The U.S. Has Forgotten the Past and Can’t See the Future
The only way to know where the virus is spreading is with heavy testing. We knew this months ago. And yet we’re still blind.
The most disturbing thing right now is not the growth in new Covid-19 cases. It’s that even after four months, we have no visibility into what’s happening. Or what has happened. And that makes for a tough fall.
At the present we see the future we invent right now. And because the country has failed, we are massively growing cases without much of anything we can do.
People don’t like social distancing. They don’t love wearing a mask. They want schools to open in person and they want to see sports. These are primitive interventions we deal with because we have no ability to track the virus. Give us that ability, everything changes.
We talk about tests either as things that will help us figure out if we have Covid-19 or as something that Trump thinks we do too much of. But tests are far more important. They are the only way cases can be found and decreased, and the only path to normality until a scientific breakthrough.
Everyone is aware that unlike the flu, this virus travels invisibly, with pre- and asymptomatic hosts. The only way to know how many people have the virus and where it is growing is with lots of testing. We knew this months ago. And haven’t done anything.
We are so spectacularly bad that we report on how many tested cases are confirmed every day, a small faction (10%-20%) of how many occur. Think back to March. Is this where you thought we would be? 60,000 cases a day that we know of? Missing almost all of them?
There’s all kinds of fancy stuff — digital thermometers, symptom checkers, mobility apps — that are supposed to tell us where it’s going next. If all of those worked and we all used them, we would catch 60% of cases. As it is, those aren’t in prime time. But they can help us focus.
So testing is the only way to get there. And right now backlogs are a week or more, test positives are growing (10% — back where we were in early May).
The fact is the testing industry hasn’t done a bad job growing the number of tests. They even doubled the price of the test from $50 to $100.
The problem feeds on itself. Here’s how: If it’s a week to 10 days for a test result, do people isolate while they wait? No. Do testing results we see reflect reality? No. They lag by a week. Will people decide it’s even worth it to get a test? No.
At the beginning of May, when states opened up, I wrote a thread (summarized here) saying welcome to the month of bliss. I said that May would feel fine by looking at the numbers. But we would have no idea until later. And now we know.
That time lag is costly. Imagine we could learn in two weeks what now takes two months? With chagrin Governor Abbott made decisions to close bars and require masks. The day he expanded restaurants to 50% capacity was likely the day he should have closed down.
Because cases lag and are lacking, look at something solid like hospitalizations. While DeSantis was peacocking “you’re all wrong. This is just young people,” and Ducey denied the problem, they knew in mid-June. And could have been seen in May if we had our act together.
So what do we all want this Fall? Schools to begin. To go to work. We have an incoming college freshman. He would like to go to college for some reason. (Aside: I mean why why why would he want to get away from us? We are really cool parents who say and do cool things and would never embarrass him. And I’m very funny everyone knows. It makes no sense.)
So we have reviewed the college opening plan. In fact we have reviewed many. They all are banking on being able to massive amounts of testing of asymptomatic people. Same with K-12. They rely on testing. So does the NBA plan. So so most office plans. So do airports.
Uh huh. Yep. Our ability to do anything is predicated on knowing who’s sick. Not just the 60% with symptoms. But we’re blind. Running out of PPE, no tests. No contact tracing. Trump wants us back to work but hasn’t lifted a damn finger.
And with 10 legislative days left, we have uninsurable benefits expiring, evictions coming. Mr. McConnell, your guy was supposed to have fixed it by now so people could get back to work like they are in the rest of the world. He didn’t. Stop hanging people out to dry.
Forget last month. This lack of visibility plagues is for next month and the month after. When cases move from the areas where we are indoors in the summer to where we are indoors in the winter, the same thing will happen again.
We not only can’t see the future, we not only can’t see the present, but we can’t even see two weeks in the past very well.
Washington, Oregon, Wisconsin, Minnesota, Pennsylvania, etc. — you’re not off the hook. Cases will spread up to a month before you see them now with reporting lags and timing of symptom onset.
Governors, stop looking at reports of new cases and assuming you’re ok. You won’t know until people start being admitted to the hospital — and you will regret not acting sooner. Don’t be like the governors who won’t admit the problem when they see it.
The Fall has its own set of challenges. The flu will make actual Covid-19 harder to detect. Kids will be in school. Trump will be in election-season open at all costs mode. His hot spots rallies will be clean up zones. People forced to work will be carrying the burden.
It’s never too late for a national approach that isn’t based on denial, lies and politics. But given that this increasingly remote, I hear from many people that they feel increasingly on their own.
So people are feeling abandoned. The rest of the world — who have excess tests (because they don’t need them) — has no interest in helping us. China tested 11 million people in one weekend. But Trump has made them all pick up our WHO burden.
So there we are with no global or national support and governors doing the best they can given that they have no tools and are running out of money.
Sorry this thread is so long. I’ve been trying to end it on a positive note for a while and I just keep making it worse.
Monday is the podcast episode on the vaccine. And as I’ve said there is optimistic news there. And it’s the weekend. I guess not every song has a happy ending. But tomorrow’s will I know.
This is pulled and lightly edited from my July 10 Twitter thread.
