WHITE HOUSE WATCH COMMENTARY: VIRUS TESTING FINALLY REACHES ‘BLUEPRINT’ STAGE

By Denny Gulino

WASHINGTON (MaceNews) – Even as the stock market and the White House look for better times ahead and soon, corona virus risks for older Americans seem to be increasing.

By the end Thursday of a single month in which more than 50,000 Americans have died already, the total will have topped 60,000.

Now the IHME, which generates projections used by the White House Corona Virus Task Force, was forced Monday night to raise its estimate of the ultimate total deaths by early August to more than 74,000. Its director says that may well be revised higher as more states encourage fewer people to stay at home.

A month ago the projection was for 80,000 ultimate deaths if social distancing was maintained that long. Then, as physical isolation was embraced by most Americans, particularly in the hard-hit New York City metro area, the projection was revised to see only about 60,000 deaths, then back up to nearly 67,000 and now heading back closer to that 80,000.

Depicted on the chart at https://covid19.healthdata.org/projections of the Institute for Health Metrics and Evaluation the deaths – that were fewer than 5,000 on March 31 – accumulate to a plateau that levels out in the summer. The 74,000 projection is a midpoint. The top of the range is more than 130,000 by Aug. 4

Most of those fatalities will continue to be seniors. The carriers will be those without symptoms. That group of mostly asymptomatic carriers is predominantly younger people, aka students. So you might want to keep students for the time being out of school where they can infect each other.

With reopening and economic recovery now the president’s main theme, with a side order of testing reassurance, as in, “Testing is not going to be a problem at all,” he went another step Monday evening.

“Not a long way to go in the school system right now for this season, for this year,” President Trump said, “but I think you’ll see a lot of schools open up even if it’s for a very short period of time.  I think it would be a good thing.” 

Having seen first Georgia and now several other states eager to ignore the White House advice to wait until new virus cases trend down for two weeks before reopening even partially, the president is nevertheless increasing the emphasis on normalization. Still many governors and most medical experts keep insisting that emphasis is premature.

“In terms of what this vicious virus goes after, young people seem to do very well,” Trump continued. “Young people seem to do very well.”

Knowing that it will be much harder for people to return to the job if there is no school available, his new focus on school reopening fits the new program.
 
“So I know that there are some governors that aren’t necessarily ready to open up their states, but they may be ready to open up their school systems,” he said. “We’ll see.”

He did add, “That’s their choice. But the word is “safety.” 

Grim numbers and at the White House, one more presidential news conference that resembled the old pattern, lots of President Trump and not much Task Force.

The event in the Rose Garden featured pharmacy and laboratory executives, talking about what’s ahead and complimenting the president in the process.

The message that came through, however, was that after all this time the U.S. testing regime is still largely still in the “blueprint” stage.

The executives in the Rose Garden were, for Vice President Mike Pence, evidence of the “public-private partnership” that will make testing much more widely available, so that up to 2% of the population of each state can be tested each week. But not for a while longer.

Asked one more time how he could have been so far off when promising weeks ago that millions of test kits were being distributed, Pence again explained that test kits that were distributed were in no way related to the number of tests administered.

Now we know that those test kits were for a slow process that is unsuited for the job of testing on a large scale.

“But for the president’s leadership,” Pence said, “we’d still be waiting on those tests to be done in many cases, because they were tests that were designed to be run in the old laboratory model.”

Okay, that was then. But now?

Even the faster turnaround tests are not what is needed to gain control and containment. As the Task Force’s Deborah Birx said on a Sunday talk show, as pointed out in Sunday’s night’s White House Watch, it’s an “antigen test,” that will be needed, not the “antibody” or PCR/RNA test, the one being administered now in growing numbers.

What she said on NBC’s “Meet the Press” bears repeating: “The intent is to continue to scale with the support of states,” she said of ordinary testing, “but at the same time we have to realize that we have to have a breakthrough innovation in testing, we have to be able to detect antigen rather than constantly trying to detect the actual live virus or the viral particle itself and to really move into antigen testing.”

 She continued, “I know corporations and diagnostics are working on that now,” and, “We have to have a breakthrough. This RNA testing will carry us certainly through the spring and summer but we need to have a huge technology breakthrough and we’re working on that at the same time.”

So with an event dedicated to urging more reopening while reassuring about testing, one might expect the Monday night briefing would further elaborate on this third type of test, the antigen test. Instead Birx was given only a brief period in which to speak about the “plan” for testing. She did mention “antigen.” You had to listen hard to catch it.

“The plan includes an approach of using science and technology to develop even newer platforms, more efficient testing, really ensuring that the antibody tests that are utilized and recommended by both FDA and CDC have high quality and predicting both exposure to the virus and antibody development,” she said.

“And then, finally, working on innovative tests that could be high throughput and point-of-care — an antigen-based test or a point-of-care expanded nucleic acid test,” she said. 
 
Point-of-care is the kind of test that can be done in a doctor’s office or even with the newly approved home test kit. The “antigen” test is even more simple, returning a positive or negative while you wait.

So, to review. Initially there was a long pause during which the president was given several PDBs, otherwise known as the President’s Daily Brief, over several weeks which either didn’t sink in or were not even read. They warned of the spread of the virus from China, The Washington Post reported Monday.

Then as the threat became more tangible, the Centers for Disease Control chose not to adopt a China-developed test procedure to instead develop its own. When distributed it proved to be contaminated and had to be abandoned.

And then government and other public labs, having started over, distributed millions of test kits that were never administered and which would have taken too long to be practical anyway.

The commercial labs were then called in, developed their own tests, and now, according to the “blueprint” are distributing them around the nation so that up to 3 million of them can be administered a week by sometime in mid May.

Too bad about February, March and April.

Despite new guidelines that say testing should be in place, a two-week decline in new cases should have been completed, and states should wait until at least May 1, Georgia jumps the gun and partially reopens before May even arrives.

And now we learn from Dr. Birx that the tests we’re talking about are not the ultimate answer anyway. That would be the still-to-come antigen test.

Georgia’s reopening of non-essential businesses is being quickly followed by Florida, Tennessee, Colorado, Texas, Idaho, Iowa, Indiana, Louisiana, Montana, Mississippi, North Dakota, Ohio, South Carolina, Wyoming and Utah.

Finally, rather than impose some order from on high, the president Monday evening calls for schools to be reopened.

Is there anything wrong with this picture? If there is it is probably the absence of NIH veteran Tony Fauci. He’s made one of the past eight briefings. He’s been elsewhere for sure, but not as part of the briefings.

President Trump said, “No, I don’t agree” with Fauci’s view that testing needs to be ramped up and presumably disagrees that the virus will be back in the fall. Fauci also opined that no, Georgia should not reopen quite yet.

You, of course, already knew all that. You knew that perfection still eludes us and, as well, the White House and the states that are too early with their reopenings. But we’re learning. The virus keeps teaching us and we can hope the summer semester won’t be called “Second Wave 101.”

Contact this reporter: denny@macenews.com.

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