The post COVID Hospitalizations Dropping Nationwide first appeared on Garner Ted Armstrong Evangelistic Association.

Helge Braun, the head of Angela Merkel’s Chancellery, warns in an interview of a possible exponential rise in the number of coronavirus cases. He warns of the risk of long-term economic damage if Germany can’t keep the number of cases under control.

Helge Braun is the head of the German Chancellery – Foto: Andreas Chudowski / DER SPIEGEL

DER SPIEGEL: Mr. Braun, are we still in the beginning of the second wave of the coronavirus pandemic, or are we already in the middle of it?

Braun: We are currently seeing a widespread increase in infections, and we have experienced an extreme rise in large cities like Berlin and Bremen.

ANZEIGE

DER SPIEGEL: What do you intend to do?

Braun: We still need a mix of different measures. Generally, though, we can say that the freedoms we had over the summer can’t be fully maintained throughout autumn and winter. Overall, the caution among the populace needs to rise again. At the same time, we have to proceed with precision in individual hotspots and impose temporary restrictions, an approach we have had good experiences with so far. We are more concerned about the development in individual large cities where there is a diffuse infection pattern. We need determination.

DER SPIEGEL: Meaning?

Braun: In cities like Berlin, it’s not about limiting or slowing down the increase. Rather, the goal has to be quite clear: to return to an incidence rate below 50 – meaning significantly less than 50 new infections per 100,000 inhabitants in a week.

DER SPIEGEL: Is the Berlin city-state government acting with enough urgency?

Braun: I have decided not to give individual grades. But every mayor and every city council of an affected city must work hard to bring about a reversal. It will take 10 days, anyway, before the measures show an effect, but then these figures really must go down. And that requires determination. Expanded mask obligations don’t go far enough – there also have to be restrictions, particularly for celebrations and events, which are the most relevant driver of infections right now. A wedding in autumn 2020 cannot be a big wild celebration. It can be made up for next year.

DER SPIEGEL: Was our political leadership too careless? Did the summer create a false sense of security?

Braun: The development could not have been predicted in this way. When the travel season began, the numbers were low across the board. But this is what happened next: Our neighboring countries loosened things, even in places where the public health service isn’t as effective as here. The numbers shot up there very quickly – and that led to a renewed increase in cases here. In August, 50 percent of our infections were due to people who had traveled abroad. This, of course, created a bad starting point for the autumn.

DER SPIEGEL: You say that it couldn’t have been foreseen, but any layman could have predicted such a thing.

Braun: Once again: The figures weren’t just low in Germany – they were so low across all of Europe that there was simply no justification for prohibiting people from taking their summer holiday. Still, even then I was worried about the travel. It’s no secret that mobility is a major factor in the spread of a disease like this.

DER SPIEGEL: Do summer vacations, parties and weddings mean that schools and daycare centers will have to be closed again?

Braun: There is no reason to see things in such sweeping terms as was necessary in the first half of the year when we knew so little about the virus. We should avoid that at all costs. Educational institutions should be the last things to close, not the first.

DER SPIEGEL: This interview is taking place in Berlin’s Mitte district. If we wanted to travel from here, we wouldn’t be allowed to stay overnight in Bavaria, but we could in Bremen, given that many states have banned hoteliers and operators of other tourist accommodation facilities from hosting people from Berlin. How are people supposed to understand that?

Braun: On Wednesday, I had a long discussion with the chiefs of staff of German state governors about which measures are the right ones. It was important to me that not everyone draws their own conclusions. The ultimate result is the tourist accommodation ban, which is the milder remedy relative to entry bans and quarantine orders. Some states were opposed even after much wrangling, but a completely uniform approach wasn’t possible in this situation. We are all aware that it creates many problems.

DER SPIEGEL: Those wanting to travel despite the accommodation ban must present a negative coronavirus test result that is no older than 48 hours. Doesn’t that mean that tourists will be taking test capacity away from patients who need it?

Braun: The states and the federal government are urging people in risk areas to avoid traveling this autumn if possible. It’s clear, for example, that in Berlin districts with a high caseload, there isn’t enough capacity to allow all vacationers to take a test punctually before their departure. We have completely different priorities.

DER SPIEGEL: Where do those priorities lie?

Braun: Our focus right now is enabling people to continue working, keeping schools and training centers open, and keeping our health-care system functional. Everything else will have to take a back seat this autumn and winter. It won’t be easy, that is clear to me.

DER SPIEGEL: What prospects can you offer?

Braun: The signals coming from vaccine research are very optimistic. There is hope that we can gradually normalize everyday life next year. Before that, we have to be careful to ensure the economy doesn’t get into a situation like in the spring. It would be hit very hard and we would also have a great disadvantage compared with countries like China and South Korea, which have been very disciplined and are on the right track economically. You can see that positive economic developments and low infection rates go hand in hand.

DER SPIEGEL: But the economy also includes the tourism sector, in addition to things like catering, events, and culture. What about them?

Braun: These are the industries that are particularly affected at the moment. We have to help them through this difficult time with government support. It would be mistaken, however, to allow a kind of normality in those sectors that isn’t possible at the moment. That would only lead to the entire economy grinding to a halt.

DER SPIEGEL: Is it still even possible to prevent a loss of control?

Braun: Yes. But we are threatened by a second wave if we don’t act very quickly and very, very decisively now. This means that restrictions and rules also have to be enforced – through controls and heavy fines, for example. It’s not a trivial offense if restaurant guests don’t provide their contact details or enter made-up names and the health authorities then have to spend days trying to reconstruct infection chains that should actually be clear at a glance.

DER SPIEGEL: Does a curfew such as the one that has now been introduced in Berlin, where bars, restaurants, and stores must be closed between 11 p.m. and 6 a.m., really make sense?

Braun: Yes. I think it is right and important. We all know from experience that people become more carefree the more alcohol is involved. That’s why I think it’s good to stop at a certain time of day.

DER SPIEGEL: Doesn’t that drive people to places indoors where controls are no longer possible?

Braun: Basically, the most important thing in this crisis is the willingness of people to do their part and be careful. All I can do is appeal to each individual to not always think only about what is allowed and what is being checked, but rather to ask themselves: What can I do to protect myself most effectively? And how do I best help to prevent the spread of the disease and protect others who are at a higher risk of developing severe symptoms?

DER SPIEGEL: The president of the United States, who has himself been infected, says we shouldn’t let the virus control our lives. And German virologist Hendrik Streeck has warned against over-dramatizing it. Are German politicians exaggerating?

Braun during his interview with DER SPIEGEL journalists Christoph Hickmann and Martin Knobbe at the Chancellery in Berlin: “I am very, very optimistic that we will have a vaccine next year.” – Foto: Andreas Chudowski / DER SPIEGEL

Braun: A look abroad explains everything. In countries that have lost control of the number of infections, the economy is also suffering dramatically. And at some point, the health care system gets overwhelmed. No country can say: We can handle it. Ultimately, tough restrictions will come anyway.

DER SPIEGEL: Virologist Streeck says that even the almost 20,000 new infections per day predicted by Chancellor Angela Merkel would be manageable because it’s mostly younger people who are getting infected, for whom the symptoms are milder. Is he right?

Braun: Over the summer, it tended to be younger people who dared to go on vacation. Older people are much more cautious of their own accord and are less likely to become infected, which explains why we have so few serious cases at the moment. But when the infection rates get very high, it becomes increasingly difficult to protect the most vulnerable groups. And it increases the risk of infection, in nursing homes, for example. The idea that we can control infections when they get to high levels is wrong. So, we have a choice: Either we keep it low and the health authorities can handle it. Or we lose control, and the virus spreads very rapidly through the population.

DER SPIEGEL: The concept of herd immunity, meaning as many as possible must get sick in order to then be immune from the coronavirus, is off the table?

Braun: To stop the virus in this way, more than half of all Germans would have to go through the infection. Even if you had a period of one and a half years for that to happen, 80,000 people would have to be infected every day. In that case, I don’t think we would be able to say that our health-care system could easily cope with such a thing. If we had the feeling that it was hopeless anyway and that we would soon get a vaccine, then we could consider a different approach. But there is a real chance, and that’s why we have to keep infection rates low over the winter.

DER SPIEGEL: What number is going to make you really nervous? At what point can the curve no longer be reversed?

Braun: There isn’t a single number. What would be alarming is exponential growth because it would mean losing control of the chains of infection. We need to keep infections under control, meaning: We inform the contacts and send them into quarantine early enough that one person, at most, will infect one other person.

DER SPIEGEL: And if that’s not successful, there isn’t much else that can be done?

Braun: Then one person infects an average of three to five others and it goes up rapidly. That’s why what we have seen in Berlin Mitte in recent days, namely exponential growth, is really alarming.

DER SPIEGEL: How certain are you that we can actually hope for a vaccine next spring? We’ve heard before that a vaccine might even be ready this autumn.

Braun: You can’t promise anything. We can currently see that there are quite a number of vaccines that are already being tested on humans and that they actually deliver immunity. There can always be setbacks with individual vaccines, and not all of them will be approved. But given that there are so many and that the first companies are entering into the approval process, I am very, very optimistic that we will have a vaccine next year.

DER SPIEGEL: But that’s not the end of the story. At that point, as many as possible will need to be vaccinated.

Braun: Then it will certainly take several months before we get enough vaccine and administer it. We are already making logistical preparations, and we are addressing the question as to who should be vaccinated and when. We have commissioned the Standing Vaccination Commission at the Robert Koch Institute (Germany’s center for disease control) to answer these questions at an early stage together with the German National Academy of Sciences Leopoldina and the German Ethics Council.

DER SPIEGEL: So far, we have not seen higher than normal mortality through the coronavirus, so there haven’t been more deaths than usual in Germany, despite the pandemic. Is the virus less lethal than initially thought?

Braun: No, I don’t think so. Think of the images from the Heinsberg district (Eds: the first region in Germany to get hit heavily by the coronavirus) and the higher mortality rate at the time. In the meantime, our health-care system is doing exemplary work. In contrast to the beginning, we have comparatively fewer cases in retirement homes. And the elderly population is being extremely cautious. In addition, social distancing rules are also preventing all other autumnal infectious diseases from spreading rapidly.

DER SPIEGEL: You warned in an interview with DER SPIEGEL in March that the behavior of the population would be closely scrutinized. What is your appeal to Germans this fall?

Braun: I recall the chancellor’s appeal at the end of her budget speech: It’s up to all of us now. We cannot enjoy all the liberties this autumn and winter that we have enjoyed in other years. We have to be more careful. Then the world will look very different in the spring. And then there’s the chance that Germany will emerge really well from this crisis.

DER SPIEGEL: But isn’t it also possible that the coronavirus will be a crisis without end?

Braun: If we don’t maintain discipline this autumn and the economy collapses again, we will continue to feel the economic effects for a very long time. If that happens, the crisis will have a very long and sad end. That would be a terrible pity.

DER SPIEGEL: Could air purifiers help us get through the winter better?

Braun: Yes, we have launched a 500 million program for the conversion of filter systems, because modern filter systems in particular rely heavily on recirculated air. This can be very favorable for energy savings, but not so favorable for fighting viruses.

DER SPIEGEL: What about mass testing for the coronavirus?

Braun: Simply conducting blind testing doesn’t make sense in many places. There will now be rapid tests, but you also need medical personnel for them. And they carry a different meaning. They can determine if I am acutely contagious, but they can’t tell us if someone is infected and will only become contagious afterward. And even there, the capacities also won’t be unlimited this winter. That’s why they need to be prioritized for use in the health-care sector and in schools and daycare centers.

DER SPIEGEL: Do you wish you could go back to March, when the state governors were still making decisions in tandem with you and the chancellor? That’s no longer the case.

Braun: It is a constant struggle to find uniform standards. Not everything has to be the same, but it does need to be comparable. And we are still managing that for the most part.

DER SPIEGEL: Mr. Braun, we thank you for this interview.

Source: https://www.spiegel.de/international/germany/merkel-s-chief-of-staff-on-the-need-for-increased-coronavirus-restrictions-a-c0741a29-ea49-42af-82dd-35782c1cbbe0#ref=rss

The post “We Are Threatened By a Second Wave If We Don’t Act Very Quickly” first appeared on Garner Ted Armstrong Evangelistic Association.

The post Trump and Melania test positive for coronavirus first appeared on Garner Ted Armstrong Evangelistic Association.

White House chief of staff Mark Meadows said Friday that President Trump is experiencing “mild symptoms” of COVID-19 after the president and first lady Melania Trump tested positive for the novel coronavirus.

“As all of you know the president and the first lady tested positive for COVID-19,” Meadows told reporters at the White House Friday. “They remain in good spirits.”

PRESIDENT TRUMP, FIRST LADY TEST POSITIVE FOR CORONAVIRUS, SET TO QUARANTINE AT WHITE HOUSE

“The president does have mild symptoms, and as we look to try to make sure that not only his health and safety and welfare is good, we continue to look at that for all of the American people,” Meadows continued.

Meadows said that the president “continues, not only to be in good spirits, but very energetic.”

Still, Trump has not made any public appearances Friday. The president was scheduled to host a phone call on COVID-19 support to vulnerable seniors. But Fox News is told Vice President Mike Pence took over the call.

Meadows did not elaborate on the types of symptoms the president was experiencing, or any potential treatments the president’s medical team was reviewing. Meadows also did not share whether the first lady was experiencing symptoms.

Meadows said that he spoke to the president “a number of times” Friday morning and that he received “the normal five or six things he tells me to do every morning.”

“He is certainly wanting to make sure that we stay engaged,” Meadows said, adding that “it is critically important” for the doctors “to continue to monitor his health and the health of the first lady.”

“They’ll be glad to provide some updates later today as we look at this,” Meadows said, adding that the White House has “a number of contingency plans in place for this.”

WHITE HOUSE CORONAVIRUS ADVISER DR. SCOTT ATLAS SAYS ‘ZERO REASON TO PANIC’ OVER TRUMP POSITIVE COVID19 TEST

The chief of staff went on to tout the president for “staying committed to working very hard on behalf of the American people.”

“His first question to me this morning was, ‘How is the economy doing?’ ‘How are stimulus talks going on Capitol Hill?’” Meadows said.

Meadows added: “He is going to remain on the job and I am optimistic he will have a very speedy recovery.”

Meanwhile, Meadows said that the White House thought it was “important” to share the news of the president’s positive COVID-19 test as soon as possible.

“In the early hours of the morning, the minute we got a confirmatory test on the president, we felt it was important to get the news out there at that time,” Meadows said. “That’s why we sent out the tweet early this morning.”

The president, just before 1 a.m. Friday, tweeted: “Tonight, @FLOTUS and I tested positive for COVID-19. We will begin our quarantine and recovery process immediately.”

He added: “We will get through this TOGETHER!”

The post White House: Trump experiencing ‘mild symptoms’ after positive coronavirus test, ‘in good spirits’ first appeared on Garner Ted Armstrong Evangelistic Association.

The post Trump Just Announced a MASSIVE Expansion in our Nation’s COVID-19 Testing Capability! first appeared on Garner Ted Armstrong Evangelistic Association.

In the midst of the COVID-19 pandemic, contact tracing is downright buzzy, and not always in a good way.

Contact tracing is the public health practice of informing people when they’ve been exposed to a contagious disease. As it has become more widely employed across the U.S., it has also become mired in modern political polarization and conspiracy theories.

Misinformation abounds, from tales that people who talk to contact tracers will be sent to nonexistent “FEMA camps” — a rumor so prevalent that health officials in Washington state had to put out a statement in May debunking it — to elaborate theories that the efforts are somehow part of a plot by global elites, such as the Clinton Foundation, Bill Gates or George Soros.

At the very least, such misinformation could hinder efforts to contain the coronavirus, and at worst it has sparked threats against tracers, say some observers, including the Institute for Strategic Dialogue, a London-based organization that studies polarization.

The dynamic, ISD notes in a June report, “is being generated both by individual social media users and by key influencers in conspiratorial communities” and plays on fears that Big Brother is watching us.

According to that report, social media posts, mainly videos, have been associated with “widespread sharing of petitions and other efforts to galvanize political action against contact tracing.” The videos, steeped in disinformation and conspiracy think — whether alleging that tracers have ties to the deep state or casting them as part of a Democratic effort to interfere in the 2020 election — “are receiving more than 300,000 views each on YouTube and are being shared tens of thousands of times across public Facebook pages and groups.”

Of course, the real story behind tracing is nothing like these colorful conspiracy theories. Contact tracing is an age-old infection-control strategy, and it’s a bit tedious, actually.

“We’ve been doing it in public health for decades,” said Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials.

Part old-fashioned shoe-leather detective work, part social work, the goal is to interrupt the spread of the illness by reaching out to people who test positive — and the people they have been in close contact with — and provide needed support for them to isolate. It has to be done quickly, and it takes a lot of people. Recent case count surges in some parts of the country are making the task more difficult.

So let’s take a look at what it is and isn’t.

What’s the process?

When a person tests positive for certain communicable diseases, health care providers must report the person’s contact information to public health departments. Contact tracers then try to reach out quickly, generally by phone.

The tracer will ask for the patient’s address. Some social media sites have decried this as nefarious, but it’s not. The tracer does not want to provide private medical information — “Mr. Smith, I see you tested positive for COVID-19” — to the wrong person. Answering contact tracers’ questions is always optional, and those contacted should also feel free to confirm it really is the public health department calling, experts note, as there have been reports of fraudulent calls.

During the initial call, the tracer makes sure the patient is OK and understands the disease and what to expect. Ideally, the contact tracer builds a relationship with the patient. Some can link the patient with local resources or services, such as food delivery or needed medical supplies, that can make it easier to stay isolated until the patient has recovered from the virus.

What’s a close contact?

Contact tracers ask where the infected person traveled and with whom they came in close contact — generally defined as being within 6 feet for 15 minutes or more — from about two days before they started showing symptoms until they isolated themselves.

That does not include such things as simply passing people on the street or opening the door to pick up a package dropped off by a FedEx driver.

Providing the information is voluntary, but it is the only way the programs will work. Most patients happily comply, but a few are reluctant, said Plescia.

“That was a little surprising,” he said. “You would think if you might cause another person to become ill, you would have an interest in that person being notified. But some worry they are snitching on other people.”

Tracers do not disclose the name of the infected person to the contacts. Contacts simply “receive a call saying, ‘You have had a significant exposure,’ ” said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security and the co-author of a report on contact tracing.

To assist with tracing, some restaurants, stores, salons, and other businesses are keeping daily logs of customers. Some voices on social media have raised concerns about those logs, saying they are intrusive and suggest that Big Brother is watching. Their purpose, though, is to make it easier for health officials to notify other employees and patrons in the event that someone tests positive.

Close contacts are urged to quarantine for 14 days, check their temperature regularly, and avoid contact with other household members, if possible.

For each infected patient, tracers need to contact an average of 10 other people, said Watson — noting, however, that the number could be far higher. “If contact tracing is done in a place where there’s a big epidemic and no one is under social distancing restrictions, you’ll have to contact more,” she said.

Speed is of the essence in finding close contacts. Infected people start showing symptoms within two to seven days of exposure — although it can take up to 14 — and they may be contagious before symptoms appear.

Who is asking these questions?

In the early days of the COVID-19 pandemic in the U.S., tracing was limited because testing for the virus was also limited. The two really go together. That meant the nation used the other tool at its disposal, the blunt instrument of stay-at-home orders. Now, with testing more available and with many states in the fits and starts of reopening, the more targeted effort of contact tracing becomes important.

Used effectively, it can sharply slow outbreaks, as seen in countries that have employed comprehensive tracing programs, such Japan, New Zealand, and China.

So far, though, the U.S. has had a more limited effort, and it varies state by state.

An estimated 37,000 contact tracers are now employed by public health departments nationwide, triple the number just a few weeks ago, according to an NPR state survey and tracking effort. Still, those numbers are far below estimates of what many say is necessary. Indeed, Watson and other Hopkins researchers say the U.S. needs to add a minimum of 100,000 contact tracers.

Can they force me into quarantine?

Although health officials do have the authority to isolate people who pose a danger to others, that power is almost never used.

“Mandatory quarantine hasn’t really been used since the days of smallpox in this country, although the president used it in the beginning of the pandemic for some people repatriating back to the county,” said Watson.

Public health officials avoid such aggressive tactics because they don’t want to discourage people from getting tested. As for hauling people away from their homes by force, that also doesn’t happen here, although it does in some authoritarian countries. Instead, a number of cities and regions have set up special hotels or other facilities where infected or exposed people who live in homes where they can’t isolate themselves from other family members can voluntarily spend their convalescence.

Is contact tracing working?

It has certainly worked in other countries, said Howard Koh, professor at the Harvard T.H. Chan School of Public Health and former assistant secretary for health in the Obama administration.

“Italy, Spain, China, Taiwan, Hong Kong, and New Zealand have all gotten to the other side of the curve,” said Koh. “When they have outbreaks, they are relatively small, and they jump on them right away.”

One difference, he said, is those places have a national strategy.

“In our country, we have a 50-state strategy, a patchwork response including contact tracing, with some states having embraced it and some have barely started.”

Massachusetts and New York have reported success with tracing, said Watson.

But there are many areas of the country, especially the Sun Belt, where cases are spiking, complicating efforts to control the virus. With more demand for testing, the turnaround time for results grows. And large numbers of new cases mean contact tracers have far more people to track down, making it challenging to do so in the short time frame needed to be effective.

“I’m discouraged that a lot of the states where we are seeing a big surge right now have not put a lot of effort into developing their contact tracing workforce,” Watson said, echoing Koh’s call for a national plan. “We need an initiative by the federal government focused on contact tracing.”

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation and is not affiliated with Kaiser Permanente.

Source: https://www.npr.org/sections/health-shots/2020/07/14/890628203/conspiracy-theories-aside-heres-what-contact-tracers-really-do

The post Conspiracy Theories Aside, Here’s What Contact Tracers Really Do first appeared on Garner Ted Armstrong Evangelistic Association.

GETTY / THE ATLANTIC

Editor’s Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.

The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.

Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.

The widespread use of the practice means that it remains difficult to know exactly how much the country’s ability to test people who are actively sick with COVID-19 has improved.

Read: There’s one big reason the U.S. economy can’t reopen

“You’ve got to be kidding me,” Ashish Jha, the K. T. Li Professor of Global Health at Harvard and the director of the Harvard Global Health Institute, told us when we described what the CDC was doing. “How could the CDC make that mistake? This is a mess.”

Viral tests, taken by nose swab or saliva sample, look for direct evidence of coronavirus infection. They are considered the gold standard for diagnosing someone with COVID-19, the disease caused by the virus: State governments consider a positive viral test to be the only way to confirm a case of COVID-19. Antibody tests, by contrast, use blood samples to look for biological signals that a person has been exposed to the virus in the past.

A negative test result means something different for each test. If somebody tests negative on a viral test, a doctor can be relatively confident that they are not sick right now; if somebody tests negative on an antibody test, they have probably never been infected with or exposed to the coronavirus. (Or they may have been given a false result—antibody tests are notoriously less accurate on an individual level than viral tests.) The problem is that the CDC is clumping negative results from both tests together in its public reporting.

Read: Pools will test the limits of social distancing

Mixing the two tests makes it much harder to understand the meaning of positive tests, and it clouds important information about the U.S. response to the pandemic, Jha said. “The viral testing is to understand how many people are getting infected, while antibody testing is like looking in the rearview mirror. The two tests are totally different signals,” he told us. By combining the two types of results, the CDC has made them both “uninterpretable,” he said.

The public-radio station WLRN, in Miami, first reported that the CDC was mixing viral and antibody test results. Pennsylvania’s and Maine’s decisions to mix the two tests have not been previously reported.

Kristen Nordlund, a spokesperson for the CDC, told us that the inclusion of antibody data in Florida is one reason the CDC has reported hundreds of thousands more tests in Florida than the state government has. The agency hopes to separate the viral and antibody test results in the next few weeks, she said in an email.

But until the agency does so, its results will be suspect and difficult to interpret, says William Hanage, an epidemiology professor at Harvard. In addition to misleading the public about the state of affairs, the intermingling “makes the lives of actual epidemiologists tremendously more difficult.”

“Combining a test that is designed to detect current infection with a test that detects infection at some point in the past is just really confusing and muddies the water,” Hanage told us.

Read: Why the coronavirus is so confusing

The CDC stopped publishing anything resembling a complete database of daily test results on February 29. When it resumed publishing test data last week, a page of its website explaining its new COVID Data Tracker said that only viral tests were included in its figures. “These data represent only viral tests. Antibody tests are not currently captured in these data,” the page said as recently as May 18.

Yesterday, that language was changed. All reference to disaggregating the two different types of tests disappeared. “These data are compiled from a number of sources,” the new version read. The text strongly implied that both types of tests were included in the count, but did not explicitly say so.

The CDC’s data have also become more favorable over the past several days. On Monday, a page on the agency’s website reported that 10.2 million viral tests had been conducted nationwide since the pandemic began, with 15 percent of them—or about 1.5 million—coming back positive. But yesterday, after the CDC changed its terms, it said on the same page that 10.8 million tests of any type had been conducted nationwide. Yet its positive rate had dropped by a percent. On the same day it expanded its terms, the CDC added 630,205 new tests, but it added only 52,429 positive results.

This is what concerns Jha. Because antibody tests are meant to be used on the general population, not just symptomatic people, they will, in most cases, have a lower percent-positive rate than viral tests. So blending viral and antibody tests “will drive down your positive rate in a very dramatic way,” he said.

The absence of clear national guidelines has led to widespread confusion about how testing data should be reported. Pennsylvania reports negative viral and antibody tests in the same metric, a state spokesperson confirmed to us on Wednesday. The state has one of the country’s worst outbreaks, with more than 67,000 positive cases. But it has also slowly improved its testing performance, testing about 8,000 people in a day. Yet right now it is impossible to know how to interpret any of its accumulated results.

Read: Should you get an antibody test?

Texas, where the rate of new COVID-19 infections has stubbornly refused to fall, is one of the most worrying states (along with Georgia). The Texas Observer first reported last week that the state was lumping its viral and antibody results together. On Tuesday, Governor Greg Abbott denied that the state was blending the results, but the Dallas Observer reports that it is still doing so.

While the number of tests per day has increased in Texas, climbing to more than 20,000, the combined results mean that the testing data are essentially uninterpretable. It is impossible to know the true percentage of positive viral tests in Texas. It is impossible to know how many of the 718,000 negative results were not meant to diagnose a sick person. The state did not return a request for comment, nor has it produced data describing its antibody or viral results separately. (Some states, following guidelines from the Council of State and Territorial Epidemiologists, report antibody-test positives as “probable” COVID-19 cases without including them in their confirmed totals.)

Georgia is in a similar situation. It has also seen its COVID-19 infections plateau amid a surge in testing. Like Texas, it reported more than 20,000 new results on Wednesday, the majority of them negative. But because, according to The Macon Telegraph, it is also blending its viral and antibody results together, its true percent-positive rate is impossible to know. (The governor’s office did not return a request for comment.)

These results damage the public’s ability to understand what is happening in any one state. On a national scale, they call the strength of America’s response to the coronavirus into question. The number of tests conducted nationwide each day has more than doubled in the past month, rising from about 147,000 a month ago to more than 413,000 on Wednesday, according to the COVID Tracking Project at The Atlantic, which compiles data reported by state and territorial governments. In the past week, the daily number of tests has grown by about 90,000.

At the same time, the portion of tests coming back positive has plummeted, from a seven-day average of 10 percent at the month’s start to 6 percent on Wednesday.

“The numbers have outstripped what I was expecting,” Jha said. “My sense is people are really surprised that we’ve moved as much as we have in such a short time period. I think we all expected a move and we all expected improvement, but the pace and size of that improvement has been a big surprise.”

The intermingling of viral and antibody tests suggests that some of those gains might be illusory. If even a third of the country’s gain in testing has come by expanding antibody tests, not viral tests, then its ability to detect an outbreak is much smaller than it seems. There is no way to ascertain how much of the recent increase in testing is from antibody tests until the most populous states in the country—among them Texas, Georgia, and Pennsylvania—show their residents everything in the data.

ALEXIS C. MADRIGAL is a staff writer at The Atlantic and the author of Powering the Dream: The History and Promise of Green Technology.

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ROBINSON MEYER is a staff writer at The Atlantic, where he covers climate change and technology.

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Source: https://www.theatlantic.com/health/archive/2020/05/cdc-and-states-are-misreporting-covid-19-test-data-pennsylvania-georgia-texas/611935/

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The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.

Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.

The widespread use of the practice means that it remains difficult to know exactly how much the country’s ability to test people who are actively sick with COVID-19 has improved.

Read: There’s one big reason the U.S. economy can’t reopen

“You’ve got to be kidding me,” Ashish Jha, the K. T. Li Professor of Global Health at Harvard and the director of the Harvard Global Health Institute, told us when we described what the CDC was doing. “How could the CDC make that mistake? This is a mess.”

Viral tests, taken by nose swab or saliva sample, look for direct evidence of a coronavirus infection. They are considered the gold standard for diagnosing someone with COVID-19, the disease caused by the virus: State governments consider a positive viral test to be the only way to confirm a case of COVID-19. Antibody tests, by contrast, use blood samples to look for biological signals that a person has been exposed to the virus in the past.

A negative test result means something different for each test. If somebody tests negative on a viral test, a doctor can be relatively confident that they are not sick right now; if somebody tests negative on an antibody test, they have probably never been infected with or exposed to the coronavirus. (Or they may have been given a false result—antibody tests are notoriously less accurate on an individual level than viral tests.) The problem is that the CDC is clumping negative results from both tests together in its public reporting.

Read: Pools will test the limits of social distancing

Mixing the two tests makes it much harder to understand the meaning of positive tests, and it clouds important information about the U.S. response to the pandemic, Jha said. “The viral testing is to understand how many people are getting infected, while antibody testing is like looking in the rearview mirror. The two tests are totally different signals,” he told us. By combining the two types of results, the CDC has made them both “uninterpretable,” he said.

The public-radio station WLRN, in Miami, first reported that the CDC was mixing viral and antibody test results. Pennsylvania’s and Maine’s decisions to mix the two tests have not been previously reported.

Kristen Nordlund, a spokesperson for the CDC, told us that the inclusion of antibody data in Florida is one reason the CDC has reported hundreds of thousands more tests in Florida than the state government has. The agency hopes to separate the viral and antibody test results in the next few weeks, she said in an email.

But until the agency does so, its results will be suspect and difficult to interpret, says William Hanage, an epidemiology professor at Harvard. In addition to misleading the public about the state of affairs, the intermingling “makes the lives of actual epidemiologists tremendously more difficult.”

“Combining a test that is designed to detect current infection with a test that detects infection at some point in the past is just really confusing and muddies the water,” Hanage told us.

Read: Why the coronavirus is so confusing

The CDC stopped publishing anything resembling a complete database of daily test results on February 29. When it resumed publishing test data last week, a page of its website explaining its new COVID Data Tracker said that only viral tests were included in its figures. “These data represent only viral tests. Antibody tests are not currently captured in these data,” the page said as recently as May 18.

Yesterday, that language was changed. All reference to disaggregating the two different types of tests disappeared. “These data are compiled from a number of sources,” the new version read. The text strongly implied that both types of tests were included in the count, but did not explicitly say so.

The CDC’s data have also become more favorable over the past several days. On Monday, a page on the agency’s website reported that 10.2 million viral tests had been conducted nationwide since the pandemic began, with 15 percent of them—or about 1.5 million—coming back positive. But yesterday, after the CDC changed its terms, it said on the same page that 10.8 million tests of any type had been conducted nationwide. Yet its positive rate had dropped by a percent. On the same day it expanded its terms, the CDC added 630,205 new tests, but it added only 52,429 positive results.

This is what concerns Jha. Because antibody tests are meant to be used on the general population, not just symptomatic people, they will, in most cases, have a lower percent-positive rate than viral tests. So blending viral and antibody tests “will drive down your positive rate in a very dramatic way,” he said.

The absence of clear national guidelines has led to widespread confusion about how testing data should be reported. Pennsylvania reports negative viral and antibody tests in the same metric, a state spokesperson confirmed to us on Wednesday. The state has one of the country’s worst outbreaks, with more than 67,000 positive cases. But it has also slowly improved its testing performance, testing about 8,000 people in a day. Yet right now it is impossible to know how to interpret any of its accumulated results.

Read: Should you get an antibody test?

Texas, where the rate of new COVID-19 infections has stubbornly refused to fall, is one of the most worrying states (along with Georgia). The Texas Observer first reported last week that the state was lumping its viral and antibody results together. On Tuesday, Governor Greg Abbott denied that the state was blending the results, but the Dallas Observer reports that it is still doing so.

While the number of tests per day has increased in Texas, climbing to more than 20,000, the combined results mean that the testing data are essentially uninterpretable. It is impossible to know the true percentage of positive viral tests in Texas. It is impossible to know how many of the 718,000 negative results were not meant to diagnose a sick person. The state did not return a request for comment, nor has it produced data describing its antibody or viral results separately. (Some states, following guidelines from the Council of State and Territorial Epidemiologists, report antibody-test positives as “probable” COVID-19 cases without including them in their confirmed totals.)

Georgia is in a similar situation. It has also seen its COVID-19 infections plateau amid a surge in testing. Like Texas, it reported more than 20,000 new results on Wednesday, the majority of them negative. But because, according to The Macon Telegraph, it is also blending its viral and antibody results together, its true percent-positive rate is impossible to know. (The governor’s office did not return a request for comment.)

These results damage the public’s ability to understand what is happening in any one state. On a national scale, they call the strength of America’s response to the coronavirus into question. The number of tests conducted nationwide each day has more than doubled in the past month, rising from about 147,000 a month ago to more than 413,000 on Wednesday, according to the COVID Tracking Project at The Atlantic, which compiles data reported by state and territorial governments. In the past week, the daily number of tests has grown by about 90,000.

At the same time, the portion of tests coming back positive has plummeted, from a seven-day average of 10 percent at the month’s start to 6 percent on Wednesday.

“The numbers have outstripped what I was expecting,” Jha said. “My sense is people are really surprised that we’ve moved as much as we have in such a short time period. I think we all expected a move and we all expected improvement, but the pace and size of that improvement has been a big surprise.”

The intermingling of viral and antibody tests suggests that some of those gains might be illusory. If even a third of the country’s gain in testing has come by expanding antibody tests, not viral tests, then its ability to detect an outbreak is much smaller than it seems. There is no way to ascertain how much of the recent increase in testing is from antibody tests until the most populous states in the country—among them Texas, Georgia, and Pennsylvania—show their residents everything in the data.

Source: https://www.theatlantic.com/health/archive/2020/05/cdc-and-states-are-misreporting-covid-19-test-data-pennsylvania-georgia-texas/611935/

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Britons should wear face coverings in enclosed public places and workers in England will be “actively encouraged” to return to work if they cannot work from home, according to new advice laid out by Prime Minister Boris Johnson set to come into effect Wednesday.

Johnson described the steps as part of the country’s “first careful measures” to lift the coronavirus lockdown. There will no longer be a limit on how much time people can spend exercising outside in England, and they can also meet someone from another household outside while observing social distancing.

The easing of restrictions is the first phase of a plan that would see schools and non-essential shops remain closed until June at the earliest, and bars and restaurants potentially reopening in July, provided there is no rise in infections. “Our challenge now is to find a way forward that preserves our hard-won gains, while easing the burden of the lockdown,” Johnson told Parliament on Monday.

The plans, part of a 60-page government document released Monday, were welcomed by some in the country who had called for a prompt reopening of the economy.

But they were also quickly condemned as both confusing and inappropriate by many others. While other European countries have offered clear roadmaps for moving out of lockdown, the U.K. government’s messaging has been mixed, experts say. Britain has the world’s second-highest confirmed the coronavirus death toll, at 32,141, and the worst in Europe. Some epidemiologists said the decision seemed to be based more on economics than public health and risks a new spike in infections.

Mixed messages?

Johnson gave a press conference on Monday from a podium bearing the words “stay alert, control the virus, save lives” — the new government slogan, replacing the one used since the start of the pandemic, which read “stay home, protect the NHS [National Health Service], save lives.”

Divisions were immediately apparent. The leaders of Scotland, Wales and Northern Ireland — all nations within the United Kingdom with the power to set their own health policy — said many of the relaxed measures would not apply outside of England, including the advice that people should return to work.

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Scotland’s First Minister Nicola Sturgeon criticized Johnson for retiring “stay home” from the government’s official messaging. She said her government would not be doing the same because it would be “catastrophic” to do so. “I am particularly not prepared to [drop] it in favor of a message that is vague and imprecise,” she said at a press conference on Monday.

Mayors of cities in England raised concerns too. “I don’t feel it’s right for the north of England right now,” Andy Burnham, the opposition Labour Party mayor of Greater Manchester, told TIME on Tuesday. Burnham, who was the U.K.’s Health Secretary during the swine flu epidemic of 2009, also criticized Johnson’s movement away from the “stay home” message. “The move to this new messaging exposes the North of England to greater levels of risk,” he said.

“I didn’t like the way it was done, because it was announced on a Sunday night without any meaningful consultation with us,” Burnham added. “Obviously a change in messaging of that nature has a direct impact on policing, on transport, and it’s very difficult to hear that on a Sunday night without being able to plan ahead for the impact that change will have on our city region.”

Trade unions also raised concerns about the safety of people who the government now says should return to work. In his statement on Monday, Johnson urged individuals to “talk to their employers” about their safety and individual circumstances. But the government only released sector-specific guidance on how to make sure safe measures were in place on Tuesday, less than a day before people were “urged” to go back to work.

“[It is] impossible to act on new rules overnight,” wrote Frances O’Grady, head of the Trades Union Congress, a large grouping of unions, on Twitter. “This isn’t how to ensure a safe, careful return to work outside the home,” she added.

“Some people are being put under pressure to return to work,” Burnham tells TIME. “I called for a safety-led release from lockdown, and I don’t think this equates to that.”

Listening to the science?

Speaking to parliament on Monday, Johnson said his government “will be driven not by hope or economic revival as an end in itself, but by data, and science and public health.”

The government’s new plans rely on keeping the reproduction number (how many people the average infected person infects, also known as “R”) below one. If that number, currently between 0.5 and 0.9, rises above one, the government says it could be forced to reimpose lockdown measures.

But some public health experts challenged the government line that the new government advice stems from listening to science, data, and public health experts. “The wording stems from a particular kind of policy drive, which is to try to get people back to work,” says Robert West, a professor of health psychology at University College London. “If the government genuinely thinks this kind of messaging can be enacted without increasing the infection rate, they’re simply not listening to the science.”

That’s because West says, the reproduction number is impossible to know until several days, if not weeks, after the fact. “The government says it can monitor this, and if it sees R going up it will reverse this policy. The problem is, as we know from the early stage of the pandemic, you won’t know whether that’s happening until it’s too late.” In Germany, which eased its lockdown earlier this month when R dropped to 0.65, politicians are now warning measures may have to be reimposed after the figure increased to 1.1.

The U.K’s current R-value is estimated by the government to be between 0.5 and 0.9, a lower-resolution figure than Germany’s largely because of the differences in testing for COVID-19 between the two countries. Germany has been testing more than 100,000 people per day for months, giving it a better idea of the exact scale of the disease. By contrast, the U.K. has struggled to roll out large-scale testing. A shortage of tests meant that for months, only the most severe cases could be tested, with official government advice telling people with mild symptoms to remain at home without getting a test. That is starting to change now. Nevertheless, the government missed its original target of 100,000 tests per day by the end of April and remains a long way away from the new target set by Johnson of 200,000 daily tests by the end of May.

“At this stage, you’re in a huge amount of uncertainty,” says West. “We haven’t got the comprehensive testing of even large random samples which you would need.”

Another problem is that R likely varies wildly across different parts of the U.K., where regional outbreaks are proceeding at different paces. Burnham, the Mayor of Greater Manchester, which has one of the highest levels of new cases in England, is calling on the government to release regional R numbers, which it is not currently doing. “My worry is that the changes are driven more by some parts of the country than others,” he says. I don’t think people understand the level of [regional] difference. We believe if the public could see the R level more clearly, they would make their own judgments.”

Ultimately, says West, governments will be judged by their level of foresight in dealing with the coronavirus. “One of the biggest things you have to do in an epidemic like this is to shoot ahead of the moving target,” he says. “And all through this crisis, the government has been shooting directly at the target and missing.”

Please send any tips, leads, and stories to virus@time.com.

Source: https://time.com/5835793/uk-reopening-coronavirus/

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