Terry H. Schwadron
May 13, 2020
Not surprisingly, yesterday’s Senate committee meeting featuring testimony by four of the top infectious disease leaders left a far more positive, if sober view of where we stand than listening to Donald Trump’s politicized re-interpretation on Monday of what should have been the same basic message.
OF course, hearing from Dr. Anthony Fauci, who heads the nation’s infectious disease agency, Dr. Robert Redfield of the Centers for Disease Control, Adm. Brett Giroir, the White House’s testing czar, and Dr. Stephen Hahn, head of the FDA, was hugely more reassuring simply because the presentations were intelligent and devoid of politics — though the questions from senators often were not.
Nevertheless, the word from the pros was at odds with the message from Trump.
The basics are known: Despite a slow start, these federal officials have gotten involved in a wide range of anti-coronavirus tools, tests, treatments and vaccine possibilities. But they were honest enough to acknowledge that despite the rise to date in diagnostic virus tests for self-selecting sick people, there is no Big Plan in place that will assure that going to back to work or recreate or to school, day camps, or even into the subway will be safe.
If anything, they stressed the depth and breadth of work yet to be done, and the variability of localized outbreaks of disease. Dr. Fauci was clearest: Opening too much too fast puts us at risk for turning the clock back to the height of pandemic.
Why Donald Trump cannot provide leadership based on these people’s work remains a troubling issue: The need for this White House to declare that the country has “prevailed” in testing for political purposes is misleading and dangerous.
What came across from these more science-sensitive advisers were recommendations for a whole lot more careful approach is reflected in the overly simplified craze to reopen everything immediately.
The Testing Numbers Maze
The idea, for example, that we have reached a crest of 9 million tests across the country sounds great — as Trump says, enough to handle “anyone who wants a test.” But the assertion skips over the fact that the only people eligible for tests outside of the White House and certain emergency settings are those who feel ill, call a doctor, and get a referral to a testing site.
At best, these tests determine how many are ill — again, Trump was quick to note a declining percentage of positive test results, a likely result from widened public testing altogether — but not a determination of who can feel safe about going into workplaces.
Even Girois, the most optimistic among the four witnesses about testing prevalence, was projecting a need for five or more times as many tests for the fall than we have now. Obviously, this is hardly “prevailing.”
But more importantly — the point that Trump was deflecting with sarcasm or avoiding, is that the type of testing going on currently in the White House is of those showing no symptoms, with self-quarantine following a positive response. Indeed, among his other misleading communications, Trump routinely mixes references of “testing” to include both diagnostic testing and immunity testing as he looks for positive, comparative efforts with other countries.
The discussion of numbers of tests are blurred with statistics that reflect very different measurements — often masking what most Americans want to know: Generally speaking, is it safe to go to work or shopping or on public transportation.
Local Conditions Rule
The clear message of the Senate hearing was the opposite of what we hear from the White House: Whether a school or college can plan to open in September — or presumably hold a political party convention in August — should be based in large part on virus trends in the local area.
It is not the blanket, magical, positive-thinking approach that we are hearing from Trump.
Among all the exchanges, those with Sen. Bernie Sanders over seeking guarantees in access to free vaccines once available and with Sen. Rand Paul over whether there has been sufficient emphasis on early immunity tests on monkeys were among the most interesting. Sen. Tammy Baldwin tried her best to get commitments to standards and supply line oversight.
So, we can conclude only that there is a complicated set of issues here, including a need for the management of public uncertainty.
What we are not hearing from either the president nor in the senators’ questions was focus on public policy built on lessening risks for workers or consumers.
We are asking the wrong questions: The issue at hand is not whether testing is inadequate — which should be obvious by now, but rather what we can do to lessen risk for contagion.