Monday Morning Thoughts: Science Will Have to Get Us out of this COVID-19 Mess

From the start the battle lines over COVID-19 have taken the shape of the political contours of the country.  Left versus right.  Urban versus rural.  But in a lot of ways this has been the extension of science versus anti-science.

The wing of the country that trusted the science was the wing more likely to heed the early warnings and projections.  That’s not necessarily concurrent with left and right splits.  There are people on the far left inclined to believe that this is a hoax or a government-concocted experiment that has been unleashed as a way to control the citizenry or seize control over the economy.

Those who heeded early warnings—like Ohio, California and Washington—have been hit by the disease but have controlled the spread.  California has at press time had more than 15,000 reported cases, but that is far fewer than what has happened in New York and New Jersey in absolute numbers and less per capita than many other states: Massachusetts, Pennsylvania, Michigan, Illinois, Florida, and Louisiana.

The states that have locked their states down have seen the curve flattened, while those who waited too long have seen the case numbers increasing.

The problem we face is also technological—we have not enough testing to know exactly how many people are infected.

That led to a warning by Dr. Anthony Fauci that perhaps as many as half the people infected with the virus may not have any symptoms.

“It’s somewhere between 25 and 50 percent,” said the specialist, Dr. Anthony S. Fauci, during a briefing by President Trump and members of the coronavirus task force on Sunday.

He acknowledged, though, that this was “only a guess” and the real need is for “more testing” to figure out how many Americans are carrying the virus without realizing it.

On the other end of the scale, there is President Trump who has repeatedly played down the crisis, stating in late January that it was under control and implying early that this was all just a hoax.

On Sunday, he doubled down on his push for the use of an anti-malarial drug, per the NY Times “issuing medical advice that goes well beyond scant evidence of the drug’s effectiveness as well as the advice of doctors and public health experts.”

“But what do I know? I’m not a doctor,” Mr. Trump said, after recommending the anti-malaria drug’s use for coronavirus patients as well as medical personnel at high risk of infection.

“If it does work, it would be a shame we did not do it early,” Mr. Trump said.

The media noted that when a reporter asked Dr. Fauci about the use of hydroxychloroquine, Mr. Trump stopped him from answering.  On Saturday, he challenged optimism about the drug’s effectiveness against COVID-19.

What is the answer to this and other questions?  More science, of course.

The New York Times reports that economists desperately want to re-open the economy.

That is largely going to depend on the ability to reduce the risk of transmission.

Without more testing, “there’s no way that you could set a time limit on when you could open up the economy,” said Simon Mongey, a University of Chicago economist who is among the authors of a new study that found that rapid deployment of randomized testing for the virus could reduce its health and economic damage.

“It’s going to have to depend on being able to identify people that have the coronavirus, understanding how readily those people can transmit the disease to others and then kind of appropriately isolating people that are contagious,” Mr. Mongey said.

The ultimate answer, of course, is a vaccine—and scientists have made progress here, but still most experts think that is probably a solution which is 18 months away.

Yesterday we pushed the antibody tests.

Governor Newsom announced that a new immunity test from Stanford could screen and allow people who are immune from the virus to go back to work.

“The testing space has been challenging for us, and I own that,” Governor Newsom said during a news conference. “I have a responsibility as your governor to do more and to do better.”

He told the media on Saturday that the Stanford blood test is just “hours” away from federal approval and could allow people to begin to return to work

Unlike others, these tests are “serological,” and “could determine whether someone has developed antibodies to the coronavirus. In theory, those who develop immunity may be able to safely interact with others without catching or spreading it.”

That would be a game changer.

Dr. Charity Dean, assistant director at the California Department of Public Health, said it would be used on Californians in the coming week.

“We’re very excited that this is a California homegrown test,” she said during the news conference.

I still believe that the real revolution, however, will be rapid testing.  That would provide us with a means to know who has it, who is carrying it, and whom to isolate.  We might with a lot of work and cooperation be able to allow those who are not carrying it or who are immune to restart their work outside of their house and thus partially restart the economy.

Oxford University scientists have now developed “rapid testing technology” which gives results in half an hour and which can be done at home.  This could be rolled out in a matter of weeks.

There is also the development of airway pressure masks, which can better treat people and avoid the need for ventilators.  The problem with ventilators is they can only be used under sedation.  This would bridge the gap and also “ensure ventilators are used only for the most severely ill.”

There is also a possibility of “temporary vaccines” which could be given to those at most risk.  This could guard their health for a few months at a time as a long-lasting solution comes forward.

Where is this research taking place?  A lot of it is at research universities like UC Davis.

In a release from last Monday, UC Davis reported, “Anticipating a scarcity of medical devices and a lack of treatment options for COVID-19, engineering researchers at the University of California, Davis, are investigating innovative technology to manufacture masks, ventilators and other critical equipment.”

And, of course, UC Davis researchers are working hard to develop a vaccine and treatments.

On March 19, they reported, “Clinical pathologists, infectious disease physicians and scientists at the UC Davis Medical Center, School of Medicine, California National Primate Research Center and Center for Immunology and Infectious Diseases are collaborating on new reagents, diagnostic tests and a vaccine for the COVID-19 coronavirus. Their goal is to unravel the biology and infectious pathology of this new virus, and to develop means for prevention and ultimately treatment.”

All in all, science holds the promise of shortening this crisis, and reducing the risk to the public until we can find a vaccine and perhaps effective treatments for those with more severe versions of the illness.

—David M. Greenwald reporting