‘We have to try something different’: Experts call for a large-scale rethinking of the U.S. testing strategy.
While most coronavirus tests to date have relied on an ultra-accurate procedure called PCR, severe supply shortages have slowed the turnaround of results, stretching to more than a week — or three — in some parts of the United States. That has complicated, if not crippled, efforts to detect and track the spread of the virus.
The best chance to rein in the sprawling outbreaks, experts said, requires widespread adoption of less accurate tests, as long as they are administered quickly and often enough.
“Even if you miss somebody on Day 1,” said Omai Garner, director of clinical microbiology in the U.C.L.A. Health System. “If you test them repeatedly, the argument is, you’ll catch them the next time around.”
This quantity-over-quality strategy has its downsides, and is contingent on an enormous supply of testing kits. Currently, only a handful of speedy tests have been cleared by the Food and Drug Administration for emergency use. But many experts now believe more rapid, frequent testing would be enough to identify those who need immediate medical care — and perhaps even pinpoint those at greatest risk of spreading the disease.
One such option includes antigen testing, which, at its simplest, could provide a fast answer in the same way as pregnancy tests. Users could swab their mouths or noses or spit into a tube, then read the results as colored bars on a strip of paper within minutes. These tests could be done at a doctor’s office, or even at home — no fancy machines or specially trained personnel required — and cost just a few dollars each, perhaps even less. And there would be no delays of a week or longer.
The approach is unconventional for lab researchers, who have traditionally valued accuracy above all else. But given the status quo, “Our backs are against the wall, and it’s Hail Mary time,” said Susan Butler-Wu, a clinical microbiologist at the University of Southern California. “We have to try something different.”
France and Germany have each recorded a higher number of daily new coronavirus cases this week than either country has seen in months. France reported 1,695 new cases on Wednesday, and Germany on Thursday reported more than 1,000.
Germany’s public health authority, the Robert Koch Institute, said new cases were spread across the country, and were not concentrated in one region as more recent spikes have been.
In France, which had been seeing a slow resurgence of the pandemic, the 1,242 daily average of cases since the beginning of August has almost reached the level of infections in the first week of May, when the country was still under lockdown. And the number of Covid-19 patients in intensive care units, which had been steadily falling since early April, has risen very slightly in recent days.
As numbers began rising last week in Germany, Lothar Wieler, the president of the Robert Koch Institute, had warned that Germans were becoming too lax and failing to uphold the social-distancing and mask-wearing requirements that remain in place.
In France, the scientific council that advises President Emmanuel Macron warned that a second wave of infections by the fall was “highly possible” given current trends. The council called on large cities — which are most likely to be the first to turn into dangerous clusters — to prepare home-confinement strategies that could be tightened or loosened in step with the evolution of the pandemic.
With Congress and the White House still bargaining over a coronavirus relief package that would extend supplemental unemployment benefits, layoffs continue to pile up.
Wall Street analysts expect that a Labor Department report on Thursday will show that the number of new state jobless claims filed from July 26 to Aug. 1 will hover around 1.4 million for the third week.
The weekly count is down from the stratospheric levels reached in the early days of the pandemic. But the data is likely to show the 20th straight week of more than one million new state jobless claims, an extraordinary figure by historical standards.
Hundreds of thousands of additional claims are being filed weekly through a separate federal emergency jobless benefit program that covers freelancers and the self-employed.
Unless and until Congress acts, the unemployed will no longer receive the $600-a-week federal supplement that helped pay bills through the spring and early summer.
“With these benefits expiring, you have another hit to income and spending,” said Rubeela Farooqi, chief U.S. economist at High Frequency Economics. “So basically, everything’s pointing to a slower pace of recovery right now unless we can get the virus under control or there is a vaccine or something.”
“I think we’re going to see the pace of layoffs pick up in the coming weeks,” she added.
Nearly every country has struggled to contain the coronavirus and made mistakes along the way, yet only one affluent nation has suffered a severe, sustained outbreak for more than four months: the United States.
Led by David Leonhardt, a team of New York Times journalists set out to reconstruct the unique failure of the United States, through interviews with scientists and public health experts around the world. The reporting points to two central themes. David writes:
First, the United States faced longstanding challenges in confronting a major pandemic. It is a large country at the nexus of the global economy, with a tradition of prioritizing individualism over government restrictions. That tradition is one reason the United States suffers from an unequal health care system that has long produced worse medical outcomes — including higher infant mortality and diabetes rates and lower life expectancy — than in most other rich countries.
“As an American, I think there is a lot of good to be said about our libertarian tradition,” Dr. Jared Baeten, an epidemiologist and vice dean at the University of Washington School of Public Health, said. “But this is the consequence — we don’t succeed as well as a collective.”
The second major theme is one that public health experts often find uncomfortable to discuss because many try to steer clear of partisan politics. But many agree that the poor results in the United States stem in substantial measure from the performance of the Trump administration.
In no other high-income country — and in only a few countries, period — have political leaders departed from expert advice as frequently and significantly as the Trump administration. President Trump has said the virus was not serious; predicted it would disappear; spent weeks questioning the need for masks; encouraged states to reopen even with large and growing caseloads; and promoted medical disinformation.
Eric M. Garcetti, the mayor of Los Angeles, said on Wednesday that the city could cut off power to homes or business that host large gatherings in defiance of public health guidelines.
Large gatherings in private homes are banned under Los Angeles County’s public health orders because of the pandemic, but there have been a number of reports of parties in recent weeks. One party that drew a large group to a mansion on Mulholland Drive on Monday night devolved into chaos and gunfire after midnight, leaving five people wounded, one of whom later died, the authorities said.
“These large parties are unsafe and can cost Angelenos their lives,” Mr. Garcetti said at a news conference on Wednesday. “That is why, tonight, I am authorizing the city to shut off Los Angeles Department of Water and Power service in the egregious cases in which houses, businesses and other venues are hosting unpermitted large gatherings.”
He said that beginning on Friday night, “if the L.A.P.D. responds and verifies that a large gathering is occurring at a property, and we see these properties reoffending time and time again, they will provide notice and initiate the process to request that D.W.P. shut off service within the next 48 hours.”
He added that this would not apply to small home gatherings, though he urged residents to avoid those, too.
“Some research has shown that 10 percent of people cause 80 percent of the spread,” Mr. Garcetti said. “These super-spreader events and super-spreader people have a disproportionate impact on the lives that we are losing, and we cannot let that happen like we saw on Mullholland Drive on Monday night.”
A surge in coronavirus cases since mid-June in California has prompted officials to reconsider their moves to loosen some restrictions. California surpassed New York last month as the state with the highest number of coronavirus cases.
For some Britons, a return to a disrupted career may not be possible.
As a national lockdown was imposed in England in March, a food deliverer, Hanna Scaife, watched her weekly hours dwindle to nothing as restaurants across Teesside, in the northeastern part of the country, shut their doors. Business has not gotten much better since then.
Rather than wait for business to pick up, Ms. Scaife, 24, is giving up the delivery job and moving in an entirely different direction: She has enrolled in an art school beginning in September, with plans to transfer to the University of Sunderland to study ceramics and glass.
In Britain, the economic collapse caused by the virus has put millions of economic futures in doubt. More than nine million people have been furloughed, or 29 percent of the country’s work force, and 2.8 million have filed unemployment claims. Some fields, such as hospitality or live entertainment, seem especially uncertain, leaving some people in a quandary: Wait for business and employment to pick up, or leave behind a job and career and try something new?
Nicola Block, 35, has held jobs in the theater industry for a decade, but the future of live theater is under a huge cloud. Even when it is allowed to resume, it is uncertain how many people will be willing to risk attending a performance in a crowded venue. She is less eager for a career change, but in September, she will begin a 12-month contract as a teaching assistant at a primary school.
“I’m really torn,” Ms. Block said. “It’s something that I’m interested in and something that I want to do, so that’s great, but on the other hand I kind of feel like I’m abandoning something.”
More than half of Americans who flew in the past year are not ready to do so again, according to a new survey, underscoring the difficulty airlines face in convincing people it is safe for them to get back on planes.
In the survey of nearly 6,500 travelers conducted by Gallup and the financial firm Franklin Templeton, 52 percent said they were uncomfortable flying.
Younger adults are more willing to travel; only a third of those between the ages of 18 and 34 expressed discomfort with the idea. But older adults, who tend to have more time and money to travel, are far more reluctant. Among those 55 or older, 69 percent said they would not be comfortable taking a flight.
Unsurprisingly, views on flying vary significantly by political identification. Nearly 60 percent of Democrats said they were uncomfortable flying, compared with 54 percent of independents and just 42 percent of Republicans.
Even those willing to fly have limits. Although 44 percent said they were comfortable getting on a flight that lasted less than two hours, only 21 percent said they were open to the idea of flying more than six hours, confirming the industry consensus that international travel will take much longer to recover than shorter, domestic trips.
Travelers are also divided in their willingness to pay to have an empty seat next to them. Just under half said they would not shell out any money for greater distance from others, while 47 percent said they would pay up to $100. That share shrinks as the price of an empty seat rises, though 18 percent said they would spend $250 or more.
North Korea’s first suspected case has ‘inconclusive’ test results, the W.H.O. says.
Test results for North Korea’s first suspected coronavirus case were “inconclusive,” a World Health Organization official has said, after the case triggered quarantine orders for more than 3,600 people.
North Korea’s state-run news media has said the patient is a man who defected to South Korea three years ago but secretly crossed back to the border city of Kaesong last month. North Korea later declared a “maximum” national emergency and put Kaesong on lockdown.
North Korea, one of the world’s most isolated countries, has repeatedly said that it has no cases of the virus, but outside experts are skeptical. The local news media said last week that the national caseload was still zero, without providing further details on what happened to the man.
Dr. Edwin Salvador, a W.H.O. representative to North Korea, said in a statement on Thursday that the test results for the man remained “inconclusive.” Extensive contact tracing is underway, he added, with 64 of the man’s first contacts and 3,571 secondary ones under quarantine in government facilities for 40 days.
Dr. Salvador said in a separate statement that hundreds of workers at a North Korean seaport and at the border with the Chinese city of Dandong who came into contact with imported goods have also been quarantined.
North Korea’s authoritarian government has adopted drastic measures against the virus, including sealing its borders in January and closing off business with China, which accounts for 90 percent of its external trade.
A coronavirus outbreak could further damage the North’s economy, which is already hobbled by international sanctions, and strain its woefully underequipped public health system. Dr. Salvador said the government had designated 15 laboratories for Covid-19 testing, and that all schools were on an extended summer break.
Facebook took down a video posted by the campaign of President Trump on Wednesday in which he claimed children were immune to the coronavirus, a violation of the social network’s rules against misinformation around the virus.
It was the first time Facebook had removed a post by Mr. Trump’s campaign for spreading misinformation about the virus, though the social network had previously taken down other ads and posts by the campaign for violating other policies. In June, for example, Facebook took down campaign ads that used a Nazi-related symbol, which broke the company’s rules against organized hate.
The video that Mr. Trump’s campaign posted on Wednesday was of an interview held earlier in the day with Fox News. In the clip, he pressed for the opening of schools this fall, arguing that children were “virtually immune” from the coronavirus. That theory is not supported by most medical experts.
Twitter on Wednesday also blocked the Trump campaign’s post with the video, saying it had violated company rules on coronavirus misinformation. The account was barred from posting new tweets until the offending post was removed, a typical procedure, Twitter said. Later Wednesday evening, the video was removed from the Trump campaign account and it had resumed posting.
Fifty million face masks bought by the British government for the National Health Service in April will not be used because of safety concerns, the BBC reported on Thursday.
The masks, which were bought as part of a 252 million-pound contract, ($332 million), use ear loop fastenings instead of head loop fastenings. The government found that they did not fit tightly enough, according to legal documents seen by the BBC.
The Department of Health and Social Care said it was unable to comment on the specifics of the case because of continuing legal proceedings but said there was a “robust” process in place to ensure that all orders of personal protective equipment are of high quality and meet strict safety standards.
Ayanda Capital, the supplier of the masks, was not immediately available for comment but told the BBC that the equipment met all the specifications that the government had set out.
In the early stages of the pandemic, the government came under fierce criticism over shortages of personal protective equipment, particularly respirator masks that protect health workers from inhaling harmful materials.
“Throughout this global pandemic, we have been working tirelessly to deliver PPE to protect people on the front line,” a government spokesman said, adding, “Over 2.4 billion items have been delivered, and more than 30 billion have been ordered from U.K.-based manufacturers and international partners to provide a continuous supply, which meets the needs of health and social care staff both now and in the future.”
Myanmar jails a Canadian pastor for attending a large gathering.
A pastor from Canada, who contracted the virus in Myanmar after preaching that Christians were immune to it, was sentenced to three months in prison on Thursday for violating the country’s strict rule against large gatherings.
The Myanmar-born preacher, David Lah, was found guilty of attending a 27-day Christian gathering in Yangon, the country’s largest city, that began in March and is blamed for spreading the virus to at least 72 people.
At the time, the government had prohibited gatherings of five or more people in an effort to contain the virus. The limit on gatherings was raised last week to 15.
The spring gathering, where Mr. Lah was a featured speaker, is Myanmar’s biggest known coronavirus cluster so far. Mr. Lah was diagnosed with Covid-19 days after it ended.
In one of his sermons at the gathering, he claimed that the coronavirus had leaked from a “nuclear biological weapon” but that those who believed in God would be spared.
“For anyone who hears the word of God,” he said, “that disease will never come and infect you.”
One of Myanmar’s two vice presidents, U Henry Van Thio, was tested for the disease after meeting separately with Mr. Lah, the authorities said. His test result was negative.
Mr. Lah, who has been imprisoned since May 20 awaiting trial, will be released in two weeks. U Wai Tun, who organized the event and played drums there, was also convicted and sentenced to three months.
Christians, who make up 6 percent of Myanmar’s population, are the largest religious minority in the predominantly Buddhist nation.
As of Thursday, Myanmar had reported 357 coronavirus cases and 6 deaths. Its testing rate — 2,219 per million people — is among the lowest in the world.
Mass infection at a retirement home came through the ventilation system, a Dutch report finds.
A leaked report by the Dutch National Institute for Public Health and the Environment seems to support the theory that the coronavirus can be transmitted through the air.
The case, in Maassluis, in the western Netherlands, is one the clearest examples of a warning by 239 experts that the virus is airborne.
The report, published on Wednesday by the Dutch newspaper De Volkskrant and 1Vandaag, a current-affairs show, focused on a retirement home where in June almost an entire ward of patients was infected.
Despite wearing face masks continuously except for lunch breaks, 18 staff members were also infected. When a newly installed air-ventilation system was inspected, the health authorities found large quantities of the virus on the mesh covering air intake and extraction units and in its filters.
“There is simply no other explanation possible, this is how everybody there got infected, all at the same time, through aerosols,” said Maurice de Hond, a data specialist who has long criticized the Dutch health authorities for ignoring spread through aerosols. “We need to realize this before autumn comes and more people will gather indoors.”
It is unclear why the Dutch National Institute for Public Health and the Environment has kept its findings secret, but it did tacitly adjust the guidelines for ventilation, according to De Volkskrant. Three days after the report was released internally, the organization started publicly advising to “avoid recirculation of air in spaces where several people are present, and refresh the air as often as possible.”
These are the hand sanitizers to avoid.
The Food and Drug Administration has moved to keep several types of hand sanitizers from entering the U.S. because they were found have inadequate concentrations of alcohol. Here are some other options for keeping your hands clean.
Reporting was contributed by Geneva Abdul, Luke Broadwater, Niraj Chokshi, Emily Cochrane, Patricia Cohen, Melissa Eddy, Thomas Erdbrink, Jacey Fortin, Sheera Frenkel, Cecilia Kang, David Leonhardt, Constant Méheut, Saw Nang, Richard C. Paddock, Jim Tankersley, Katherine J. Wu, Ceylan Yeginsu and Elaine Yu.