Covid-19 Live Updates: Flu Season Could Worsen Virus Testing Delays

Flu-season testing delays could make it easier for the coronavirus to spread undetected.

Come fall, the rise of influenza and other seasonal respiratory infections could exacerbate already staggering delays in coronavirus testing, making it easier for the virus to spread unnoticed, experts said.

In typical years, doctors often don’t test for flu, simply assuming that patients with coughs, fevers and fatigue during the winter months are probably carrying the highly infectious virus. But this year, with the coronavirus bringing similar symptoms, doctors will need to test for both viruses to diagnose their patients, further straining supply shortages.

Testing for individual viruses poses many challenges for doctors and laboratory workers already fighting their way through supply shortages. Several of these tests use similar machines and chemicals, and require handling and processing by trained personnel.

Some manufacturers have begun making tests that can screen for several pathogens at once. But these combo tests are expensive and will likely make up only a small fraction of the market.

“The flu season is a bit of a ticking time bomb,” said Amanda Harrington, the medical director of microbiology at Loyola University Medical Center. “We are all waiting and trying to prepare as best we can.”

Flu viruses and coronaviruses differ in many ways, including how they spread, how long they linger in the body and the groups they affect most severely. Food and Drug Administration-approved antivirals and vaccines exist for the flu, but no such treatments exist for the coronavirus, which has killed at least 812,000 people worldwide in less than a year, according to a New York Times database.

Being infected with one virus doesn’t preclude contracting the other. And researchers also don’t yet know how risky it is for a person to harbor both viruses at the same time.

Those differences make it essential to tease the two pathogens apart, as well as to rule out other common winter infections like respiratory syncytial virus, or R.S.V., which hits the very young and very old especially hard.

But many flu and R.S.V. tests vanished from the market this spring as the companies that make them rapidly pivoted to address the coronavirus.

At a news conference on Sunday, President Trump announced the emergency authorization of the use of blood plasma for treatment of hospitalized Covid-19 patients. The president and two of his top health officials — Alex M. Azar II, the health and human services secretary; and Dr. Stephen M. Hahn, the commissioner of the Food and Drug Administration — highlighted the same statistic: that the treatment reduced Covid-19 deaths by 35 percent.

But scientists and experts, including one researcher who worked on the study cited by the officials, say that the framing and use of the statistic, which refers to a subset of a Mayo Clinic study, are misleading.

“For the first time ever, I feel like official people in communications and people at the F.D.A. grossly misrepresented data about a therapy,” said Dr. Walid Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.

The statistic in question was not mentioned in the official letter authorizing the treatment, the 17-page memo written by F.D.A. scientists about the treatment or in the Mayo Clinic’s analysis.

Some fear that the process of approving treatments and vaccines for the coronavirus has been politicized, and as data emerges from vaccine clinical trials, the safety of potentially millions of people will rely on the scientific judgment of the F.D.A.

“That’s a problem if they’re starting to exaggerate data,” Dr. Gellad said.

Plasma has been touted by Mr. Trump as a promising cure for the coronavirus, with his administration funneling $48 million into a program with the Mayo Clinic to test infusions. Although there have been some positive signs that it can reduce deaths in Covid-19 patients, no randomized trials have shown that it works.

Dr. Hahn’s claim that 35 out of 100 sick Covid-19 patients would have been saved by receiving plasma appeared to be an overstatement, statisticians and scientists said.

Dr. Eric Topol, a professor of molecular medicine at Scripps Research in La Jolla, Calif., said that convalescent plasma has not yet shown the benefit that Dr. Hahn described — and that he should issue a correction.

On Monday night, after The New York Times published an article questioning the statistic, Dr. Hahn said on Twitter that the “criticism is entirely justified,” and clarified that his earlier statements imprecisely suggested an absolute reduction in risk, instead of the relative risk of a certain group of patients compared with another.

President Trump and his political allies mounted a fierce and misleading defense of his political record on the first night of the Republican convention on Monday, while unleashing a barrage of attacks on Joseph R. Biden Jr. and the Democratic Party that were unrelenting in their bleakness.

Hours after Republican delegates formally nominated Mr. Trump for a second term, the president and his party made plain that they intended to engage in sweeping revisionism about Mr. Trump’s management of the coronavirus pandemic, his record on race relations and much else.

A team of New York Times reporters followed the developments and fact-checked the speakers, providing context and explanation.

At times, the speakers and prerecorded videos appeared to be describing an alternate reality: one in which the nation was not nearing 180,000 deaths from the coronavirus; in which Mr. Trump had not consistently ignored serious warnings about the disease; and in which someone other than Mr. Trump had presided over an economy that began crumbling in the spring.

Donald Trump Jr., the president’s son, praised his father’s management of the pandemic in one of several segments asserting an unsupported narrative that the president had been a sturdy leader in a crisis even as polls show Americans believe he has handled the pandemic poorly.

“As the virus began to spread, the president acted quickly and ensured ventilators got to hospitals that needed them most,” the president’s son said, making no mention of the millions of Americans sickened and killed or the complaints from governors that they were not receiving the necessary equipment. “There is more work to do, but there is light at the end of the tunnel.”

Another defense of Mr. Trump’s management of the pandemic took the form of a video that criticized the news media, Democrats and the World Health Organization, and presented a greatly distorted version of Mr. Trump’s record, casting him as a decisive leader against Democrats who had minimized the threat of the disease. The video featured three clips of Democratic governors, including Gov. Andrew M. Cuomo of New York, praising Mr. Trump in the spring, when state executives were pleading with the federal government for help and taking exceptional pains to stay on the president’s good side.

Mr. Trump’s first appearance in the evening program came in a brief segment that showed him at the White House interacting with frontline workers, who related their experiences in the health crisis. Mr. Trump largely deferred to the other speakers and prompted them to make comments — “Please, go ahead,” he said repeatedly — though he interjected his own commentary about the drug hydroxychloroquine, which the president had promoted aggressively as a remedy for the coronavirus despite no consensus among doctors that it was effective.

How Spain has become a new virus hot spot.

In today’s edition of the Morning newsletter, David Leonhardt examined how Spain has, like the United States, become one of the few rich countries suffering a major outbreak of the virus. He writes:

Adjusted for population, Spain’s outbreak has even surpassed the U.S. outbreak over the last few days. How has it happened? Health experts are still trying to figure that out. But some of the early answers may sound familiar to Americans.

Lack of a clear national message. Spain’s prime minister — Pedro Sánchez, of the Socialist Workers’ Party — has not promoted medical disinformation, as President Trump has. Yet Sánchez has recently handed back control of virus policy to regional governments, instead of continuing to provide clear leadership about how people should behave.

Premature reopening. Spanish officials, like their American counterparts, made the mistake of thinking they could help the economy by prioritizing it over public health. Bars and nightclubs reopened. British tourists — a major source of revenue — were allowed to travel to Spain without restriction.

In truth, the only way to help the economy is to control the virus.

Not enough testing and contact tracing. The shortages have made it “difficult for health authorities to identify and isolate potential virus carriers,” according to The Wall Street Journal.

As I’ve written before, there is a set of consistent lessons from around the world about how to beat back the virus: Mass testing. Rapid quarantines, contact tracing and, when necessary, lockdowns. Limited social gatherings, especially indoors. Widespread mask wearing.

South Korea said it was again closing schools and switching back to online classes for students in the Seoul metropolitan area, as the country reported 280 new cases on Tuesday, the 12th-straight day of triple-digit daily increases in virus infections.

A rapidly spreading outbreak early this year had forced South Korea to delay the reopening of schools, originally scheduled for February. After a successful battle against the epidemic, students began returning to classrooms in May. But​ on Tuesday, Education Minister Yoo Eun-hae said another fast-spreading outbreak from a church in Seoul made it inevitable that schools would need to be shut down again in the greater Seoul area, home to half the country’s 51 million people.

Ms​.​ Yoo said that all students at kindergartens, elementary, middle and high schools would begin remote learning starting Wednesday until Sept. 11, except for high school seniors who will continue to go to school ​and prepare for the year-end college-entrance exams​.

To South Korean students and parents, the ​national college-entrance exams are of paramount importance. Students endure years of cramming for the written tests​, which determine which universities they can enter. Diplomas from elite universities often decide the students’ career prospects.​ On the day of the exam, the Air Force cancel​s all of its flights for fear ​their noise might disrupt students.

As the epidemic surged again, fear has​ begun growing whether the exams can proceed, or whether they should be conducted online. Ms. Yoo said on Tuesday that online exams ​will be all but impossible because of potential problems like cheating.

“The priority is to quickly stem the spread of transmissions and stabilize the situation, if only to hold the Dec. 3 national college entrance exam as planned without disruption,” she said.

The new outbreak started at Sarang Jeil Church in Seoul, where a worshiper tested positive on Aug. 12. So far, 915 infections have been found among church members and their contacts. Nationwide, 3,285 cases have been reported since Aug. 12, 193 of them students or teachers in the Seoul metropolitan area.

In other news from around the world:

  • As Hong Kong on Tuesday announced plans to begin easing its social-distancing rules, the city’s leader, Carrie Lam, said that criticism by health experts of a new, Beijing-backed coronavirus testing program was a “politically calculated” effort to smear the Chinese government. Some of those experts say the plan is a waste of resources, while activists fear it could lead to the harvesting of DNA samples for China’s surveillance apparatus, accusations that local officials deny.

  • Usain Bolt, the Olympic medalist, has tested positive and is isolating at his home in Jamaica. He celebrated turning 34 on Friday at a surprise party attended by, among others, his girlfriend, his newborn daughter and the prominent soccer players Raheem Sterling and Leon Bailey. Videos posted by the music news outlet Urban Islandz showed attendees dancing near one another without wearing masks. Jamaica has recently had a spike in cases.

Education roundup

Colleges take different approaches to opening, but still see cases grow.

In a matter of days, nearly all colleges and universities in the United States will be back in session — whether it’s online, in person, or some combination. Davidson College and The Chronicle of Higher Education are tracking the reopening plans of nearly 3,000 institutions:

  • 6 percent will be online-only.

  • 27 percent will be primarily online.

  • 15 percent will be a hybrid of online and in-person.

  • 20 percent will be primarily in-person.

  • 2.5 percent will be solely in-person.

  • 6 percent are doing something else entirely.

  • 24 percent of schools have still not yet finalized their plans.

Two colleges where classes have started said they had identified new cases among students. Officials at the University of Alabama said that 531 cases had been identified among students, faculty and staff on its Tuscaloosa campus since classes resumed Wednesday. The university is holding in-person classes and said the total number of cumulative cases over that period, including infections on other campuses in the university’s system, was 566.

The University of Southern California, which is holding online classes but giving students limited access to campus, said it had identified 43 new cases in the past week, all of them related to “off-campus living environments.” The university, where classes began Aug. 17, called it “an alarming increase” and said that more than 100 students were under a two-week quarantine because of exposure to the virus. It warned students that “every surface, every interaction where you share close contact or remove your face covering, can pose a risk to yourself and your friends.”

In other education news:

  • A Florida judge ruled on Monday that the state’s requirement that public schools open their classrooms for in-person instruction violates the state’s constitution because it “arbitrarily disregards safety” and denies local school boards the ability to decide when students can safely return. The state later filed an appeal to the ruling, prompting an immediate stay.

Feel the urge to scream? Maybe these zombies can help.

Many people feel trapped by the coronavirus pandemic. In Japan, some are distracting themselves by screaming inside closed caskets.

During 15-minute shows performed in Tokyo over the weekend, thrill seekers shrieked and trembled in glass caskets as they listened to ghost stories and the roar of chain saws. With nowhere to run, they were menaced by zombies, poked with rubber hands and splashed with water, all for less than $10 in admission.

The event was organized by Kowagarasetai, a horror event production company whose name means “Scare Squad.” But some customers said they actually left feeling more relaxed.

The coffins are a better place to scream than at Japanese theme parks, which have encouraged visitors to keep their mouths shut on roller coasters to prevent virus transmission through droplets. (“Please scream inside your heart,” the Fuji-Q Highland amusement park suggested in June in a video demonstration by two of its executives, who inspired social media users to try the “serious face challenge” on their own roller coaster rides.)

Kenta Iwana, founder of Kowagarasetai, said he wanted to give people a way to express themselves without holding back.

“There are no places to scream,” Mr. Iwana, 25, told Agence France-Presse this summer as he introduced another one of his socially distanced productions, a drive-in haunted house. In addition to providing people with an emotional outlet, he said, his company creates job opportunities for performers who normally work at theme parks.

Japan, which has been fighting a resurgence of the virus in recent weeks, reported 740 new cases nationwide on Sunday, including 212 in Tokyo. The country has had a total of more than 63,000 cases and almost 1,200 deaths, according to a New York Times database.

Reporting was contributed by Gillian R. Brassil, Alexander Burns, Choe Sang-Hun, Sheri Fink, Mike Ives, Annie Karni, David Leonhardt, Jonathan Martin, Tiffany May, Amelia Nierenberg, Adam Pasick, Katie Thomas, Katherine J. Wu and Elaine Yu.

source: nytimes.com