COVID This Week: Decreasing Cases, Increasing Danger

(Blog initially published in Tom Frieden’s LinkedIn account https://www.linkedin.com/pulse/covid-week-decreasing-cases-increasing-danger-tom-frieden/)

The latest data show that Covid is decreasing from very high levels to high levels in much of the U.S., but don’t be lulled into a false sense of security—danger is still very present. Schools are reopening and outbreaks are inevitable. And although human immunity against the virus now appears possible, FDA and CDC immunity from political interference is much less so.

First, the trends from last week. National test positivity decreased from 6.2 to 5.7%, which confirms that there has been a steady decrease in cases over the past few weeks. Case rates in the Northeast remain relatively low, and these states are now joined by MI, WV, NM, MT, WY, AK which have relatively low rates. The number of tests done decreased in some states, including Florida. Antigen testing—which is much faster than most PCR testing but less reliable—will make the national positivity number harder to track, and there’s a risk that many antigen tests won’t get reported. State and local health departments need to receive 100% reporting of PCR and antigen tests.

To date, the US has seen more than 500,000 cumulative hospitalizations, 6 million diagnosed cases, 180,000 reported deaths, plus at least another 50,000 or so excess deaths above baseline, which are from a combination of undiagnosed Covid and Covid-disrupted care. To put the U.S. situation into perspective, the US Covid death rate just for last week was more than three times the rate in South Korea since January.

The Latinx population in the U.S. as well as many Latin American countries are being very hard hit by the virus. Many are essential workers who have insufficient protection, are more likely to face crowding, have lack of access to care, and have underlying health problems. Peru now has the highest cumulative death rate in the world, and also has many unreported deaths.

There are high hospitalization rates in Native American, Latinx, and Black communities in the U.S., but these numbers are gradually declining. We can only reopen more by staying safer, masking up, and finding and stopping spread with the box-it-in strategy.

Masks matter. At Resolve to Save Lives, we released a toolkit this week sharing evidence, tools, and best practices for policymakers and communities to promote mask-wearing, which I summarized in the Washington Post. Masks are one of the lowest-cost, most effective tools we have to get more of our economy, education, and health care back. Mask up to keep deaths down. Kudos to Philadelphia for measuring and improving use. 

These are troubling times, not just because of epidemiological trends but also because of political interference with science. It’s been said that in war, truth is the first casualty. In this war against a virus, truth can be our strongest weapon.

Indefensible framing by the FDA of emergency use authorization (EUA) for convalescent plasma threatens to undermine trust in the agency. Convalescent plasma is a 100-year old treatment that may work, a bit, for some patients. There’s still so much we don’t know. For example: What antibodies should be used? For which patients? When in the course of illness? What dose? For how long? We need more science and less politics.

The CDC also made an indefensible recommendation, dictated by White House/HHS, that asymptomatic contacts of Covid-positive patients don’t need to be tested. That recommendation is not backed by science. We need to test asymptomatic contacts. If these contacts are positive, their contacts can be identified, warned, and quarantined. Not testing asymptomatic contacts allows Covid to spread. Let’s hope the CDC website gets corrected.

There have been far too many preventable casualties from the failed US response to the pandemic already: lives, jobs, education, and more. We cannot let the FDA and CDC become the next casualties of Covid. We must base decisions on science and insist on complete transparency on data and process.