1 00:00:00,880 --> 00:00:05,880 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one hundred 2 00:00:07,120 --> 00:00:12,200 Speaker 1: since coronavirus was declared a global pandemic. Today's main story 3 00:00:13,200 --> 00:00:16,560 Speaker 1: in the US. We still don't have as many COVID 4 00:00:16,640 --> 00:00:20,680 Speaker 1: tests as we need, and when people can get their 5 00:00:20,680 --> 00:00:26,960 Speaker 1: hands on tests, they're not always reliable. But first, here's 6 00:00:26,960 --> 00:00:36,760 Speaker 1: what happened in virus news today. The UK added London 7 00:00:36,960 --> 00:00:41,760 Speaker 1: to its watch list of potential pandemic hotspots as coronavirus 8 00:00:41,880 --> 00:00:47,240 Speaker 1: cases surge across the country. The move is fueling fears 9 00:00:47,280 --> 00:00:51,080 Speaker 1: that the capital, which recorded six hundred and twenty new 10 00:00:51,200 --> 00:00:55,040 Speaker 1: COVID nineteen cases on Thursday, could face the kind of 11 00:00:55,120 --> 00:01:00,720 Speaker 1: local lockdown measures imposed on other cities. The no new 12 00:01:00,760 --> 00:01:04,920 Speaker 1: restrictions will be put on London immediately. Its designation as 13 00:01:04,920 --> 00:01:09,600 Speaker 1: an area of concern means extra testing will be made available, 14 00:01:09,800 --> 00:01:15,959 Speaker 1: according to London Councils. In China, annual vaccine capacity is 15 00:01:16,000 --> 00:01:19,880 Speaker 1: expected to reach six hundred and ten million doses by 16 00:01:20,000 --> 00:01:24,120 Speaker 1: year end and one billion doses by the end of 17 00:01:26,280 --> 00:01:29,960 Speaker 1: that's according to Jiang jongwe, an official at the National 18 00:01:29,959 --> 00:01:34,360 Speaker 1: Health Commission. At a briefing in Beijing. Jang said prices 19 00:01:34,400 --> 00:01:38,240 Speaker 1: will be affordable for the public, but did not give specifics. 20 00:01:39,480 --> 00:01:43,399 Speaker 1: No serious cases of adverse reaction were reported yet in 21 00:01:43,480 --> 00:01:49,920 Speaker 1: an emergency use program of China's innoculations, And finally, in 22 00:01:49,960 --> 00:01:54,040 Speaker 1: the next few days, the world will officially record one 23 00:01:54,120 --> 00:01:59,080 Speaker 1: million deaths from COVID nineteen, but the real tally might 24 00:01:59,120 --> 00:02:04,680 Speaker 1: be almost double that. Actual fatalities from the worst pandemic 25 00:02:04,720 --> 00:02:08,320 Speaker 1: in a century may be closer to one point eight million. 26 00:02:09,160 --> 00:02:12,120 Speaker 1: The death toll could grow to as high as three 27 00:02:12,160 --> 00:02:16,880 Speaker 1: million by the end of the year. Both projections are 28 00:02:16,919 --> 00:02:20,800 Speaker 1: according to Alan Lopez, a laureate professor and director of 29 00:02:20,800 --> 00:02:25,360 Speaker 1: the University of Melbourne's Global Burden of Disease Group. The 30 00:02:25,480 --> 00:02:30,320 Speaker 1: coronavirus is rapid spread and transmission by people without symptoms 31 00:02:30,840 --> 00:02:34,360 Speaker 1: mean that it has moved faster than our ability to 32 00:02:34,440 --> 00:02:43,680 Speaker 1: do widespread testing. And now for today's main story, six 33 00:02:43,720 --> 00:02:47,919 Speaker 1: months into the coronavirus pandemic, the US is still hamstrung 34 00:02:48,160 --> 00:02:53,040 Speaker 1: by testing efforts. There simply aren't enough COVID nineteen tests, 35 00:02:53,680 --> 00:02:58,280 Speaker 1: and even when there are tests available, they aren't always reliable. 36 00:02:59,360 --> 00:03:02,480 Speaker 1: Here's you order, Kristin V. Brown on the free for 37 00:03:02,639 --> 00:03:12,000 Speaker 1: roll that US coronavirus testing has become last month when 38 00:03:12,120 --> 00:03:15,840 Speaker 1: nineteen people at a nursing home and Needham, Massachusetts, suddenly 39 00:03:15,880 --> 00:03:20,399 Speaker 1: tested positive for COVID nineteen. It sent the facility into 40 00:03:20,440 --> 00:03:25,079 Speaker 1: a tailspin. But North Hill Communities hadn't had any positive 41 00:03:25,080 --> 00:03:31,160 Speaker 1: tests for weeks. That's North Hill CEO Ted Owens. He 42 00:03:31,320 --> 00:03:34,600 Speaker 1: was especially worried because in the US, more than a 43 00:03:34,720 --> 00:03:38,040 Speaker 1: third of deaths from the novel coronavirus have been connected 44 00:03:38,160 --> 00:03:43,000 Speaker 1: to nursing homes. Massachusetts long term care facilities were especially 45 00:03:43,000 --> 00:03:48,280 Speaker 1: hard hit emotionally. You get to the point where in 46 00:03:48,360 --> 00:03:52,760 Speaker 1: the beginning, as people were dying, it was very stressful 47 00:03:52,800 --> 00:03:57,960 Speaker 1: for the staff, and then things calmed down, things tapered down. 48 00:03:58,360 --> 00:04:00,560 Speaker 1: He kind of got used to it, you know, you 49 00:04:00,640 --> 00:04:05,080 Speaker 1: reached some sort of new normal, not completely, but you 50 00:04:05,200 --> 00:04:09,360 Speaker 1: kind of adjusted to where things were. And then suddenly 51 00:04:10,720 --> 00:04:15,720 Speaker 1: you go probably three weeks with no positives, and then 52 00:04:15,840 --> 00:04:19,960 Speaker 1: suddenly you have nineteen positives that came out of the blue. 53 00:04:23,680 --> 00:04:27,039 Speaker 1: At the height of the pandemic, dozens of staff members 54 00:04:27,040 --> 00:04:31,320 Speaker 1: and residents had contracted the virus and nine residents had died, 55 00:04:32,360 --> 00:04:35,160 Speaker 1: but they had figured things out and put infection control 56 00:04:35,160 --> 00:04:39,040 Speaker 1: measures in place. Ted said that those positive results had 57 00:04:39,080 --> 00:04:42,440 Speaker 1: instilled fear throughout the nursing home that a second wave 58 00:04:42,480 --> 00:04:46,000 Speaker 1: of infection had come to the facility. But it turned 59 00:04:46,000 --> 00:04:48,640 Speaker 1: out there wasn't a new wave of virus sweeping through 60 00:04:48,680 --> 00:04:54,360 Speaker 1: the nursing home. The problem was the test. North Hill 61 00:04:54,480 --> 00:04:57,719 Speaker 1: was one of about sixty nursing homes in Massachusetts that 62 00:04:57,800 --> 00:05:02,440 Speaker 1: contracted with the Boston company called Origin. Origin is better 63 00:05:02,520 --> 00:05:06,440 Speaker 1: known as a consumer DNA testing company, and not a 64 00:05:06,520 --> 00:05:09,919 Speaker 1: very serious one. One of its tests actually hunts for 65 00:05:10,040 --> 00:05:14,360 Speaker 1: superhero genes. But Ted didn't know any of this when 66 00:05:14,360 --> 00:05:18,119 Speaker 1: he started using the company. In late June, the state 67 00:05:18,200 --> 00:05:22,159 Speaker 1: ordered all nursing homes to do regular surveillance testing and 68 00:05:22,200 --> 00:05:24,320 Speaker 1: gave them less than three weeks to set up a 69 00:05:24,360 --> 00:05:28,360 Speaker 1: testing program. Ted doesn't know how he heard about Origin. 70 00:05:28,880 --> 00:05:31,440 Speaker 1: He just knows it was a scramble to find any 71 00:05:31,480 --> 00:05:34,719 Speaker 1: company that could complete the amount of testing he needed 72 00:05:34,720 --> 00:05:38,839 Speaker 1: every week. At one point, the state did recommend Origin 73 00:05:38,880 --> 00:05:44,800 Speaker 1: to nursing homes. My analogy is it was like, Okay, 74 00:05:44,960 --> 00:05:48,719 Speaker 1: we're telling you that from now on you have to fly. Well, 75 00:05:48,800 --> 00:05:52,080 Speaker 1: how do I fly? That's up to you. You figure 76 00:05:52,120 --> 00:05:54,560 Speaker 1: that out. I'm just telling you what you need to do. 77 00:05:55,200 --> 00:05:57,640 Speaker 1: And that's kind of what they did with the surveillance testing. 78 00:05:57,720 --> 00:06:01,599 Speaker 1: They said, you need to do the surveillance testing, and 79 00:06:02,000 --> 00:06:03,920 Speaker 1: it's up to you to figure out how to get 80 00:06:03,960 --> 00:06:08,080 Speaker 1: it done. A few weeks into surveillance testing, when all 81 00:06:08,120 --> 00:06:11,760 Speaker 1: of those positive results came back, ted thought it seemed odd, 82 00:06:12,600 --> 00:06:15,560 Speaker 1: and he told the state Health Department that, but he 83 00:06:15,640 --> 00:06:19,200 Speaker 1: still had to treat the results seriously. He sent the 84 00:06:19,240 --> 00:06:22,640 Speaker 1: eighteen staff members who tested a positive home and asked 85 00:06:22,640 --> 00:06:26,120 Speaker 1: other staff to work over time. He isolated the one 86 00:06:26,160 --> 00:06:29,080 Speaker 1: resident who had tested positive, and he sent out a 87 00:06:29,200 --> 00:06:32,440 Speaker 1: letter to all the family members of residents telling them 88 00:06:32,600 --> 00:06:37,080 Speaker 1: what had happened. And, as you would expect, it through 89 00:06:37,640 --> 00:06:41,520 Speaker 1: everyone into a panic. We were in scramble mode. So 90 00:06:41,640 --> 00:06:44,920 Speaker 1: the first thing we did was we we started to 91 00:06:45,240 --> 00:06:50,040 Speaker 1: do a complete audit of all our infection control procedures 92 00:06:50,520 --> 00:06:55,800 Speaker 1: to try and figure out Initially, we just dissowned that 93 00:06:56,000 --> 00:06:58,760 Speaker 1: somewhere there was a source of infection and we had 94 00:06:58,800 --> 00:07:05,120 Speaker 1: missed it. It turned out that North Hill wasn't the 95 00:07:05,200 --> 00:07:08,880 Speaker 1: only nursing home in Massachusetts going through this fire drill. 96 00:07:09,680 --> 00:07:13,360 Speaker 1: The state investigation found that the company returned almost four 97 00:07:13,480 --> 00:07:18,200 Speaker 1: hundred false positive results. At least eleven nursing homes were impacted. 98 00:07:19,600 --> 00:07:23,480 Speaker 1: False positives are almost always the result of a laboratory error. 99 00:07:24,000 --> 00:07:28,320 Speaker 1: They usually mean that somehow a sample was contaminated. This 100 00:07:28,480 --> 00:07:31,720 Speaker 1: happened sometimes, but labs are supposed to have checked someplace 101 00:07:31,840 --> 00:07:36,000 Speaker 1: to catch those errors. The state said the Origin didn't 102 00:07:37,040 --> 00:07:40,720 Speaker 1: for ted. That meant spending tens of thousands of dollars 103 00:07:40,880 --> 00:07:44,480 Speaker 1: in overtime and sick time and trying to figure out 104 00:07:44,520 --> 00:07:48,080 Speaker 1: where the virus had come from. It also meant really 105 00:07:48,160 --> 00:07:52,520 Speaker 1: scaring people for no reason. I think about the fear 106 00:07:52,600 --> 00:07:58,080 Speaker 1: that this instills in these nine year old people who 107 00:07:58,120 --> 00:08:03,080 Speaker 1: are scared to begin with about this whole thing. And 108 00:08:03,680 --> 00:08:08,200 Speaker 1: you know, we spend months trying to get them to 109 00:08:09,480 --> 00:08:13,160 Speaker 1: calm down, to convince them that we're doing everything we 110 00:08:13,200 --> 00:08:16,200 Speaker 1: can to keep them safe, that we're following all the 111 00:08:16,240 --> 00:08:19,880 Speaker 1: protocols that are sent to us by c d C, 112 00:08:20,640 --> 00:08:25,680 Speaker 1: the Massachusetts Department of Public Health. Now, this wasn't the 113 00:08:25,760 --> 00:08:30,000 Speaker 1: first time that Origin had run into lab issues. Last year, 114 00:08:30,200 --> 00:08:32,800 Speaker 1: I reported a story in which former employees said that 115 00:08:32,840 --> 00:08:38,160 Speaker 1: the company had generally troubling lab practices, including tampering with results. 116 00:08:38,920 --> 00:08:41,840 Speaker 1: At the time, the company said that the former employees 117 00:08:41,840 --> 00:08:46,840 Speaker 1: were disgruntled and called their accounts grossly inaccurate. A few 118 00:08:46,920 --> 00:08:50,280 Speaker 1: years ago, Origin also grabbed headlines for not distinguishing a 119 00:08:50,280 --> 00:08:54,200 Speaker 1: difference between DNA from a dog and DNA from a person. 120 00:08:55,240 --> 00:08:58,440 Speaker 1: Origin is not even close to the only company that 121 00:08:58,480 --> 00:09:01,840 Speaker 1: has had issues with its tests. Here is Davy Smith, 122 00:09:02,120 --> 00:09:05,120 Speaker 1: the head of the Division of Infectious Diseases and Global 123 00:09:05,200 --> 00:09:09,600 Speaker 1: Public Health at the University of California, San Diego. At 124 00:09:09,600 --> 00:09:12,560 Speaker 1: the beginning of the epidemic, the CDC realized that there 125 00:09:12,600 --> 00:09:16,280 Speaker 1: was going to be quality control issues, right, so they 126 00:09:16,280 --> 00:09:19,600 Speaker 1: said only we could test, and that allowed them to 127 00:09:19,720 --> 00:09:23,040 Speaker 1: have as much control over the quality because they knew 128 00:09:23,040 --> 00:09:25,280 Speaker 1: exactly this is the one test that was done, this 129 00:09:25,320 --> 00:09:27,920 Speaker 1: is how it was going to be diagnosed, and they 130 00:09:27,920 --> 00:09:30,800 Speaker 1: would have all the data. So that's a very good 131 00:09:30,960 --> 00:09:35,360 Speaker 1: top down quality control process. The problem was there was 132 00:09:35,600 --> 00:09:38,480 Speaker 1: no way the CDC could do all the tests that 133 00:09:38,480 --> 00:09:42,280 Speaker 1: were necessary, um that was needed in a pandemic. So 134 00:09:42,360 --> 00:09:44,480 Speaker 1: the second thing they did was, Okay, you know what, 135 00:09:45,000 --> 00:09:48,880 Speaker 1: everybody has machines in all these labs all across the country, 136 00:09:49,120 --> 00:09:50,920 Speaker 1: and you can do your own tests, so we can 137 00:09:50,960 --> 00:09:56,000 Speaker 1: democratize testing. So go out there and go forth and test. 138 00:09:57,080 --> 00:10:00,920 Speaker 1: Amidst a massive shortage of tests, the fd a basically 139 00:10:00,960 --> 00:10:05,400 Speaker 1: opened the floodgates. Making a basic COVID nineteen test in 140 00:10:05,480 --> 00:10:09,080 Speaker 1: theory isn't all that difficult. A lot of labs have 141 00:10:09,120 --> 00:10:12,200 Speaker 1: the equipment to do it. An Origin isn't even the 142 00:10:12,240 --> 00:10:15,480 Speaker 1: weirdest company to pivot to COVID nineteen testing. There at 143 00:10:15,559 --> 00:10:19,320 Speaker 1: least two companies that were previously best known for treating 144 00:10:19,320 --> 00:10:24,880 Speaker 1: erectile's function that also now offer coronavirus tests. Origin did 145 00:10:24,960 --> 00:10:28,600 Speaker 1: receive what's known as an emergency Youth authorization for its test, 146 00:10:29,080 --> 00:10:31,680 Speaker 1: but the review process for that is just not all 147 00:10:31,679 --> 00:10:35,760 Speaker 1: that rigorous, and as of last month, labs that develop 148 00:10:35,800 --> 00:10:38,720 Speaker 1: their own tests like Origin won't even have to jump 149 00:10:38,760 --> 00:10:41,520 Speaker 1: through that hoop. At the moment, it's a little bit 150 00:10:41,559 --> 00:10:45,200 Speaker 1: of the wild West, because the demand is so great 151 00:10:45,280 --> 00:10:48,199 Speaker 1: and the supply it is so small that anybody out 152 00:10:48,200 --> 00:10:51,680 Speaker 1: there can make a test. You may recall other headlines 153 00:10:51,720 --> 00:10:55,680 Speaker 1: about false results in recent months, including seventy seven false 154 00:10:55,679 --> 00:11:00,280 Speaker 1: positives that sent the NFL spinning. The US needs more tests, 155 00:11:00,280 --> 00:11:03,240 Speaker 1: but those tests just aren't all that valuable if they're 156 00:11:03,280 --> 00:11:07,880 Speaker 1: not reliable, Davy said. We need better standards for internal 157 00:11:07,960 --> 00:11:11,160 Speaker 1: quality control at labs, as well as a system that 158 00:11:11,240 --> 00:11:14,440 Speaker 1: periodically checks to make sure labs are doing things properly 159 00:11:15,120 --> 00:11:18,480 Speaker 1: rather than just responding once an issue comes up. There 160 00:11:18,520 --> 00:11:23,040 Speaker 1: are always going to be contamination issues, and they're always 161 00:11:23,040 --> 00:11:30,040 Speaker 1: going to be technical issues and personnel errors, and we're humans, etcetera. 162 00:11:30,280 --> 00:11:32,440 Speaker 1: The trick is to be able to catch it early 163 00:11:33,000 --> 00:11:38,679 Speaker 1: and to be able to have rigorous quality assurance practices 164 00:11:38,760 --> 00:11:41,120 Speaker 1: that are both internal. So if I run a lab, 165 00:11:41,200 --> 00:11:42,839 Speaker 1: I want to make sure that my what I give 166 00:11:42,880 --> 00:11:47,800 Speaker 1: my results out are reproducible and correct, and I want 167 00:11:47,840 --> 00:11:50,240 Speaker 1: to be able to have an external agency that checks 168 00:11:50,240 --> 00:11:53,840 Speaker 1: all my homework. Davy said the free market is supposed 169 00:11:53,840 --> 00:11:57,960 Speaker 1: to produce the best, most reliable products, but he said 170 00:11:58,440 --> 00:12:01,679 Speaker 1: that is not what has happened during the pandemic. One 171 00:12:01,720 --> 00:12:03,760 Speaker 1: of the things that I learned early on in this 172 00:12:03,880 --> 00:12:07,360 Speaker 1: pandemic is that there wasn't if you had a task, 173 00:12:07,720 --> 00:12:11,160 Speaker 1: there wasn't any competition you had. The demand for your 174 00:12:11,240 --> 00:12:14,720 Speaker 1: test was so high that there was no Everybody was 175 00:12:14,760 --> 00:12:17,440 Speaker 1: after you, and it didn't matter how good your quality was. 176 00:12:21,360 --> 00:12:24,400 Speaker 1: The state of Massachusetts required Origin to submit a plan 177 00:12:24,679 --> 00:12:28,400 Speaker 1: to fix its internal quality issues. The company is now 178 00:12:28,520 --> 00:12:31,240 Speaker 1: waiting for a green light to resume testing in the 179 00:12:31,280 --> 00:12:35,400 Speaker 1: state in a statement to Bloomberg Origins said that it 180 00:12:35,520 --> 00:12:39,920 Speaker 1: is confident that it will resume operations soon and provide accurate, 181 00:12:40,160 --> 00:12:43,520 Speaker 1: timely test results. The company said it has made a 182 00:12:43,559 --> 00:12:47,280 Speaker 1: plan to address its shortcomings in the lab, including hiring 183 00:12:47,320 --> 00:12:51,000 Speaker 1: outside consultants to review its processes and hiring a new 184 00:12:51,120 --> 00:12:54,760 Speaker 1: vice president of operations and a director of quality assurance. 185 00:12:55,720 --> 00:12:59,640 Speaker 1: The company said that is conducted more than forty thou tests, 186 00:13:00,080 --> 00:13:03,680 Speaker 1: including for schools and nursing homes. It continues to sell 187 00:13:03,720 --> 00:13:20,080 Speaker 1: its tests in other states. That was Kristin V. Brown 188 00:13:20,679 --> 00:13:23,320 Speaker 1: and that's it for our show today. For coverage of 189 00:13:23,320 --> 00:13:25,960 Speaker 1: the outbreak from one and twenty bureaus around the world, 190 00:13:26,320 --> 00:13:30,840 Speaker 1: visit Bloomberg dot com, slash coronavirus and if you like 191 00:13:30,920 --> 00:13:33,520 Speaker 1: the show, please leave us a review and a rating 192 00:13:33,880 --> 00:13:37,480 Speaker 1: on Apple Podcasts or Spotify. It's the best way to 193 00:13:37,520 --> 00:13:42,640 Speaker 1: help more listeners find our global reporting. The Prognosis Daily 194 00:13:42,800 --> 00:13:47,760 Speaker 1: edition is produced by Topher foreheads Jordan Gospore, Magnus Hendrickson 195 00:13:47,920 --> 00:13:52,520 Speaker 1: and me Laura Carlson. Today's main story was reported by 196 00:13:52,559 --> 00:13:57,960 Speaker 1: Kristin V. Brown. Original music by Leo Sidrin. Our editors 197 00:13:57,960 --> 00:14:03,000 Speaker 1: are Francesco Levi and Rick Shawn Francesco Levie is Bloomberg's 198 00:14:03,080 --> 00:14:15,040 Speaker 1: head of podcasts. Thanks for listening, MHM.