Work on a vaccine is underway

Over the weekend, President Trump’s tweets indicated he may be abandoning the daily briefings offered his White House Coronavirus Task Force.  If you’ve been diligently watching the briefings, as we have, you may be relieved to learn this.  While a wide variety of health policy experts and senior members of the administration have shared valuable information and updates on the governments’ massive efforts to combat the virus, the briefings have become far too partisan and combative. 

We’re now many weeks into this pandemic and the fundamental challenge remains the same.  There is simply not enough testing happening to identify: those who were infected and are currently ill; those who were infected, were only mildly symptomatic and recovered; those who were infected and who were completely asymptomatic; and those who have not been exposed at all. 

New Cases
The Institute for Health Metrics and Evaluation (IHME) at the University of Washington posits that, in order to corral Covid-19, states need to keep the rate of new cases of infection per day below one per million people.  In Washington, which has a population of 7.6 million people, new cases per day need to be below 8.  In Oregon, which has population of 4.2 million, new cases per day need to be below 4.  In California, which has a population of nearly 40 million, new cases per need to be below 40.  Only a handful of states would meet the IHME threshold.  To put things in perspective, yesterday The Washington State Department of HealthThe Washington State Department of Health reported 202 cases, the Oregon Health AuthorityOregon Health Authority reported 58 cases yesterday, and the California Department of HealthCalifornia Department of Health reported 1,074 new cases.

The only way to identify cases, of course, is to test people for infection.  While testing has increased, the rate of testing has stagnated nationally.  As of yesterday, there have been 5.4 million tests completed across the United States, which has a population of about 328 million people.  Washington has conducted 170,000 tests; Oregon, 49,000 tests; and California, 526,000 tests (source: The COVID Tracking Project).

How many tests need to be conducted to get ahead of the virus?  The World Health Organization suggests that a positive test rate of 10% would be sufficient.  The Wall Street Journal reports that the United States has a positive test rate of 20%.  The Harvard Global Health Institute believes at least 500,000 tests per day in the US are required to identify cases of Covid-19 and trace their contacts. 

If you look at data at the Centers for Disease Control and Prevention, you will see that testing is not nearly high enough to meet the desired levels.  Dr. Debora Birx, the Coronavirus Response Coordinator for the White House Task Force, said yesterday on network television that US will need a breakthrough in testing to screen large numbers of individuals quickly. 

Contact Tracing
There is another major issue, and that is contact tracing.  Once a new case is identified, health officials have to identify everyone with whom that person had contact in the prior two weeks.  Estimates for the number of contract tracers that will be needed come from Johns Hopkins, The National Association of State and Territorial Health Organizations, Scott Gottlieb (the former Commissioner for the Food and Drug Administration) and Andy Slavitt (the former head of the Centers for Medicare and Medicaid Services), and they range from 100,000 to 300,000.  The Wall Street Journal reports that the nation’s local public health departments employ between 130,000 and 160,000 people, and only a fraction do contract tracing.  So, health authorities will have to hire and train tens of thousands of workers who will just do contract tracing.

The Economy Remains Largely Shackled
You might wonder why we continue to write so much about the health aspects of this pandemic.  Why don’t we focus more on the economy and the stock market?  Because, until we gain some level of control over the virus, the economy will be crippled.  There will be no meaningful resumption of normal economic activity until the health crisis has abated and it’s safe to return to work. 

The Markets
The Dow Jones Industrial Average ended Friday up 260 points, or 1.1%.  The S&P 500 Index rose 39 points, or 1.14%.  The Dow is up 28% since March 23, but down 17% for the year.

Final Thought
During World War II, when the US and the Allies were waging a seesaw battle against Germany and the Axis powers, some of the brightest scientists in the US, the United Kingdom and Canada came together under the Manhattan Project.  The result of their efforts was the development of the first nuclear weapons.  The Allies’ use of these weapons turned the tide of the war and was critical to their victory.

We need this kind of undertaking to develop widespread, accurate testing, contact tracing, treatments, and, ultimately, a vaccine.  While perhaps not well-known, these efforts are well underway. 

Keep the faith.

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