None of us gets to take a break from the stuff that’s wearing us out. I hope you’ve noticed.
On Thursday, the Senate adjourned until Sept. 8. The House had already left and isn’t expected back till Sept. 14. But House Speaker Nancy Pelosi (D-Calif.) was right when she said Wednesday that punting on negotiations until September is not okay because “people will die.” More than 163,000 people have died so far. In another month, the toll will likely be at least 20,000 higher.
You have no right to take a break, Congress. Our country has not yet controlled the disease.
A bipartisan piece of legislation, the Suppress Covid-19 Act, is teed up, ready to deliver the public health outcomes we all want and need. Bipartisan groups of lawmakers — in both the Senate and House — have introduced parallel legislation to invest $50 billion in testing and contact tracing with the goal of achieving suppression of covid-19 cases to near-zero, so schools can open safely. The bill sends money to the states for this work, including a bonus pool for states that form compacts to collaborate on scaled-up regional purchasing and investment in testing innovation, as Maryland has recently done.
Members of Congress need to get back to work on a deal now and make a down payment on a full relief package by passing this legislation.
We’ve all had a habit of hoping for a silver bullet. Some thought summer would bring relief; others focused on a vaccine. We do need a vaccine, but even in the best-case scenario, it’s not likely to be more than 80 percent effective — more like a flu shot than the polio vaccine. Still others have lifted up therapies such as convalescent plasma. Like a vaccine, this can contribute to changing this situation, but it can’t resolve it on its own.
But there is only one real silver bullet. It’s called grit. This is a can-do country, and our determination to beat the disease is our ultimate weapon. We have to apply that grit by activating all modes of response. We need to chase the virus down and eliminate it through testing and contact tracing. We also need to weaken it, with improved therapies. And we need to build defenses against it with the vaccine and face masks and six-foot social distancing.
Defend against it, weaken it and take it out of circulation. We need all three things. They all take hard work.
We are well on our way with vaccines and therapeutic advances. Where we continue to struggle most is in our approach to diagnostic testing and tracing.
The Suppress Covid-19 Act sets a goal of suppressing the disease by supporting full diversification of our testing options. This includes innovation; an expanded testing market capable of supporting both scaled-up use of rapid point-of-care tests and much faster turnaround time on conventional testing; and full implementation of testing and tracing programs by states.
In diagnostic testing, we have been too dependent on the two main commercial labs (Quest and LabCorp) and a handful of testing platforms. But models now exist, for instance at the Broad Institute in Massachusetts, for building testing labs with nonproprietary tools. Also, genome sequencing labs, such as Ginkgo Bioworks, have figured out how to build the systems of sample collection and data accessioning necessary for them to process tests. They have received a contract from the National Institutes of Health testing “shark tank” program and are rapidly scaling up and, ultimately, these labs will have capacity to operate at millions of tests a day. They have already shared their lab and system plans with public health officials around the country. Additionally, the Biomedical Advanced Research and Development Authority recently approved grants for innovative point-of-care tests with rapid results on high-sensitivity tests. With all this, we can elevate our supply of tests to another level.
We also have work to do organizing demand. One of the hardest parts of fighting covid-19 is that data has to be integrated among health-care systems, public health systems, labs and providers of tests. To control covid-19 consistently, health officials need to know where positive cases are appearing.
States have been working hard to stabilize markets for testing and to implement public health systems capable of tracking the disease and responding to hot spots. This has involved intensive labor. State, local and tribal health officials are in the process of converting public health infrastructure that might be analogized to a network of country roads into a fully developed interstate highway system.
Their hard work is grit in action. Will Congress match them?