Can’t pass coronavirus without taking test
Testing, 1 2 3.
Here is the thing people don’t get about COVID-19 testing. Testing and stayhome policies are essentially conjoined twins.
If you do enough testing, you can figure out who’s infected and isolate them while letting the healthy population do more of its business. If you don’t do enough testing to know who’s infected and who isn’t, you need to isolate as many people as possible.
Ashish Jha, director of Harvard’s Global Health Initiative gave that a little poetic spin in the New Yorker this week. “Every single test you have buys you a little tiny bit more freedom.”
As Kris Kristofferson would say, “Freedom’s just another word for a swab stuck way up your nose.”
Testing was the way we could have avoided much of our current economic pain. Nobel Prize laureate Paul Romer, an economist, explained way back in March that we could save the economy by testing everybody. A lot. We’d need a national strategy of cycling through the entire population every two weeks, Romer said, and isolating every person who tested positive, irrespective of symptoms.
If we tested 20 million Americans per day, even with a 20 percent inaccuracy rate, we could quell the disease without contact tracing or social distancing, Romer said.
To do this, we would have needed strong national leadership and a coherent federal policy, so forget I even mentioned it.
Here in Connecticut, we’re in woeful shape, testing-wise. I checked the numbers through several reputable sources, including Kaiser Family Foundation and Politico’s data project, which relies entirely on official reports by state health departments.
Connecticut, which is wrestling with a severe outbreak, totaled 143,000 tests Thursday. Contrast that with Georgia (274,000 tests) and Florida (595,000). Yes, those states have larger populations, but they also have (for the time being) mild outbreaks and governors who don’t seem to take this thing very seriously.
Connecticut’s outbreak is rated “severe” by the Harvard initiative. Jha’s team has developed a (relatively conservative) calculation to tell states when they’re doing enough testing to safely lift mitigation measures.
Given Connecticut’s size and the severity of our outbreak, they say we need 29,288 tests per day. The most recent one-day figure as of this writing was 4,122 tests, pretty typical of where we are.
Gov. Ned Lamont’s testing target for reopening has been 42,000 tests per week (which is 6,000 per day). That’s a puny benchmark, and, even so, we’re not going to hit it when the state starts trickling back on Wednesday.
According to Lamont’s reopening task force, failing to reach the goal is not a deal breaker. The number is “not the important thing” task force co-chair Dr. Albert Ko said at a recent briefing.
Which makes you wonder what the point was of having the number at all.
So, to recap, our testing target was ridiculously low, and we’re not going to hit it. Ladies and gentlemen, start your blow dryers.
How did this happen? Part of the reason can be found in a statement by U.S. Sen. Chris Murphy when sparring with Trump administration officials Tuesday about the lack of federal guidance on reopening.
“My state needs it,” Murphy said. “We don’t have all the experts that you have.”
Truer words were never spoken. As Murphy spoke them, Lamont was in the process of canning the state’s public health commissioner, which is a little bit like firing the fire chief in the middle of the Great Chicago Fire.
That becomes even more alarming when you realize that the equivalent of the deputy fire chief had already resigned at the start of the conflagration. Deputy Commissioner Susan Roman (who was supposed to be the DPH pandemic point person) quit March 6, telling an odd story of racial harassment — Roman is white — in the department and calling the experience of working for Commissioner Renee Coleman-Mitchell “an incredible disappointment.”
Coleman-Mitchell’s overall grasp of her job seemed shaky back in 2019, in that golden era when our main worry was about measles outbreaks in schools.
She has not been especially visible in the last couple of months. It could be argued that the de facto commissioner of public health has been the aforementioned Ko, a professor of epidemiology and microbial diseases at Yale Medical School.
But wait. There’s more. According to Lamont, the state has more testing capacity than people are currently using. (So it’s our fault?) Raise your hand if you know somebody who wants a test but doesn’t know how to get one.
Meanwhile, the DPH put in a strong bid for the Unforced Bureaucratic Error of the Year last week by launching a strategy of testing nursing home residents but not the staff. You know, the people who go in and out of the nursing homes.
Somehow, we have too many tests but also not enough, and we’re giving them to the wrong people. This is the kind of mess you get when your top two public health officials have either physically or mentally checked out.
Lamont has been the face and voice of the Connecticut pandemic. In the world of epidemiology, it’s considered a mistake to let a politician play the lead role. “If you have a politician on the stage, there’s a very real risk that half the nation is going to do the opposite of what they say,” former acting CDC director Richard Besser recently told the New Yorker.
Hiring new public health officials during a pandemic is like trying to switch out jockeys in the middle of the Kentucky Derby. It’s hard to see how you do it.
The frustrating thing is that massive amounts of testing would make both opposed factions — those who fear the spread of the disease and those who prioritize restarting the economy — happy.
So far, we’ve failed that test.