Virus Slows in Some States But Testing Czar Warns of Undercount

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Testing shortcomings are making it more difficult to get a clear picture of the U.S. coronavirus pandemic, as case counts in some hot spots wane but health officials warn that new infections may be significantly undercounted.

The U.S. outbreak remains on a troubling trajectory. The country is on course to reach a total of four million infections, and deaths continue to hit records in some states. But new cases in Florida and Arizona are showing signs of slowing down after a surge that has jarred residents, businesses and policy makers and led President Donald Trump to resume daily briefings on the pandemic.

Still, a definitive picture of Covid-19’s spread in the U.S. remains elusive. Health and Human Services Assistant Secretary Brett Giroir, the country’s testing czar, told Fox News Thursday that while the nation is officially logging about 67,000 new cases a day, the reality is more likely about 200,000.

That’s twice the level of 100,000 that Anthony Fauci, the country’s top infectious disease expert, warned senators the country could reach early this month.

71,695 in U.S.Most new cases today

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According to an analysis by the nonprofit Kaiser Family Foundation, the majority of states qualify as hot spots -- about 36, accounting for more than 70% of the country’s population. The assessment is based on trends in case increases, positivity rates and new daily cases per million population.

Still, there’s some cause for cautious optimism that outbreaks in some states may be stabilizing. Arizona reported a slowing rate of increase of new cases on Thursday, and the rate at which tests returned positive results dropped to 26.7% from 30.5% on Wednesday. But the outbreak is still causing pain and suffering, with Florida posting record deaths on Thursday, and trends evening out are no guarantee of a rosy path ahead as the U.S. continues to grapple with inadequate public-health infrastructure that has hamstrung efforts to measure and mitigate the virus’s spread.

Briefings Return

Trump resumed his coronavirus briefings solo on Tuesday with a markedly different tone from earlier, when he downplayed the severity of the situation, berated governors and touted unproven treatments, including hydroxychloroquine and bleach.

Trump Reboots Virus Briefings With Warning and a Shift in Tone

“It will probably, unfortunately, get worse before it gets better,” Trump said.

It’s a perspective shared by Manisha Juthani, an infectious disease specialist at Yale School of Medicine.

“Things will get worse before they start getting better,” Juthani said Thursday. “Some areas are not hit very hard, while some are approaching catastrophic levels,” she said of hot-spot states like California, Texas and Florida.

As Giroir indicated, however, it’s hard to precisely assess the spread of the virus relying purely on the data. A surge in demand for testing has led to backlogs that have increased turnaround times in laboratories and left people in limbo, wondering if they’ve caught Covid-19.

Quest Diagnostics Inc. Chief Executive Steve Rusckowski said on Thursday that demand for the screenings has “soared” in recent weeks. However that’s led to lengthy turnaround times, driving down the effectiveness of testing in curbing the spread. Even for high-priority patients, results now take about two days. The lab giant has done about 20% of the country’s tests. It’s up to 130,000 diagnostic screenings a day and expects to reach 150,000 in the coming weeks, he said.

Over the weekend, Quest received the first Food and Drug Administration clearance for “pooled” testing, which allows for the processing of multiple patient samples at a time. While that will significantly expand the number of people tested, it’s most useful in areas with low virus prevalence, ideally “lower than 2%,” Rusckowski said. But nation-wide, about 10% of tests come back positive, according to a Centers for Disease Control and Prevention dashboard updated on Thursday, meaning it likely won’t be as helpful in many parts of the country curb their outbreaks.

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Other health executives also sounded cautious notes regarding testing.

Roche Holding Ag Chief Executive Officer Severin Schwan said in an interview with Bloomberg TV Thursday that even though the Swiss health-care giant has quadrupled its capacity to turn out various types of tests, there aren’t enough to go around and the world should be careful in how it uses the existing supply.

Gustavo Ferrer is a pulmonologist and critical care physician who runs an intensive care unit in the Miami area that’s at 120% capacity now due to the surge in Covid-19 in the region. While he said Thursday that he’s glad the president has taken a more serious tone about the virus, Americans should understand they’re entering a new normal.

“Normality is going to be abnormal for awhile,” Ferrer said.

While there have been many improvements since March, the surges in new cases since the Memorial Day holiday weekend show “clearly we are going in the wrong direction,” said Andrew Badley, head of Mayo Clinic’s Covid Research Task Force.

“We still have major challenges ahead,” Badley said.

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