with Paulina Firozi
The United States is finally getting clues about how widespread the novel coronavirus really is among the population.
Antibody testing being conducted by states, localities and private companies is helping officials determine how many people were infected without realizing it.
The early results are offering some hopeful signs about the severity of the pandemic – and some not as optimistic.
The good: The virus is less deadly than initially thought. The bad: It is more deadly than the seasonal flu. And “herd immunity” is still far off.
Officials in New York, California, Florida and Colorado have preliminary results.
In New York City, nearly 1 in 4 people tested positive for coronavirus antibodies, Gov. Andrew Cuomo (D) announced this week. Across the entire state, 15 percent had coronavirus antibodies. It's likely that infections spread much further in New York City – which is the source of roughly 1 in 5 of the more than 58,000 coronavirus deaths in the United States – than in other parts of the country, given the city’s urban density and relative slowness to shut down.
In Miami-Dade County, Florida, officials say antibody testing indicates that between 4.4 and 7.9 percent of the population has been infected.
Officials in Los Angeles, which locked down several days before New York, reported an even lower rate of positive antibody tests, saying their research indicates between 2.8 and 5.6 percent of the population has already been infected with the virus.
And in the ski town Telluride, Colo., just a tiny fraction of the processed antibody tests came back positive: 26 out of 4,757.
The data shows that at least 10 times as many people were infected with the virus as were diagnosed with covid-19.
It underscores the reality that many people are hardly affected by the coronavirus. “Many people experience mild symptoms or none at all, and never get the standard diagnostic test with a swab up the nose, so they’re missed in the official covid-19 case counts,” my colleague Joel Achenbach writes.
And many Americans haven't been able to get tested even if they had mild symptoms because of strict state rules seeking to preserve limited testing materials for medical workers and those living in group settings.
Higher infection rates translate to lower fatality rates.
The true fatality rate — which has been exceedingly hard to determine because the total number of infections isn’t known — now appears below 1 percent. New York City’s antibody tests indicate an infection fatality rate of between 0.5 and 0.8 percent.
Yet that number still translates to a lot of people nationally, as The Atlantic's Yascha Mounk notes: “Even if the virus has a fatality rate of a little less than 1 percent, this means that letting it spread through the population of the United States would cause about 2 million deaths.”
And there’s a flip side: People with no symptoms can still easily transmit the highly infectious disease to those more vulnerable to it, especially the elderly and those with preexisting medical conditions.
The infection rate doesn’t appear anywhere close to the point of “herd immunity.”
The point at which a disease’s transmission halts naturally is typically if about 60 to 70 percent of the population is exposed to the virus.
A sizable majority of the American public hasn’t yet gotten the virus, so the potential for severe illness and death is still quite high. A 0.5 fatality rate is considerably higher than the seasonal flu’s fatality rate, which is probably less than 0.1 percent.
“As infectious disease experts point out, even a seemingly low rate can translate into a shockingly large death toll if the virus spreads through a major portion of the population,” Joel writes.
Serology tests detecting past coronavirus infections are popping up all over the country.
Quest Diagnostics, one of the largest networks of commercial laboratories, announced yesterday that individuals can purchase antibody tests through its website for $120 without having to first get a doctor’s order. Test results will be available one to two days after the blood is drawn at a Quest lab, and a doctor will be available to discuss the results with the patient, the company said.
Antibody surveys have been started by the Centers for Disease Control and Prevention, the National Institutes of Health, and colleges and universities around the nation.
Ahh, oof and ouch
AHH: President Trump will order meat plants to stay open.
Trump is expected to sign an executive order to require meat production plants to stay open, ensuring continued food supply during the pandemic. Trump will invoke the Defense Production Act to classify meat plants as essential, Taylor Telford and Kimberly Kindy report, citing a person familiar with the plan.
The Post has found at least 20 meatpacking plants have closed in recent weeks because of covid-19 outbreaks. “The government will provide additional protective gear for employees as well as guidance,” Taylor and Kimberly write. “… The government order would keep meat companies from using the most effective weapon available to protect their employees — closures.”
The United Food and Commercial Workers said at least 17 workers have died of covid-19. The CDC and the Occupational Safety and Health Administration have released interim guidance for such facilities, including ways to ensure safe distance between employees and procedures for cleaning shared equipment.
Industry analysts say pork and beef processing has fallen 25 percent because of these outbreaks. “Major meat companies, including Tyson Foods, Smithfield Foods and JBS USA, have repeatedly touted their essential role in the nation’s food supply chain, often resisting calls from government officials and labor advocates to close their facilities due to outbreaks,” Taylor and Kimberly write.
OOF: The adviser helping to shape Trump's China policy is deeply distrustful of the regime in Beijing. He covered it as a reporter for Reuters and the Wall Street Journal.
As the virus was spreading beyond China's borders in February, deputy national security adviser Matthew Pottinger believed Chinese leaders were engaging in a massive coverup and a “psychological warfare” operation to obscure the origins of the virus and deflect blame, David Nakamura, Carol D. Leonnig and Ellen Nakashima report.
“U.S. intelligence officials were picking up signs that Chinese operatives were deliberately sowing disinformation, including state media manipulating stories to change key facts,” they write, adding that Pottinger's personal experience as a journalist in China two decades ago “left him deeply distrustful of the regime in Beijing and is now shaping the administration’s hard-line posture.”
“Pottinger believes Beijing’s handling of the virus has been ‘catastrophic' and ‘the whole world is the collateral damage of China’s internal governance problems,’ ” a person familiar with his thinking told our colleagues.
The 46-year-old is now a pivotal player in the administration’s attempts to make U.S. policy on China more confrontational. “In private, Pottinger has described [Chinese President] Xi [Jinping] as steering China’s authoritarian system toward a more dangerous ‘totalitarianism,’ seeking to implement Orwellian-style controls over most aspects of society,” David, Carol and Ellen write.
OUCH: The White House abruptly reassigned the head of the Office of Refugee Resettlement it viewed as soft on immigration.
The director of the Office of Refugee Resettlement, Jonathan Hayes, was reassigned with little notice, World Magazine’s J.C. Derrick and Harvest Prude report.
It was a move that shocked ORR staff as well as the former director’s supervisors, including HHS Secretary Alex Azar. Hayes was praised by people across sides of the aisle, especially as he led the office that was at the center of the president’s controversial 2018 child separation policy. Hayes was made director of the office in early 2019.
“Anti-immigration hard-liners—led by presidential adviser Stephen Miller—saw Hayes as soft on immigration and ousted him while the nation’s attention was focused on the exploding pandemic,” J.C. and Harvest write. “Now, they’ve imported new leaders in an effort to refashion ORR into an arm of immigration enforcement—sparking concerns that the child-separation policy Melania and Ivanka Trump intervened to stop may return in another form.”
Even though immigration has been temporarily halted during the pandemic, the change could have long-term effects.
The Trump administration’s coronavirus response
Vice President Pence chose not to wear a face mask while visiting the Mayo Clinic.
It was an apparent violation of the Minnesota medical center’s policy, as well as a move that flouted the administration’s own recommendations, Felicia Sonmez reports.
Pence later defended the decision by saying he is frequently tested for the virus.
“As vice president of the United States, I’m tested for the coronavirus on a regular basis, and everyone who is around me is tested for the coronavirus,” Pence said.
After visiting the clinic, Pence told reporters: “Since I don’t have the coronavirus, I thought it’d be a good opportunity for me to be here, to be able to speak to these researchers, these incredible health-care personnel, and look them in the eye and say thank you.”
The CDC’s guidelines on wearing masks — which note that they’re helpful for preventing coronavirus transmission — don’t specify whether someone who has been tested recently should still wear a covering, Felicia writes.
The clinic posted a notice on its website that as of April 13 it is “requiring all patients and visitors to wear a face covering or mask to help slow the spread of COVID-19.”
In a since-deleted tweet, the clinic said it “had informed @VP of the masking policy before his arrival today.”
Politico's Dan Diamond:
An entirely preventable situation.— Dan Diamond (@ddiamond) April 28, 2020
— Mayo’s mask policy took effect April 13
— Pence’s visit was set up last week
— POLITICO contacted Mayo and Pence’s office yesterday, asking about mask plans
— Pence was offered a mask today but refused
— Mayo still let Pence visit a patient
An emergency room doctor and head of the Committee to Protect Medicare:
It is a selfish display by @Mike_Pence disregarding @MayoClinic policy by not wearing a mask. As an ER doc, on behalf of the staff with whom I work, I think he owes an apology to every essential worker keeping things going and trying not to get sick. pic.twitter.com/SzRK7BPHfj— Dr. Rob Davidson (@DrRobDavidson) April 28, 2020
Vox's Aaron Rupar:
Trump and Pence's refusal to follow their own government's guidance and wear masks in public stands in contrast to a variety of world leaders who have been photographed with them on https://t.co/N0U0xlIBTY— Aaron Rupar (@atrupar) April 28, 2020
Congress on coronavirus
A coalition of hospitals, health insurers and businesses want lawmakers to support uninsured Americans.
More than 30 organizations, mostly health-care industry trade associations, sent a letter to congressional leaders with suggestions for how to help the growing number of Americans who are losing coverage as they lose their jobs.
“The magnitude of the COVID-19 crisis is extraordinary. It has taxed our health care system like never before, and it has stressed the economy as consumers and businesses limit commerce and adhere to social distancing to reduce the transmission of the disease,” the letter reads.
“These actions have undoubtedly saved lives, but they also have cost millions of jobs — more than 26 million by the latest employment reports. Because nearly 180 million Americans get their health care coverage through their work, it is critical to ensure millions of Americans continue to have employer coverage.”
“The groups are hoping to influence a next relief package being debated on Capitol Hill,” Amy Goldstein reports in the live blog. “The options, which industry leaders call a ‘menu,’ include new subsidies to employers to help them preserve health benefits during the pandemic, as well as helping more Americans afford to buy health plans through Affordable Care Act marketplaces by subsidizing premiums up to a higher income threshold.”
Here are a few more headlines to catch up on this morning:
The hardest hit:
- Patients with cancer, especially patients with blood or lung malignancies or tumors that have spread in the body, are at a higher risk of dying of covid-19, a new study has found, Laurie McGinley reports.
More on the Trump administration:
- The president’s aides and allies are hoping to soon refocus him away from public health updates on the pandemic, a change that follows his dangerous suggestion that injecting bleach or other disinfectants could cure the virus, Ashley Parker reports. Instead, Trump will talk about the economic fallout and recovery.
Congress on coronavirus:
- House leaders scrapped a plan to bring lawmakers back to Washington next week, citing warnings from the attending physician of Congress that bringing them back would put lawmakers and staff at risk, Mike DeBonis and Seung Min Kim report. “Meanwhile, many logistical questions remain unsettled as the Senate plots its return,” they add.
Good to know:
- Pfizer’s chief executive told CNBC the company is preparing to manufacture vaccines in the United States and Europe. They hope to be able to supply millions of doses of vaccines this year and hundreds of millions in 2021.
On the front lines:
- Children of doctors and nurses fighting the pandemic are having nightmares, recording worries in journals and writing goodbye letters to parents they worry they won’t see again, John Woodrow Cox reports.
- An analysis published in the Annals of Internal Medicine examines 29 different approaches for how to prioritize ventilators if there’s a shortage, Ariana Eunjung Cha reports.
- There’s a growing demand for abortion through telemedicine, as a wave of states and the administration restricts access to the procedure. Women can have a video visit with a doctor before receiving abortion pills in the mail, the New York Times’s Pam Belluck reports.
Thinking about a new normal:
- Americans remain concerned about becoming ill. A new Post-University of Maryland poll found nearly two-thirds of Americans say restrictions in restaurants, retail stores and other businesses in their state are appropriate, and 16 percent say they’re not strict enough, Dan Balz and Scott Clement report. That’s compared with 17 percent who say the limits are too restrictive.
- Researchers say cellphone location data found that for a second week, people stayed home less, signaling a “quarantine fatigue” in the United States, Katherine Shaver reports.