President Trump will address the nation on the coronavirus pandemic on Monday, as state leaders and health experts say that testing limitations continue to slow the country's ability to safely re-open the economy.
The White House last week issued guidelines on a three-tiered approach for states to begin easing coronavirus restrictions. But many state officials have said that they do not yet have the capacity to aggressively test for new COVID-19 cases.
Trump has been resistant to states' demands for additional testing help, tweeting on Monday: "States, not the Federal Government, should be doing the Testing - But we will work with the Governors and get it done."
The Monday coronavirus task force briefing comes after a series of tense disagreements between Trump and a number of Democratic governors last week.
Almost immediately after the administration's three-phase plan to ease coronavirus restrictions was released, several governors openly disputed the president's projected timeline on their ability to safely begin lifting stay-at-home orders.
A new study in California has found the number of people infected with coronavirus may be tens of times higher than previously thought.
The study from Stanford University, which was released Friday and has yet to be peer reviewed, tested samples from 3,330 people in Santa Clara county and found the virus was 50 to 85 times more common than official figures indicated.
To ease the sprawling lockdowns currently in place to stop the spread of Covid-19, health officials must first determine how many people have been infected. Large studies of the prevalence of the virus within a region could play a key role, researchers say.
“This has implications for learning how far we are in the course of the epidemic,” said Eran Bendavid, the associate professor of medicine at Stanford University who led the study. “It has implications for epidemic models that are being used to design policies and estimate what it means for our healthcare system.”
The study marks the first large-scale study of its kind in the US, researchers said. The study was conducted by identifying antibodies in healthy individuals through a finger prick test, which indicated whether they had already contracted and recovered from the virus. Volunteers for the study were recruited through Facebook ads, which researchers say were targeted to capture a representative sample of the county’s demographics and geography.
At the time of the study, Santa Clara county had 1,094 confirmed cases of Covid-19, resulting in 50 deaths. But based on the rate of participants who have antibodies, the study estimates it is likely that between 48,000 and 81,000 people had been infected in Santa Clara county by early April.
That also means coronavirus is potentially much less deadly to the overall population than initially thought. As of Tuesday, the US’s coronavirus death rate was 4.1% and Stanford researchers said their findings show a death rate of just 0.12% to 0.2%.
The study confirms the widely-held belief that far more people than originally thought have been infected with the coronavirus, said Arthur Reingold, an epidemiology professor at UC Berkeley who was not involved in the study, but it doesn’t mean the shelter-in-place order will be lifted any time soon.
“The idea this would be a passport to going safely back to work and getting us up and running has two constraints: we do not know if antibodies protect you and for how long, and a very small percentage of the population even has antibodies,” he said.
COVID-19 Antibody Seroprevalence in Santa Clara County, California Eran Bendavid, Bianca Mulaney, Neeraj Sood, Soleil Shah, Emilia Ling, Rebecca Bromley-Dulfano, Cara Lai, Zoe Weissberg, Rodrigo Saavedra, James Tedrow, Dona Tversky, Andrew Bogan, Thomas Kupiec, Daniel Eichner, Ribhav Gupta, John Ioannidis, Jay Bhattacharya doi: doi.org/10.1101/2020.04.14.20062463
Abstract Background Addressing COVID-19 is a pressing health and social concern. To date, many epidemic projections and policies addressing COVID-19 have been designed without seroprevalence data to inform epidemic parameters. We measured the seroprevalence of antibodies to SARS-CoV-2 in Santa Clara County. Methods On 4/3-4/4, 2020, we tested county residents for antibodies to SARS-CoV-2 using a lateral flow immunoassay. Participants were recruited using Facebook ads targeting a representative sample of the county by demographic and geographic characteristics. We report the prevalence of antibodies to SARS-CoV-2 in a sample of 3,330 people, adjusting for zip code, sex, and race/ethnicity. We also adjust for test performance characteristics using 3 different estimates: (i) the test manufacturer's data, (ii) a sample of 37 positive and 30 negative controls tested at Stanford, and (iii) a combination of both. Results The unadjusted prevalence of antibodies to SARS-CoV-2 in Santa Clara County was 1.5% (exact binomial 95CI 1.11-1.97%), and the population-weighted prevalence was 2.81% (95CI 2.24-3.37%). Under the three scenarios for test performance characteristics, the population prevalence of COVID-19 in Santa Clara ranged from 2.49% (95CI 1.80-3.17%) to 4.16% (2.58-5.70%). These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50-85-fold more than the number of confirmed cases. Conclusions The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases. Population prevalence estimates can now be used to calibrate epidemic and mortality projections.
Across the U.S., state leaders are grappling with the challenging decision of when to relax the social distancing restrictions that have helped keep COVID-19 in check.
Already this week, Georgia's governor has allowed businesses such as gyms, hair salons and movie theaters to reopen — despite not meeting many of the White House's guidelines for Phase 1 of reopening. South Carolina's governor has taken a similar tack — including reopening the state's beaches.
And the governors of other states such as Tennessee and Ohio say they will allow their stay-at-home orders to expire next week, with varying degrees of social distancing required beyond that point.
But how should states decide when to reopen? Epidemiologists and other public health specialists warn against moving too fast. They note that the coronavirus is still circulating. Cases could spiral up to catastrophic levels all over again unless proper measures are taken.
The consensus view is that states shouldn't open up unless they have a robust system to detect and quash new flare-ups by testing to see who is infected, tracing their contacts, and isolating and quarantining as needed.
Unfortunately, there's widespread concern that most states will not be ready to launch such a system any time soon because of continued problems with testing capacity, as well as limited staffing at state and local health departments.
So one team of disease modelers — from the University of Washington's Institute for Health Metrics and Evaluation or IHME — has come up with a different standard. They are asking the question: What is the maximum number of new infections that states could handle with their current testing and contact tracing capacity?
IHME's answer: 1 new infection per million people in a given state. They estimate that states with this level of transmission should be able to keep outbreaks from flaring up even after people start mingling again, though the researchers stress that states would still need to limit large gatherings.
IHME's team built a model to forecast when each state will reach that threshold of 1 new infection per million. Their main finding is that very few states are close.
By May 10, just five states are projected to get there — Alaska, Hawaii, Montana, West Virginia and Vermont. Twenty states and the District of Columbia won't reach the threshold until the beginning of June or later. These include two of the states whose governors have been most aggressive about reopening — Georgia and South Carolina. In addition, Ohio is not projected to meet the standard until May 14; Tennessee not until May 20.
President Donald Trump reposted a video of a reporter being hounded by angry anti-lockdown protesters in New York, calling the demonstrators "great people."
The president tweeted the video on Saturday morning, commenting: "People can't get enough of this. Great people"
The video was posted to Twitter by Kevin Vesey, a reporter with News 12 Long Island, who was reporting on an anti-lockdown demonstration organized by a pro-Trump group called the Setauket Patriots in Commack, Long Island on May 14.
The journalist was met with hostility as protesters started aggressively shouting and jeering at him while he walked past, recording his report on Facebook Live. One woman confronts Vesey, shouting, "You are disgusting. You are the virus", while another woman says in the background: "You are the enemy of the people."
At one point, an unmasked protester wearing a red Make America Great Again hat follows and taunts the reporter as he tries to keep six feet between them.
"I think you need to back away from me, sir," Vesey said from behind the camera.
"No, I've got hydroxychloroquine, I'm fine," the man answered — a reference to the anti-malaria drug President Trump promoted in the early weeks of the pandemic.