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| Did Federal Officials Really Question W.H.O. Tests for Coronavirus? | Did Federal Officials Really Question W.H.O. Tests for Coronavirus? |
| (about 3 hours later) | |
| At a time when the Trump administration is facing intense criticism for its failure to make coronavirus tests available to millions of nervous Americans, remarks by a federal health official on Tuesday appeared to suggest that the World Health Organization’s diagnostic tests were wildly inaccurate. | At a time when the Trump administration is facing intense criticism for its failure to make coronavirus tests available to millions of nervous Americans, remarks by a federal health official on Tuesday appeared to suggest that the World Health Organization’s diagnostic tests were wildly inaccurate. |
| In a somewhat rambling answer to a question related to W.H.O. tests, Dr. Deborah Birx, the White House coronavirus response coordinator, said: “It doesn’t help to put out a test where 50 percent or 47 percent were false positives. Imagine what that would mean to the American people. Imagine what that would mean to tell someone they were positive when they weren’t.” | In a somewhat rambling answer to a question related to W.H.O. tests, Dr. Deborah Birx, the White House coronavirus response coordinator, said: “It doesn’t help to put out a test where 50 percent or 47 percent were false positives. Imagine what that would mean to the American people. Imagine what that would mean to tell someone they were positive when they weren’t.” |
| It was not clear where Dr. Birx got those figures, but obviously such an inaccurate test would be worthless. Late on Tuesday night, Dr. Birx confirmed that although she was responding to a question about the W.H.O. test, she was referring to a study of an early diagnostic test used in China. | It was not clear where Dr. Birx got those figures, but obviously such an inaccurate test would be worthless. Late on Tuesday night, Dr. Birx confirmed that although she was responding to a question about the W.H.O. test, she was referring to a study of an early diagnostic test used in China. |
| The paper found that, in a specific subset of those tested in China — asymptomatic contacts of known cases — the tests wrongly found them to be positive 47 percent of the time. | The paper found that, in a specific subset of those tested in China — asymptomatic contacts of known cases — the tests wrongly found them to be positive 47 percent of the time. |
| But there have been no suggestions that the W.H.O. test, distributed worldwide, has such significant accuracy problems. On Tuesday night, Dr. Birx said she has not looked into the W.H.O. test, “but I assume it is functional.” | But there have been no suggestions that the W.H.O. test, distributed worldwide, has such significant accuracy problems. On Tuesday night, Dr. Birx said she has not looked into the W.H.O. test, “but I assume it is functional.” |
| Dr. Birx was asked several questions by reporters about the lack of tests during the news conference, and came and went to the microphone several times. | Dr. Birx was asked several questions by reporters about the lack of tests during the news conference, and came and went to the microphone several times. |
| Early on, she was asked a question that the administration has struggled to deal with: If federal officials have shipped millions of tests, as White House officials have said several times, why have only 60,000 Americans been tested? | Early on, she was asked a question that the administration has struggled to deal with: If federal officials have shipped millions of tests, as White House officials have said several times, why have only 60,000 Americans been tested? |
| Dr. Birx answered that tests in the United States were now being made by many producers, which is correct. Differing diagnostic tests are now made by state laboratories, medical school laboratories and private companies like Thermo Fisher, which she mentioned as an example. | Dr. Birx answered that tests in the United States were now being made by many producers, which is correct. Differing diagnostic tests are now made by state laboratories, medical school laboratories and private companies like Thermo Fisher, which she mentioned as an example. |
| Dr. Birx said she was strongly urging commercial providers to get their tests out, but of course, they first had to prove to the Food and Drug Administration that they were of high quality. | Dr. Birx said she was strongly urging commercial providers to get their tests out, but of course, they first had to prove to the Food and Drug Administration that they were of high quality. |
| Later, she was asked about a criticism made by former Vice President Joseph R. Biden Jr. in Monday’s night’s debate. He said the W.H.O. had “offered tests to the United States but we didn’t buy them.” | Later, she was asked about a criticism made by former Vice President Joseph R. Biden Jr. in Monday’s night’s debate. He said the W.H.O. had “offered tests to the United States but we didn’t buy them.” |
| In her answer, she did not refer to the W.H.O. tests at all, but said, “We don’t buy tests that haven’t been quality-controlled and they show us the data," then adding that a test with high rates of inaccuracy would be a disaster. | In her answer, she did not refer to the W.H.O. tests at all, but said, “We don’t buy tests that haven’t been quality-controlled and they show us the data," then adding that a test with high rates of inaccuracy would be a disaster. |
| A spokeswoman for the W.H.O. said she did not know what Dr. Birx was referring to, but the agency had been supplying kits to member nations since January. | A spokeswoman for the W.H.O. said she did not know what Dr. Birx was referring to, but the agency had been supplying kits to member nations since January. |
| The accuracy of the test was validated by three laboratories before it was rolled out, the spokeswoman said, and it had consistently showed “good performance in laboratory and clinical use, and neither a significant number of false positive nor false negative results have been reported.” | The accuracy of the test was validated by three laboratories before it was rolled out, the spokeswoman said, and it had consistently showed “good performance in laboratory and clinical use, and neither a significant number of false positive nor false negative results have been reported.” |
| In any case, Mr. Biden’s assertion that the Trump administration refused tests offered by the W.H.O. appears to be wrong. The W.H.O. does not sell tests to wealthy countries, which usually prefer to make their own. | In any case, Mr. Biden’s assertion that the Trump administration refused tests offered by the W.H.O. appears to be wrong. The W.H.O. does not sell tests to wealthy countries, which usually prefer to make their own. |
| Dr. Anne Schuchat, deputy principal director of the Centers for Disease Control and Prevention, confirmed that the W.H.O. gave test kits “primarily to underresourced countries.” Another administration official, speaking on the condition of anonymity, confirmed that the W.H.O. had never offered to sell or give tests to the United States. | Dr. Anne Schuchat, deputy principal director of the Centers for Disease Control and Prevention, confirmed that the W.H.O. gave test kits “primarily to underresourced countries.” Another administration official, speaking on the condition of anonymity, confirmed that the W.H.O. had never offered to sell or give tests to the United States. |
| China, Hong Kong, France, Germany, Thailand and the United States have all designed their own tests, according to the W.H.O. website. Each one looks for the presence of two or three short stretches of viral genes. | China, Hong Kong, France, Germany, Thailand and the United States have all designed their own tests, according to the W.H.O. website. Each one looks for the presence of two or three short stretches of viral genes. |
| For example, the C.D.C’s test looks at three targets on the N gene, while the tests ordered by the W.H.O. look at bits of the N gene, the RdRP gene and the E gene. Each gene performs a different function in helping the virus break into cells, hijack their DNA machinery and reproduce million of copies of itself. | For example, the C.D.C’s test looks at three targets on the N gene, while the tests ordered by the W.H.O. look at bits of the N gene, the RdRP gene and the E gene. Each gene performs a different function in helping the virus break into cells, hijack their DNA machinery and reproduce million of copies of itself. |
| For countries that are unable to make the tests or buy them from other countries, the W.H.O. asks academic or government laboratories to make tests. | For countries that are unable to make the tests or buy them from other countries, the W.H.O. asks academic or government laboratories to make tests. |
| It then delivers them to poor and middle-income countries at low or no cost, paying for them out of emergency funds or loans from institutions like the World Bank. | It then delivers them to poor and middle-income countries at low or no cost, paying for them out of emergency funds or loans from institutions like the World Bank. |
| The test ordered by the W.H.O. was designed in a lab run by Dr. Christian Drosten at the medical school of Berlin’s Charity Hospital, which is considered one of the world’s top genomic laboratories. | The test ordered by the W.H.O. was designed in a lab run by Dr. Christian Drosten at the medical school of Berlin’s Charity Hospital, which is considered one of the world’s top genomic laboratories. |
| According to a detailed description of the test posted on the W.H.O. website, in its initial rollout, it was accurate 100 percent of the time. | According to a detailed description of the test posted on the W.H.O. website, in its initial rollout, it was accurate 100 percent of the time. |
| In a Feb. 21 email, another W.H.O. spokesman said the test’s accuracy had been verified by three other laboratories before it was sent to a German diagnostics company for manufacturing. There had been no problems with the first shipment of 250,000 doses, he said. | In a Feb. 21 email, another W.H.O. spokesman said the test’s accuracy had been verified by three other laboratories before it was sent to a German diagnostics company for manufacturing. There had been no problems with the first shipment of 250,000 doses, he said. |
| Dr. Michael Mina, an assistant professor of epidemiology at the Harvard School of Public Health, said both the W.H.O. test and the initial C.D.C. tests were “exceptional” in their accuracy. | Dr. Michael Mina, an assistant professor of epidemiology at the Harvard School of Public Health, said both the W.H.O. test and the initial C.D.C. tests were “exceptional” in their accuracy. |
| Updated June 16, 2020 | Updated June 16, 2020 |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| The problems with the C.D.C. test have been attributed to flaws in the manufacturing of reagents for kits, not in the C.D.C.’s design. | The problems with the C.D.C. test have been attributed to flaws in the manufacturing of reagents for kits, not in the C.D.C.’s design. |
| No test is accurate 100 percent of the time, but the errors are usually introduced by medical personnel who fail to take samples correctly or lab personnel who run the test incorrectly or accidentally contaminate it with stray DNA. | No test is accurate 100 percent of the time, but the errors are usually introduced by medical personnel who fail to take samples correctly or lab personnel who run the test incorrectly or accidentally contaminate it with stray DNA. |
| For example, in February an American passenger released from the cruise ship Westerdam, which went from port to port for many days before Cambodia allowed it to dock, tested positive for the virus as she passed through Malaysia, setting off a crisis. | For example, in February an American passenger released from the cruise ship Westerdam, which went from port to port for many days before Cambodia allowed it to dock, tested positive for the virus as she passed through Malaysia, setting off a crisis. |
| The C.D.C. later said she did not have the virus and judged the Malaysian test to be a likely false positive. | The C.D.C. later said she did not have the virus and judged the Malaysian test to be a likely false positive. |
| Since Malaysia did not have its own test, it presumably used the W.H.O.’s. But Malaysia does not have a top-quality lab, and many labs make initial errors when they are rolling out a new test. | Since Malaysia did not have its own test, it presumably used the W.H.O.’s. But Malaysia does not have a top-quality lab, and many labs make initial errors when they are rolling out a new test. |
| Sheri Fink and Ellen Gabler contributed reporting from New York. Abby Goodnough contributed reporting from Washington. | Sheri Fink and Ellen Gabler contributed reporting from New York. Abby Goodnough contributed reporting from Washington. |