrun by protests and violence on the streets? Democrats and Republicans painted wildly different pictures of America at their party conventions this month. In the latest POLITICO Dispatch, Scott Bland breaks down the biggest takeaways from the past two weeks — and what they tell us about what's next.

Play audio

Listen to the latest POLITICO Dispatch podcast

NIGHTLY NUMBER

350,000

The number of students in Miami-Dade Public Schools, Florida’s largest school district, where the first day of classes today was hampered by technology issues that prevented teachers and students from logging in to their online courses.

PARTING WORDS

PANDEMIC PRIMATE PERIL — Pandemic shortages have become familiar to us over the five months, whether in PPE, tests or toilet paper. But a new shortage has scientists and researchers worried: monkeys. “Nationally, there is basically a big shortage,” Koen Van Rompay, an infectious-disease scientist at the California National Primate Research Center, told The Atlantic. The problem has three sources: a limited pool for a huge number of Covid-19 research projects, a huge downturn in the number of monkeys coming from China, and previous shortages being made worse.

 

JOIN TOMORROW - A PLAYBOOK INTERVIEW ON THE INTERSECTION OF SPORTS AND ACTIVISM: Last week, sports leagues across the country took an unprecedented stand against police brutality and racial injustice. Join POLITICO Playbook co-authors Anna Palmer and Jake Sherman for a virtual interview with Milwaukee Bucks Senior Vice President Alex Lasry and Bucks Assistant Coach Vin Baker to discuss the NBA's newly established social justice commission, the league's commitment to turn its arenas into voting locations in the upcoming election and how the current debate in America is bigger than basketball. REGISTER HERE.

 
 

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Renuka Rayasam @renurayasam

 

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