Weekly coronavirus-related chat, questions, and minor updates - week of December 20

neat system we have set up where cyberbullying the White House Press Secretary is the only way to get the federal government to do something.

my thoughts and prayers are with the workers at US Digital Service (or maybe some federal contractor) who just had "your holidays are cancelled, we need a website and we need it by early January" dropped in their laps. especially when the usefulness of a federal "enter address, get covid tests delivered" website has been apparent for months. there's no reason this needed to be a "I know it's the week of christmas but drop everything" project.

The Biden Administration Rejected an October Proposal for “Free Rapid Tests for the Holidays” (Vanity Fair)

On October 22, a group of COVID-19 testing experts joined a Zoom call with officials from the Biden administration and presented a strategy for overhauling America’s approach to testing.

The 10-page plan, which Vanity Fair has obtained, would enable the U.S. to finally do what many other countries had already done: Put rapid at-home COVID-19 testing into the hands of average citizens, allowing them to screen themselves in real time and thereby help reduce transmission. The plan called for an estimated 732 million tests per month, a number that would require a major ramp-up of manufacturing capacity. It also recommended, right on the first page, a nationwide “Testing Surge to Prevent Holiday COVID Surge.”

[…]

An administration official who attended the meeting told Vanity Fair that, while everyone present shared the same goal of expanding rapid testing as soon as possible, the plan could not be implemented at that time: “We did not have capacity to manufacture over-the-counter tests at that scale.” The problem, in essence, was twofold: The FDA had authorized only a handful of different home tests, and those it had authorized could not increase manufacturing fast enough.

[…]

Three experts who interacted with the White House came to believe that the Biden administration had deprioritized rapid testing, partly out of concern that people would opt for that instead of getting vaccinated. As one expert put it, “It was clear they felt that people who didn’t want to get vaccinated might like no-strings-attached rapid testing.” The White House’s Tom Inglesby said the administration was always committed to both: “In our analysis, they are not competing with each other. They are not zero sum.”

[…]

[Michael Mina’s] journey began as early as January 2020, when he saw clearly that Boston was going to need COVID tests it didn’t have. He sought funding from Brigham and Women’s Hospital to build a test. “They thought it was a joke,” he said of some of the hospital’s pathology officials.

So he went to the Broad Institute, got approval to use its sequencing platform, and helped establish what became a prodigious testing laboratory there. From the Broad, he went back to top Boston hospitals, including Brigham and Women’s, Tufts Medical Center, and Beth Israel Deaconess Medical Center, to offer the Broad’s new testing capacity as an additional resource. “The pushback I got was amazing and swift,” he said. There were “pissing contests everywhere,” as the physicians worked to protect their turf running hospital-based tests.

Once Mina began to advocate for rapid home tests, he encountered the same mindset: doctors “trying to guard their domain.” Some doctors had long opposed home testing, even for pregnancy and HIV, arguing that patients who learned on their own about a given condition would not be able to act on the information effectively. Testing, in this view, should be used only by doctors as a diagnostic instrument, not by individuals as a public-health tool for influencing decisions.

A similar view prevailed within the FDA. The agency had approved PCR tests with perfect sensitivity that could tell people for certain whether they were infected with SARS-CoV-2. Those tests, while crucial, were expensive, hard to access, and tended to take days to yield results, meaning that they had little mitigating effect on spread. By contrast, low-cost antigen tests, which patients could administer themselves at home, were less sensitive. And sensitivity is what mattered inside the agency. As one FDA medical device reviewer told Vanity Fair, “We review data. If the data we’re presented with aren’t great, we’re not going to want the public to use that device.”

[…]

Speaking for the administration, Inglesby said of Mina’s idea, “There is a strong scientific consensus in the administration that there should not be a second, lower public health standard for some tests. Not only would this be confusing, but members of the public will use these tests to make very serious decisions for themselves and their families and so they need to meet the same standard.”

I'm guessing someone didn't keep Jen Psaki in the loop on that one : https://twitter.com/mkarolian/status/1467959999645298697

It seems this number was badly wrong. Revised from 73% to 22%.

Now it’s 59% but should we trust it?