Stunningly high reported New York infection rate illustrates coronavirus uncertainty

By | April 24, 2020

Recent analyses of testing for the coronavirus illustrate just how difficult it is to understand the nature of the pandemic, and the uncertainty facing President Trump and governors as they seek to ease restrictions while avoiding further outbreaks.

New York state data released by Gov. Andrew Cuomo Thursday, based on 3,000 antibody tests conducted at grocery stores and big-box retailers, indicated an infection rate of an alarming 13.9%.

On its face, the analysis, like a few other recent studies based on testing for COVID-19 antibodies among the general population, suggests that the pandemic is much worse than previously thought, in the sense that it infected far more people than realized. With a population of 19.4 million, the infection rate would mean that 2.7 million New Yorkers have or have had the virus. That is 10 times greater than the official number of coronavirus cases in New York: 257,216.

However, the results are also good news, in that they suggest that the disease is much less lethal than thought, as the vast majority of cases are asymptomatic. It found an infection to fatality rate, or IFR, of 0.6%. That is lower than the fatality ratio of 6% based on confirmed cases and deaths in New York.

White House Coronavirus Task Force Coordinator Dr. Deborah Birx has said that random antibody testing is key to the administration’s strategy for containing the virus. “I think it’s fundamental, both for right now and going through the fall, because that will be our early alert if any of the COVID virus reappears,” she said Wednesday.

Yet the New York research, as with similar noteworthy analyses of antibody testing from recent days, is subject to limitations and second-guessing. It may be considerably overestimating the number of people with the coronavirus and underestimating the lethality, meaning that it would be difficult for policymakers to draw definitive conclusions about how to proceed.

Two recent studies based on antibody testing in California generated controversy among experts.

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One, of Los Angeles County, found an infection rate of 5.6% and an IFR of 01.-0.3% and another of Santa Clara County found an infection rate of 4.1% and an IR of 0.1-0.2%. In the case of the Santa Clara study, the test had such a high rate of false positives that some researchers suggested that it is possible that all of the positives were false positives, while others raised the possibility that the sample was designed in such a way that it was not random . The Los Angeles study has been criticized for not releasing its methodology or the type of antibody test it used.

The New York state study may also have bias problems. “Is testing 3k people at supermarkets a biased (non-representative) sample? Likely, in some sense,” tweeted Craig Spencer, an emergency room physician in New York City. One possible bias is that people who are out shopping may also be people more likely to be exposed to the virus. In that case, the results overstate the prevalence of the virus.

Cuomo cautioned against drawing firm conclusions from the data. “You are testing people who, by definition, who are out of the home and not at work,” he said. “These are people who are out and about, shopping. They were not people who were in their home, isolated, or quarantined, who you could argue had a lower rate of infection because they wouldn’t come out of the house. These are people who are outside.”

Another difficulty with drawing lessons about the lethality of the virus from the data is that the state may not have a good count of how many people have died from the virus. “This data doesn’t include people who died in their home and were not in a hospital or nursing home,” Cuomo said. “It’s not accurate because there will have been many other deaths that were never tested for COVID, that should be attributed to that number.”

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The daily death toll in New York has steadily decreased for the past couple of weeks. About 480 people died Wednesday, and Cuomo reiterated that the fatality rate is basically “flat.” Nationwide, the number of cases has surpassed 873,100. At least 47,890 people have died, according to a tally maintained by Johns Hopkins University.

The House voted to pass the $ 484 billion economic relief bill Thursday, which includes added funding to help small businesses maintain payrolls, hospital aid, and additional support for coronavirus testing capacity. The bill passed in a 388-5 vote. Trump said Thursday during the White House press briefing he would sign it into law “probably tonight.” Four Republicans and Democrat Alexandria Ocasio-Cortez voted against it, while independent congressman Justin Amash voted “present.”

Before passing the relief package, the House approved a Democrat-led select subcommittee to monitor how the Trump administration spends relief funds approved by Congress.

To avoid transmission of the virus on the House floor, members were divided into eight groups of roughly 60 members each and went into the chamber in shifts.

The public overwhelmingly supports restrictions meant to limit the pandemic. A Kaiser Family Foundation poll found that 80% of people still think shelter-in-place orders are needed to fight the coronavirus. Only 19% say that such measures are an unnecessary burden on the economy and are doing more harm than good. That includes 79% who think the measures are needed and live in a state headed by a Republican governor. GOP governors have been leading the charge to reopen the economy.

Vice President Mike Pence praised governors Thursday for embracing the White House strategy of reopening in phases, saying that 16 states have released formal plans.

“We do believe by early summer we could be in a much better place as a nation with much of this coronavirus epidemic behind us,” he said.

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Yet Michigan has seen political unease over its pandemic restrictions. Dozens of demonstrators gathered outside Gov. Gretchen Whitmer’s home Thursday to protest economic restrictions and strict lockdown measures. The demonstration was similar to one that took place last week in front of the capital in Lansing. Most people stayed in their vehicles Thursday, but during “Operation Gridlock” in Lansing last week, people did not abide by social distancing guidelines, standing close to one another, often without protective masks.

Thursday’s event organizer Brandon Hall told 6 News, “We can’t go on like this … it’s not acceptable … if you saw last week, businesses and families are hurting. They are about to bankrupt. I’ve never seen Michigan like this.”

South Dakota Gov. Kristi Noem has been the subject of criticism for her decision not to enforce a statewide lockdown, which she says is unnecessary given the state’s low tally of cases and deaths.

“We have 2,500 beds set aside for COVID-19 patients, but we only have 63 in,” Noem said in an interview with Breitbart. “We probably, from all of our projections and studying the science behind the virus, we won’t peak until the middle of June. But we already have done much better than what we had thought would have been hitting our state already.”

China rebuffed Secretary of State Mike Pompeo’s call for the Chinese government to allow foreign inspectors into the Wuhan Institute of Virology and other labs where Chinese scientists study coronaviruses. Suspicions have arisen that the coronavirus pathogen leaked out of one of these labs, causing a global outbreak.

“Any objective person will see that some U.S. politicians have been peddling lies that discredit China’s anti-epidemic efforts to fuddle people’s minds and deflect attention from the fact that they fell short of fulfilling their own anti-epidemic responsibilities,” Chinese Foreign Ministry spokesman Geng Shuang said Thursday.

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