“We Are Way, Way Behind”: U.S. Lags on Coronavirus Testing & Medical Experts Warn “No One Is Immune”

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: It’s been seven weeks since the first case of coronavirus was reported in the United States. Today we look at how the Trump administration has failed to account for what may be thousands of infections because of ongoing problems with access to testing. Here in the United States, the number of reported coronavirus infections jumped by 400 Thursday alone to about 1,650, but the actual number is believed to be far, far higher. Congress’s in-house doctor has privately told Capitol Hill staffers that he expects 70 million to 150 million people in the United States will contract the coronavirus.

Six states have announced plans to close all public schools: Oregon, Ohio, Michigan, Maryland, Kentucky and New Mexico. Schools in Houston, Texas, and near Seattle are also closing. Almost 5 million children are being impacted by the school closings.

All major sporting events in the United States have been halted. The NCAA has canceled the upcoming men and women’s college basketball tournaments known as March Madness. Disney has shuttered all its theme parks around the world, including Disney World in Florida. New York state has banned public gatherings of more than 500 people. Broadway has shut down. On Thursday, New York City Mayor Bill de Blasio declared a state of emergency as the number of confirmed cases in the city jumped from 42 to 95 in a single day.

MAYOR BILL DE BLASIO: Again, these overall numbers are striking and troubling. We now — and even compared to this morning, we’ve seen a big jump. We now have 95 confirmed cases. That is 42 new since yesterday, so you can see the progression now.

AMY GOODMAN: Mayor de Blasio estimated New York could have a thousand cases of coronavirus by next week, and said, quote, “We’re getting into a situation where the only analogy is war,” unquote. The New York Times reports fewer than 2,000 people in New York have been tested. There have been just 11,000 tests throughout the United States. Compare this to what BBC is reporting: Nearly 20,000 people are being tested for coronavirus every day in South Korea alone.

At a congressional hearing Thursday on the coronavirus outbreak, Democratic Congressmember Debbie Wasserman Schultz of Florida pressed CDC Director Robert Redfield on the limited availability of coronavirus tests to medical workers who think they’ve been exposed. Redfield was unable to answer and then turned to National Institute of Health official Dr. Anthony Fauci for guidance. This is how Dr. Fauci, who’s the director of the National Institute of Allergy and Infectious Diseases, top member of Trump’s coronavirus task force, responded.

DR ANTHONY FAUCI: The system does not — is not really geared to what we need right now, what you are asking for. That is a failing.

REP. DEBBIE WASSERMAN SCHULTZ: A failing, yes.

DR ANTHONY FAUCI: It is a failing, let’s admit it.

REP. DEBBIE WASSERMAN SCHULTZ: Very much so.

DR ANTHONY FAUCI: The fact is, the way the system was set up is that the public health component, that Dr. Redfield was talking about, was a system where you put it out there in the public, and a physician asks for it, and you get it.

REP. DEBBIE WASSERMAN SCHULTZ: OK.

DR ANTHONY FAUCI: The idea of anybody getting it easily, the way people in other countries are doing it, we’re not set up for that. Do I think we should be? Yes. But we’re not.

REP. DEBBIE WASSERMAN SCHULTZ: OK. That’s really disturbing, and I appreciate the information.

AMY GOODMAN: Dr. Fauci’s statement appeared to directly refute a claim President Trump made just last week.

PRESIDENT DONALD TRUMP: Anybody that needs a test gets a test. They’re there. They have the test.

AMY GOODMAN: “Anybody who wants a test gets a test.” That’s what President Trump said. This comes as the Trump administration’s coronavirus task force has gone two days with no press briefings, and the World Health Organization has officially classified the coronavirus outbreak as a pandemic.

For the rest of the hour, we’re joined by two guests. In Baltimore, Justin Lessler is with us. He’s associate professor at the Johns Hopkins Bloomberg School of Public Health, senior author on a new study that suggests the median incubation period for the new coronavirus is about five days. And joining us from Stanford University, which is now closed to students on campus — it’s got online learning — Dr. Steven Goodman is with us, associate dean at Stanford Medical School, where he’s also a professor of epidemiology and population health and medicine — oh, and he’s also my brother. He joins us from Stanford University. Yes, they are continuing, like Johns Hopkins, to hold their classes online over concerns about COVID-19.

We welcome you both to Democracy Now! Steve, let’s begin with you. I consider you my lifeline on issues like this, and that’s why we called you. Why don’t we start by this issue of testing. It is absolutely astounding that in countries like South Korea, where we hear the tests are something like 20,000 a day, in this country it is believed that there have only been 11,000 tests over the entire period of this outbreak. How is this possible? What happened?

DR. STEVEN GOODMAN: Well, I don’t know all the details of what happened, but it is clear that there were decisions that were made centrally about what tests to use and restrictions on who could do the test. That has been changed. And finally, other laboratories, including one at Stanford, have finally been authorized to develop and now deliver their own tests. So the original decisions to use a U.S.-specific test, not the one that was suggested by the WHO, which has been used in many, many other countries, in retrospect, obviously, was a big mistake. And we had trouble manufacturing and distributing a valid test centralized at the CDC.

AMY GOODMAN: I mean, this is the critical

DR. STEVEN GOODMAN: But now that we have —

AMY GOODMAN: This is the critical issue, right? I mean, there was a test available. It was the World Health Organization test, the one that countries all over the world are using now. But the CDC made a decision not to accept that test. They made their own test, sent it out, and it was faulty.

DR. STEVEN GOODMAN: That’s right. So now we’re having to depend on the many labs around the country and commercial laboratories to develop and offer this test. We are really just gearing up now for that. The Stanford test, which is the one that’s being used regionally, also for a variety of medical institutions, I think this week they were offering between 200 and 300 a day. They say that next week they’ll be up to about a thousand a day. That obviously is not remotely enough to track where the epidemic is going, but that’s what we have right now regionally. Nationally, I don’t know what the capacity is, but, as Dr. Fauci said, we are way, way behind.

AMY GOODMAN: Well, let’s bring Professor Justin Lessler into this conversation, from Hopkins, from Johns Hopkins. Let’s talk about why testing is so important. Why is it so important that we know in this country where the disease is, where the outbreak is? Why is it important to know the number?

JUSTIN LESSLER: I mean, this is our ability to have situational awareness about what’s going on with the virus, where it is, how to react. So, you know, the most extreme measures that we take to combat the virus, essentially, potentially closing whole cities down, like they did in China or Italy, we don’t want to do those in places where there isn’t a lot of — you know, there isn’t actually a lot of disease. And we don’t want to wait ’til the hospitals are filling up with dead people to do this, because then it’s sort of too late. So, we want to react in time. And that means we need testing, and that means we need to be testing with the right intention.

I think there is still some inertia towards trying to test people who have traveled, etc., with the idea that we’re going to go around those people and contain and trace their contacts and try to find those chains of transmission. But I think we maybe need to rethink that, with the idea that what we really want is situational awareness about what’s going on in the community and what silent outbreaks might be happening, so that we can respond accordingly in our public health measures.

AMY GOODMAN: And in terms of people isolating themselves, Dr. Steve Goodman, if you can talk about what it means not to have a test, so you don’t know even if you’ve been exposed to someone who has tested positive? And also, isn’t it true that these tests at this point, in most cases, take days to get results, although there are some that are now being developed that simply take hours? But what it means for people protecting the community?

DR. STEVEN GOODMAN: Well, as Justin said, people don’t actually know what the threat is. They don’t know how many people around them have the disease, and they don’t know, obviously, whether they themselves have the disease, if they have been exposed. So it’s very, very difficult for either public health authorities to calibrate the response properly, as Justin just described, or individuals to calibrate their own actions.

And I also want to point out that when we talk about self-isolation or anything that an individual can do, the paradigm really has to be not just what can I do to protect myself, but what can we each do to protect each other. And the act of self-isolation is not just individual protection. It is protecting everybody you’re in contact with. But to know how extreme the behavior should be, whether you should not go to a park, whether you should not go to the store, is very much driven by your awareness, as Justin described as situational awareness, of how many cases there are, often silent cases, in your own community, in your own neighborhood, going to your own stores. So this decision, this personal decision, has social and health consequences. But without testing, we’re flying blind.

AMY GOODMAN: I want to go to the issue of coronavirus, and if you could talk about the difference, Steve, or what the language is — coronavirus, COVID-19 — for people to understand. Explain that, the lexicon there of this disease, and also how it compares to the flu. President Trump has repeatedly tried to say that the flu kills tens of thousands of people. He said, “Who knew the flu killed?” It actually turns out that his grandfather, Frederick Trump, died of the flu in this country at a young age. But he tried to use it to show, you know, coronavirus doesn’t even compare. So talk about both, the language we use and what it means in comparison with the flu.

DR. STEVEN GOODMAN: Well, COVID-19 is the name of the disease, not the virus specifically. And what we’re most concerned about is obviously the spread of the disease.

Let me talk about the flu. And the flu is a big killer, and it does infect many people. I think we have roughly in the range of 15 million to 20 million in this season alone in the United States, with a roughly one in a thousand death rate, so in the range of 15,000 to 20,000 deaths from the flu. So, a flu is very, very serious. But that represents roughly 5 to 7% of the U.S. population. And the reason it doesn’t represent more is because both we have flu shots and we have years, decades of sort of cross-reactive immunity built up over people who have been exposed to different virus strains.

The difference with this virus is two. First of all, no one is immune. So, in theory, 100% of the population is susceptible to this virus, or very close to it. The second part is the fatality rate, either for people who present to the medical care system sick enough to go to a doctor or per infection, which is something different because not everybody who is infected necessarily goes to a doctor, looks to be a fair bit higher than the flu, maybe on the order of five times, maybe even 10 times higher than the flu. So we have maybe a much, much larger reservoir of susceptible people, on the order of 10 to 20 times larger, and we have a fatality rate that is between five and 10 times larger. So that’s why the potential for this, even though we have a tiny fraction of the cases and deaths right now, why we’re taking the extreme measures that we are taking.

Now, all that said, a lot — the fatality rate can be affected by what we do. And that’s why we’re doing it now, because the fatality rate is a function both of the age of the people who are infected but also of the capability of the medical care system to take care of them. So, if we can protect the medical care system — that is, keep the number of patients coming in at a rate that they can be cared for, with adequate ICU beds and ventilators, etc., and also healthy medical care folks — we can keep the fatality rate low, or at least lower than it would have been without that.

AMY GOODMAN: We’re going to break, then come back to this discussion. We’re going to talk about strategies to keep yourself and your family healthy, what to say to children — both of you, Dr. Goodman and Dr. Lessler, have children — how you’re talking to them about what could be, to say the least, extremely frightening for them, as it is for the whole population. And I want to ask Dr. Lessler about the study he did in China, comparing Wuhan and how it dealt with the coronavirus with a community right next door. We’re talking to Dr. Steven Goodman. He is associate dean of the Stanford Medical School, and Justin Lessler, Johns Hopkins Bloomberg School of Public Health associate professor. This is Democracy Now! We’ll be back with them in a minute.

[break]

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» “We Are Way, Way Behind”: U.S. Lags on Coronavirus Testing & Medical Experts Warn “No One Is Immune” | Democracy Now | Radio Free | https://www.radiofree.org/2020/03/13/we-are-way-way-behind-u-s-lags-on-coronavirus-testing-medical-experts-warn-no-one-is-immune/ | 2021-09-22T01:47:31+00:00
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