America is testing more. But the results are too slow, a survey finds.
Frustrated by a nationwide testing backlog, the governors of six states took the unusual step of banding together on Tuesday to reduce the turnaround time for coronavirus test results to minutes from days.
The agreement, by three Republicans and three Democrats, was called the first interstate testing compact of its kind. The six states — Louisiana, Maryland, Massachusetts, Michigan, Ohio and Virginia — agreed to work with the Rockefeller Foundation and two U.S. manufacturers of rapid tests to buy 3 million tests.
More than six months into the pandemic, the bipartisan plan highlights the depth of the testing problems in the United States as well as how the lack of a federal testing program has left municipalities and states to fend for themselves. The Trump administration has offered new support to hard-hit regions by providing free testing in cities through a “surge testing” program, but the bulk of government-sponsored testing has been provided by cities, counties and states that hire third-party contractors. As a result, the length of the delay varies between states, and within them.
The United States is testing about 755,000 people a day, up from about 640,000 per day a month ago, and far more than in April and May, according to the Covid Tracking Project. But numbers alone do not tell the whole story. With testing chemicals in short supply, and an increase in cases nationwide leading to skyrocketing demands, many people still have to wait many days for results, in effect rendering those tests useless.
Most who are tested for the virus do not receive results within the 24 to 48 hours recommended by public health experts to effectively stall the virus’s spread and quickly conduct contact tracing, according to a new national survey by researchers from Harvard University, Northeastern University, Northwestern University and Rutgers University.
The survey — representing 19,000 people from 50 states and Washington, D.C., who responded to an online questionnaire last month — found lengthy wait times among those who had been tested for the virus, about 18 percent of all respondents. Respondents in a vast majority of states reported a median turnaround time of at least three days, including residents of California, Florida, Texas and other hot spots. The survey also found disparities across racial groups, an indication that people who are hit hardest by the pandemic are also having to wait longer for test results.
“Testing is just not quick enough,” said Matthew A. Baum, a professor of public policy at Harvard University and one of the researchers in the group, which found that wait times were “strikingly similar” across the country. “This is an enormously widespread problem.”
Negotiators on Wednesday will reconvene on Capitol Hill to continue hammering out the details of a coronavirus relief package, having agreed to work toward an agreement by the end of the week and have legislative text prepared for the following week.
Speaker Nancy Pelosi of California is expected to again host Mark Meadows, the White House chief of staff; Steven Mnuchin, the Treasury secretary; and Senator Chuck Schumer of New York, the minority leader, in her Capitol Hill suite. The four are also expected to meet with Louis DeJoy, the postmaster general, to “explain to us why there’s so many delays and how that might affect the election,” Mr. Schumer said on Tuesday.
The meeting with Mr. DeJoy, a Trump campaign megadonor, comes as mail delays fuel concerns over the politicization of the Postal Service and the administration’s moves to undermine mail-in voting ahead of the general election in November. Democrats are fighting for the inclusion of aid for the Postal Service and election security in an overall coronavirus relief package, while Republicans did not include any such funding in their $1 trillion proposal.
White House officials and Democratic leaders acknowledged some progress in talks on Tuesday. Senator Mitch McConnell of Kentucky, the majority leader, signaled he may be open to accepting a compromise measure, even if it contained provisions that he — and members of his conference — disagreed with, such as the extension of $600-per-week jobless-aid payments.
But it remains unclear whether negotiators would be able to adhere to the timeline they had agreed to, given the number of remaining policy divisions. Several Senate Republicans, particularly moderates facing tough re-election campaigns, have urged Republican leadership to keep lawmakers in Washington until a deal is reached, instead of departing for a scheduled monthlong recess at the end of this week.
The number of coronavirus deaths around the world passed 700,000 on Wednesday, according to a New York Times database. The virus has sickened more than 18.5 million people.
Almost twice as many countries have reported a significant rise in new cases over the past two weeks as have reported significant declines, according to the database.
Numbers are also going up in Latin America. Brazil, which has been particularly hard hit, is still seeing cases rise, as are Colombia and Peru.
In other news from around the world:
The United States’ top health official, Alex M. Azar II, will lead a delegation on a trip to Taiwan, a rare high-level visit by an American official to the island that has won praise for its success in battling the coronavirus.
The state of Victoria in Australia reported 725 new cases and 15 deaths from the coronavirus on Wednesday, its highest numbers since the pandemic began. New curfews and restrictions in the state mean essential workers must now carry a permit before leaving home.
Sri Lanka is holding a general election on Wednesday after twice delaying it because of the pandemic. Voters were required to wear masks and were encouraged to bring their own pens to the voting booths, which will be outfitted with hand sanitizer. Sri Lanka has reported 2,834 coronavirus cases, 299 of which are currently active.
As Trump praises plasma, researchers struggle to finish critical studies.
The truth is that no one knows if it works.
Since April, the Trump administration has funneled $48 million into a program with the Mayo Clinic, allowing more than 53,000 Covid-19 patients to get plasma infusions. Doctors and hospitals desperate to save the sickest patients have been eager to try a therapy that is safe and might work. Tens of thousands more people are now enrolled to get the treatment that has been trumpeted by the President Trump and a number of celebrities.
But the unexpected demand for plasma has inadvertently undercut the research that could prove that it works. The only way to get convincing evidence is with a clinical trial that compares outcomes for patients who are randomly assigned to get the treatment with those who are given a placebo. Many patients and their doctors — knowing they could get the treatment under the government program — have been unwilling to join clinical trials that might provide them with a placebo.
The Food and Drug Administration is preparing an emergency authorization to use the treatment, according to scientists who have been briefed on the plans. The policy would ease the clerical burden on hospitals to get clearance for transfusions, further hampering clinical trials, researchers said. An F.D.A. spokeswoman declined to comment on whether such an authorization was in the works.
The move would mean the F.D.A. is “yielding to political pressure,” said Dr. Luciana Borio, who oversaw public health preparedness for the National Security Council under Mr. Trump and who was acting chief scientist at the F.D.A. under former President Barack Obama.
“I’m not as concerned about the political leaders having a misguided approach to science,” she said. “What I’m really concerned about is scientists having a misguided approach to science.”
Convalescent plasma, the pale yellow liquid that is left after blood is stripped of its red and white cells, has been used since the 1890s to treat infectious diseases, including the flu, SARS and Ebola. Scientists believe it may work by giving sick patients the antibodies of those who have recovered from the infection.
Thousands of business owners in the United States have discovered that the business interruption policies they bought, and have been paying thousands of dollars in annual premiums to sustain, will not pay them a thing — just as they are struggling through the biggest business interruption in modern memory. (Business interruption insurance is a type of coverage that replaces a portion of a firm’s lost revenue when a disaster forces it to suspend operations.)
Now, many of them — including proprietors of gyms, dental practices, high-profile restaurateurs and even a National Basketball Association team — are taking their insurers to court, hoping to force them to cover some of the financial carnage. So far, more than 400 business interruption lawsuits have been filed, according to insurance lawyers.
“I think business interruption claims should be paid when business is interrupted,” said Nick Gavrilides, who closed his dining room when Michigan went into lockdown and had expected that he would get some of his losses covered because he had paid for business interruption insurance. (When he did not get a cent, he sued.)
Insurance companies do not see it that way. Most business interruption policies include highly specific language stating that for a claim to be paid out, there has to be “direct physical damage” — say, a flood that washes away a building or a fire that burns down inventory, forcing a business closure.
On top of that, after SARS swept through Asia nearly two decades ago and caused widespread economic damage, many insurers began to write in language that excluded business interruption caused by viral epidemics.
Insurers say they are not being stingy; they simply do not have enough capital to cover all coronavirus-related claims and would suffer enormous losses if they had to pay out.
The American Property Casualty Insurance Association has estimated that if insurers were required to cover all U.S. business interruption losses tied to the shutdowns, regardless of policy exclusions — something proposed by lawmakers in some states — it would cost $1 trillion a month.
With more than 18 million cases of coronavirus worldwide, one thing is clear: The symptoms are varied and strange, they can be mild or debilitating, and the disease can progress, from head to toe, in unpredictable ways.
Despite hundreds of published studies on Covid-19 symptoms, just how common any given symptom is depends on the patient group studied. Patients in hospitals typically have more severe symptoms. Older patients are more likely to have cognitive problems. Younger patients are more likely to have mild disease and odd rashes.
“This is a very tricky and confounding virus and disease, and we are finding out surprising things about it every day,” said Dr. Asaf Bitton, executive director of Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health.
Anosmia, the loss of sense of smell that is also often accompanied by a loss of taste, is viewed as one defining symptom, but it is not foolproof. Even a symptom as common as fever can be tricky; in a European study of 2,000 Covid-19 patients with mild to moderate illness, 60 percent never had a fever.
“The problem is that it depends on who you are and how healthy you are,” said Dr. Mark Perazella, a kidney specialist and professor of medicine at Yale School of Medicine. “If you’re healthy, most likely you’ll get fever, achiness, nasal symptoms, dry cough and you’ll feel crappy. But there are going to be the oddballs that are challenging and come in with some symptoms and nothing else, and you don’t suspect Covid.”
About one-third of Afghanistan’s population, or roughly 10 million people, have likely been infected by the coronavirus and recovered, Afghanistan’s health ministry said on Wednesday, based on a survey that deployed rapid tests for antibodies.
Ahmad Jawad Osmani, Afghanistan’s acting health minister, said the infection rate varied across the country according to the “cross-sectional survey,” conducted with the help of the World Health Organization and Johns Hopkins University. Crowded urban centers showed higher rates than the rural areas. The ministry said about 9,500 people were tested for the survey.
“The survey showed that 31.5 percent of the population of Afghanistan has been infected by coronavirus according to rapid tests which show antibodies in the blood, and that they have recovered,” Mr. Osmani said.
Kabul, the capital city of more than five million people, has been worst hit, with about 53 percent of the residents infected. The rate of infection in the east of the country was nearly 43 percent, the west 34 percent, and the northeast 32.4 percent.
“In Kabul, 46 percent of children were infected by the virus, but they don’t have symptoms. And 57 percent of adults were also infected in Kabul,” Mr. Osmani said. “The infection rates were lowest in central parts of the country with 25 percent of adults and 14 percent of children infected.”
The country’s nascent health system has been overwhelmed by the virus at a time when the war continues to bring large numbers of casualties to the hospitals as well. Testing has been extremely limited, casting doubt on official numbers.
There have been 36,782 confirmed cases of the coronavirus in Afghanistan and 1,288 deaths, according to a New York Times database.
The University of Connecticut canceled its football season on Wednesday, becoming the first member of the Football Bowl Subdivision to abandon its schedule in full because of the pandemic.
Connecticut’s season was already in flux because of the decisions of leading conferences, including the Big Ten and Southeastern, to play exclusively within their leagues. By the time Connecticut announced its decision on Wednesday morning, a third of its planned games had been canceled.
But in a statement, David Benedict, the athletic director at Connecticut, cited the pandemic’s perils, not scheduling complications, as the reason to drop plans for the season, saying it put athletes “at an unacceptable level of risk.”
In a statement released through the university, football players said they supported the decision, in part because “not enough is known about the potential long term effects” of the virus.
The decision from Connecticut came as the National Collegiate Athletic Association prepared to offer more details on Wednesday about its plans for championships in 22 fall sports, not including football, which runs its national championships under a different system.
Job hunting tips for today.
It is no longer about a firm handshake and confident eye contact, but some of the usual job interview tips do still apply when you take your job hunt online.
Reporting was contributed by Fahim Abed, Alan Blinder, Emily Cochrane, Nicholas Fandos, Manny Fernandez, Hailey Fuchs, Mujib Mashal, Sarah Mervosh, Tara Parker-Pope, Amy Qin, Michael D. Shear, Kaly Soto, Katie Thomas, Kenneth P. Vogel, Mary Williams Walsh, Noah Weiland and Billy Witz.