|
 Barely more than a handful of public health departments across the
country are able to test for the novel virus, which began in China
and has spread to at least 44 countries. The federal government has
less than 10% of the protective masks required to protect healthcare
workers and the public. And Washington still does not have adequate
funding in place to support health departments' efforts, though more
money is on the way.
Conflicting messaging from the White House and top U.S. officials
regarding the severity of the threat has only added to the
uncertainty.
The U.S. Centers for Disease Control and Prevention (CDC) this week
for the first time advised American businesses, schools, hospitals
and families to prepare for domestic acceleration of the virus,
which has infected more than 80,000 people worldwide and killed
nearly 3,000.
President Donald Trump on Wednesday assured Americans that the risk
of coronavirus transmission in the United States was "very low."
Despite an explosion of cases in China over the past two months, the
Trump administration only this week put in a request for $2.5
billion to aid in the response, an amount both Republicans and
Democrats have said is too small.
Critics of the federal response say the United States squandered
precious weeks by focusing too narrowly on keeping the coronavirus
from crossing U.S. borders rather than marshalling resources to
prepare American communities for a widespread domestic outbreak that
officials now say was inevitable.
"This has been a realistic risk for a month, and the signal to
trigger that kind of preparedness has only been going out in the
last few days in an explicit way," said Jeremy Konyndyk, a senior
policy fellow at the Center for Global Development in Washington.
"That's a huge problem."
FEW BEING TESTED
There are 60 confirmed U.S. cases of the novel coronavirus, which
causes the disease known as Covid-19, U.S. health officials said on
Wednesday. But experts admit they have no way of knowing the true
figure because access to testing at present is severely limited.
So far, the U.S. strategy has focused almost exclusively on testing
infected travelers, using a test that looks for genetic material
from the virus in saliva or mucus. As of February 23, fewer than 500
people from 43 states had been or are being tested for the virus.
Currently, just seven state and local health departments have the
ability to screen for the virus, the Association of Public Health
Laboratories (APHL) said on Wednesday. CDC-developed tests issued
three weeks ago were producing inaccurate results in some labs, so
new tests had to be made and cleared by the U.S. Food and Drug
Administration (FDA), leaving many labs with no local testing
capability, the group said.
The CDC and FDA have worked out a fix that will allow 40 more public
health labs to do testing by the end of next week, the APHL's Chief
Executive Scott Becker told Reuters.
In the meantime, the burden has fallen largely on the CDC, which
does testing for most of the country on its campus in Atlanta.
"Unfortunately, we are now in the bottom tier in countries capable
of doing population-based testing," said Dr. Michael Osterholm,
director of the Center for Infectious Disease Research and Policy at
the University of Minnesota.
U.S. patients typically wait 24 to 48 hours to find out whether they
have tested positive and need to be quarantined, health officials
said, during which time those who are infected can spread the virus
to others
The CDC's test is restricted solely for use by public health labs,
but if the virus begins spreading widely in the United States,
hospitals will need to be able to do the tests themselves, public
health experts say. Such testing is typically done using kits
produced by commercial companies. Several privately developed tests
are in the works, but none have yet won approval from the FDA.
Some health experts also fault the narrow testing criteria that the
United States is using to screen for potential infections.
Currently, individuals with flu-like symptoms are only tested for
the coronavirus if they have traveled to a country where the virus
is spreading. This has raised concerns that there are far more cases
in the United States than are currently recorded.
[to top of second column] |
"If the majority of testing is all around airports or travelers, we won't know
whether it's circulating in communities," said Dr. Tom Inglesby, director of the
Center for Health Security of the Johns Hopkins Bloomberg School of Public
Health.
Those worries were reinforced on Wednesday when the CDC confirmed the first U.S.
case of coronavirus in a California patient with no apparent travel history. The
University of California Davis said in a statement the patient was transferred
to the hospital with severe pneumonia and the hospital requested testing. But
since the patient didn't fit the CDC's criteria, those tests were delayed by
several days.
On Thursday, CDC said it is broadening those criteria to allow testing when the
virus is suspected.
MASKS IN SHORT SUPPLY
Around 15 state health departments contacted by Reuters raised concerns about
challenges they would face in the event of community spread, including worries
about not having enough personal protective gear to safeguard frontline medical
workers.
The U.S. Department of Health and Human Services on Tuesday estimated that the
United States would need 300 million face masks to protect healthcare workers
and the public from people infected with the virus. The country has fewer than
20 million of the kind of masks needed to protect healthcare workers in the
Strategic National Stockpile, a government repository of medical supplies needed
to address public health emergencies.
"There is a real concern the availability of this equipment may be limited, in
part because of the public buying it in a panic when they don't need it," said
Matt Zavadsky, head of the National Association of Emergency Medical
Technicians.
President Donald Trump's administration is considering invoking special powers
through a law called the Defense Production Act to quickly expand domestic
manufacturing of protective masks and clothing to combat the coronavirus in the
United States, two U.S. officials told Reuters.
With no Covid-19 vaccine or proven anti-viral medicine available, states are
planning to isolate sick people in their homes, both to slow community spread
and reduce pressure on hospitals, according to the CDC.
Their ability to track a rapidly expanding web of patients who test positive,
and all the people with whom they have had contact, is of major concern,
according to chief epidemiologists in several states.
Health departments in some states have purchased disease surveillance software
to help them with that task. The state of Washington's system, for instance,
tracks patients and people they have had contact with, and asks them about their
condition. If someone reports symptoms that merit hospitalization, the patient
and doctors are informed of that.
The CDC said in a news conference on Tuesday that transmission of the virus
could be slowed by the closure of schools and businesses and the cancellations
of concerts and other mass gatherings.
But exactly who would make those decisions or how they would be enforced isn't
clear and could vary widely throughout the nation.
In Texas, for example, such decisions may be made by local officials, said Chris
Van Deus, a spokesman with the Texas health department.
"Texas is a home rule state so the buck really stops with county judges and
mayors," Van Deus said.
Another concern is a flood of patients into health systems that are already
overburdened in many parts of the country, particularly during winter flu
season.
Washington state is considering temporary drive-through care facilities to stop
potential coronavirus carriers entering healthcare facilities, mindful that
hospitals can amplify outbreaks, as was the case with the viruses that cause
MERS and SARS.
New Mexico is working with healthcare systems to turn outpatient facilities into
care units if needed, said State Epidemiologist Michael Landen.
"The biggest challenge is getting a consistent message to the public with
respect to their options with dealing with this virus," Landen said.
(Reporting by Julie Steenhuysen in Chicago, Andrew Hay in Taos, New Mexico and
Brad Brooks in Austin, Texas; Editing by Marla Dickerson)
[© 2020 Thomson Reuters. All rights
reserved.] Copyright 2020 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
