WEBVTT - The Problem With Trump's Testing Plan 0:00:01.080 --> 0:00:03.600 Before we begin, I want to remind you that we'd 0:00:03.640 --> 0:00:06.840 still like to hear from you. We're looking for more 0:00:06.880 --> 0:00:10.760 of your questions about the ethics and etiquette of social distancing. 0:00:11.600 --> 0:00:15.080 If there's a situation, behavior, or activity in your life 0:00:15.120 --> 0:00:17.319 that you're not your how to handle, and the age 0:00:17.320 --> 0:00:21.000 of COVID nineteen, leave us a voicemail at six four 0:00:21.120 --> 0:00:26.119 six three two four. We may use your voice on 0:00:26.120 --> 0:00:36.120 the show. And now let's get started. Welcome to Prognosis. 0:00:36.520 --> 0:00:41.080 I'm Laura Carlson. It's day forty eight since coronavirus was 0:00:41.120 --> 0:00:46.400 declared a global pandemic. Our main story, the goal of 0:00:46.440 --> 0:00:49.880 widespread testing, seems to finally be one the White House 0:00:49.960 --> 0:00:55.080 is taking seriously. President Donald Trump announced a comprehensive testing 0:00:55.120 --> 0:00:59.080 plan on Monday, but the country is already months into 0:00:59.120 --> 0:01:02.480 a testing crisis that may be too far gone to fix. 0:01:03.640 --> 0:01:07.560 It leaves open the question can the US prepare itself 0:01:07.720 --> 0:01:14.679 for the next phase. But first, here's what happened today. 0:01:19.040 --> 0:01:21.920 After an outrage about how funds for a government relief 0:01:21.959 --> 0:01:25.320 program for small businesses were dispersed, the government says it 0:01:25.360 --> 0:01:27.800 will keep a close eye on who's getting the money 0:01:28.240 --> 0:01:32.919 and whether they need it. U s. Treasury Secretary Stephen 0:01:32.959 --> 0:01:36.600 Menuchin said the government will audit every small business loan 0:01:36.640 --> 0:01:41.759 of more than two million dollars under the Paycheck Protection Program. 0:01:41.800 --> 0:01:43.960 In the first round of funds from the p p P, 0:01:44.720 --> 0:01:48.960 large amounts went to big public companies and chains. Menu 0:01:49.040 --> 0:01:55.440 Chan's comments came in a CNBC interview today. Some American 0:01:55.480 --> 0:01:59.400 car manufacturing is revving up again. Ford said it intends 0:01:59.440 --> 0:02:02.640 to restart initial production at most of its main European 0:02:02.720 --> 0:02:07.440 plants starting May fourth. The company said manufacturing will resume 0:02:07.480 --> 0:02:11.520 in a phased approach, and employees will receive personal care kits, 0:02:11.639 --> 0:02:18.000 including masks and thermometers. Finally, President Donald Trump plans to 0:02:18.120 --> 0:02:21.400 order meat processing plants to remain open. According to a 0:02:21.440 --> 0:02:25.240 person familiar with the matter, the government will provide additional 0:02:25.240 --> 0:02:29.800 protective gear for employees, as well as guidance. The order 0:02:29.840 --> 0:02:33.200 comes under the Defense Production Act, which gives a president 0:02:33.360 --> 0:02:38.600 broad powers to direct industrial production in a crisis. The 0:02:38.800 --> 0:02:42.720 order sets the stage for a showdown between America's meat giants, 0:02:43.040 --> 0:02:46.880 who have been pressing to reopen plants, and local officials 0:02:46.880 --> 0:02:50.680 and labor unions who say the government is not protecting 0:02:50.680 --> 0:02:56.800 workers across the country. At least six hundred meat processing 0:02:56.800 --> 0:03:01.079 employees have either tested positive for the disease or had 0:03:01.080 --> 0:03:04.440 to go into self quarantine. According to the United Food 0:03:04.480 --> 0:03:09.600 and Commercial Workers Union, the largest private sector union, twenty 0:03:09.639 --> 0:03:20.280 workers have died and now our main story. The Trump 0:03:20.320 --> 0:03:24.600 administration announced a plan yesterday to ramp up coronavirus testing. 0:03:25.560 --> 0:03:27.800 The White House said its goal was to provide enough 0:03:27.840 --> 0:03:30.880 tests to allow every state to test at least two 0:03:30.880 --> 0:03:35.400 percent of residents. But even as it announces a new 0:03:35.400 --> 0:03:39.080 commitment to testing, the federal government has pushed much of 0:03:39.120 --> 0:03:43.880 the responsibility to states. Because of the lack of federal 0:03:43.960 --> 0:03:47.480 leadership on testing, experts say the result has been a 0:03:47.560 --> 0:03:50.880 free for all among states who are all desperate to 0:03:50.920 --> 0:03:55.400 get their hands on tests. The competition drives up prices, 0:03:55.720 --> 0:04:00.520 eats up time, and ultimately dictates how many tests can do. 0:04:01.880 --> 0:04:04.760 And the Court in John Tazzi has both reported on 0:04:04.800 --> 0:04:08.560 the difficult logistics required to mount a meaningful testing operation. 0:04:09.600 --> 0:04:12.440 I talked to them to understand how prepared we really 0:04:12.480 --> 0:04:21.120 are to scale up widespread testing. Why is testing so 0:04:21.200 --> 0:04:25.960 important for COVID nineteen? So usually when we think about testing, 0:04:26.080 --> 0:04:28.279 you think of it in the scenario that you're sick, 0:04:28.320 --> 0:04:31.080 but It actually has a really tremendous kind of importance 0:04:31.080 --> 0:04:33.240 when you think about the health of our communities and 0:04:33.279 --> 0:04:36.479 our states and the country, because you if you someone 0:04:36.560 --> 0:04:38.560 is sick, you want to make sure that they are 0:04:38.600 --> 0:04:40.520 not kind of out in the community and going to 0:04:40.560 --> 0:04:43.240 the grocery store and seeing their friends and things like that, 0:04:43.880 --> 0:04:47.279 because that's how this disease spreads. So testing has a 0:04:47.320 --> 0:04:50.400 really important role when you think about kind of public 0:04:50.440 --> 0:04:53.600 health and and you know, preventing this infection from spreading 0:04:53.640 --> 0:04:56.680 further and preventing sort of a second wave of infections. 0:04:56.680 --> 0:04:58.880 You know, so many people are social distancing right now, 0:04:59.240 --> 0:05:02.440 and that's really really important, but testing is actually even 0:05:02.520 --> 0:05:06.040 more important when people sort of relax the social distancing 0:05:06.080 --> 0:05:08.320 as we're starting to see sort of happen, you know 0:05:08.360 --> 0:05:12.279 in states all around the US right now. Who oversees 0:05:12.680 --> 0:05:19.400 how and to what extent communities are tested for coronavirus. Yeah, 0:05:19.400 --> 0:05:24.240 so the testing landscape is incredibly fractured. Um. You know, 0:05:24.320 --> 0:05:28.760 we talk about US testing like it's one monolithic entity, 0:05:28.800 --> 0:05:31.480 but it's actually carried out by a ton of different 0:05:31.480 --> 0:05:35.919 actors around the country. Commercial labs like Quest Diagnostics and 0:05:36.040 --> 0:05:38.800 lab COREP do a lot of the testing, but you're 0:05:38.839 --> 0:05:42.119 also seeing you know, hospitals do testing. You're seeing state 0:05:42.160 --> 0:05:45.040 public health labs do testing in a in a given 0:05:45.120 --> 0:05:48.159 state or area. So there's been a lot of criticism 0:05:48.240 --> 0:05:50.480 of the White House since they put out some guidelines 0:05:50.520 --> 0:05:54.200 about states reopening about ten days or so ago, and 0:05:54.560 --> 0:05:58.600 public health experts saying, we need a sharper focus on testing. 0:05:58.800 --> 0:06:02.240 Testing is what's going to really be key and getting 0:06:02.320 --> 0:06:05.799 us out of this situation and allowing economies to reopen. 0:06:05.839 --> 0:06:07.719 And so we saw this come out of the White House, 0:06:08.200 --> 0:06:12.000 you know, yesterday, is saying testing is important. Here's our plan. 0:06:12.440 --> 0:06:16.200 We're gonna try to help, uh, you know, states test better. 0:06:16.320 --> 0:06:19.240 But they're still really putting this emphasis on the states 0:06:19.320 --> 0:06:22.599 leading the charge. And so we're hearing public health experts 0:06:22.640 --> 0:06:25.360 say this is great that there's a new focus on testing, 0:06:25.480 --> 0:06:28.800 but the federal government needs to be involved more, you know, 0:06:28.839 --> 0:06:31.200 as sort of the link the link and the key 0:06:31.279 --> 0:06:33.839 kind of authority that that can kind of act between 0:06:33.960 --> 0:06:36.400 states and across states. You know, what are some of 0:06:36.400 --> 0:06:40.159 the things that they're able to do that states individually 0:06:40.320 --> 0:06:43.600 can't do with regard to testing. A big thing we've 0:06:43.640 --> 0:06:47.039 been hearing from labs around the country is we need 0:06:47.120 --> 0:06:51.600 you to really coordinate the sort of division of supplies 0:06:51.720 --> 0:06:55.120 among different labs. So a big problem facing labs and 0:06:55.120 --> 0:06:58.200 inhibiting how much testing they can do has been you know, 0:06:58.320 --> 0:07:00.880 one lab maybe doesn't have enough jobs to take the 0:07:00.920 --> 0:07:04.719 samples to do the testing, the diagnostic testing for COVID nineteen. 0:07:04.800 --> 0:07:07.919 Let's say, another lab maybe is having trouble getting the 0:07:08.000 --> 0:07:11.280 right re agents needed to process the testing. Um. You know, 0:07:11.320 --> 0:07:14.240 some labs are struggling with getting enough protective equipment, which 0:07:14.240 --> 0:07:16.800 has been an issue not just in hospitals but also 0:07:16.840 --> 0:07:19.560 in labs, because labs also need to protect their people, 0:07:20.040 --> 0:07:23.440 you know, from getting this infection. So we're seeing labs say, 0:07:23.720 --> 0:07:27.960 the divisions of these supplies around the country are very uneven. 0:07:28.120 --> 0:07:30.480 You know, some people have too much, some people have 0:07:30.560 --> 0:07:33.840 too little. So what exactly is the Trump administration doing 0:07:33.880 --> 0:07:37.960 about testing and and what has led so much criticism 0:07:38.080 --> 0:07:40.440 of their approach. So it's important to say that the 0:07:40.440 --> 0:07:43.520 Trump administration is aware of these issues, aware of the 0:07:43.520 --> 0:07:47.040 supply chain problems you know, involved, and trying to to 0:07:47.120 --> 0:07:50.520 make some differences in these sort of challenges. The real 0:07:50.720 --> 0:07:53.560 thing that has been sort of a persistent criticism of 0:07:53.600 --> 0:07:56.480 the Trump administration has been this sort of the fact 0:07:56.520 --> 0:07:59.480 that they came out with this guideline, these guidelines the 0:07:59.480 --> 0:08:03.560 other week for reopening state economies, saying this is how 0:08:03.600 --> 0:08:05.240 we measure it, this is how we know if a 0:08:05.320 --> 0:08:08.680 state is prepared to reopen. But by the way, these 0:08:08.720 --> 0:08:13.440 guidelines are voluntary, and these guidelines talked about testing, but 0:08:13.520 --> 0:08:17.200 they didn't set specific goals in terms of testing, leading 0:08:17.200 --> 0:08:20.200 to a lot of criticism that the Trump administration wasn't 0:08:20.360 --> 0:08:24.360 stressing testing enough in terms of its talking about reopening. 0:08:24.480 --> 0:08:27.400 So fast forward to this week on Monday, you're having 0:08:27.440 --> 0:08:31.400 more states talking about reopening, pressing towards reopening, and the 0:08:31.440 --> 0:08:35.479 Trump administration is putting out that same day new guidelines 0:08:35.559 --> 0:08:38.800 about testing, sort of outlining what they've done so far 0:08:38.920 --> 0:08:42.400 and saying, you know, testing is important. Deborah Burkes, who's 0:08:42.400 --> 0:08:46.160 a top medical advisor to the administration, has been involved 0:08:46.160 --> 0:08:49.280 in talking to lab directors about the situations in their lab. 0:08:49.600 --> 0:08:54.120 There's one diagnostic manufacturer that has actually too much supply 0:08:54.400 --> 0:08:57.320 of their testing product, and she's trying to figure out 0:08:57.440 --> 0:09:00.480 why aren't labs using this product. So they're out there 0:09:00.520 --> 0:09:03.600 they're listening to these problems. But you know, you also 0:09:03.640 --> 0:09:07.000 have the President repeatedly stressing that we have enough testing 0:09:07.040 --> 0:09:12.400 capacity right now, and experts say that's just not true. John, 0:09:12.559 --> 0:09:16.800 you wrote about contact tracing. Explain what contact tracing is 0:09:17.120 --> 0:09:20.360 and what it has to do with testing. Yeah, so, 0:09:20.400 --> 0:09:24.520 contact tracing is something that public health departments have done 0:09:24.920 --> 0:09:28.280 for decades. It's sort of bread and butter detective work 0:09:28.400 --> 0:09:33.040 to understand how diseases are spreading and to really stop 0:09:33.200 --> 0:09:37.320 that transmission. We're hearing a lot more about it now 0:09:37.520 --> 0:09:40.840 because of the coronavirus, and the idea behind it is, 0:09:40.960 --> 0:09:43.840 you know, if you have someone who has an infectious disease, 0:09:44.120 --> 0:09:47.400 you know they may be in contact with a number 0:09:47.440 --> 0:09:50.560 of other people who are susceptible to that disease. With 0:09:50.600 --> 0:09:54.360 the coronavirus, they may have those contacts before they even 0:09:54.400 --> 0:09:57.200 realize they were sick themselves, or they may never realize 0:09:57.200 --> 0:09:59.760 that they were sick because they were asymptomatic. So the 0:09:59.760 --> 0:10:02.440 idea behind contact tracing as you find out all the 0:10:02.480 --> 0:10:06.880 people who may have been in touch with someone who 0:10:06.960 --> 0:10:11.480 is infected and might have transmitted the disease to and 0:10:11.520 --> 0:10:14.480 then you monitor them. In the case of COVID nineteen, 0:10:14.520 --> 0:10:18.560 you ask them to isolate for fourteen days to see 0:10:18.600 --> 0:10:22.000 if they develop symptoms. If they do, you know that 0:10:22.000 --> 0:10:25.360 that person may have infected others. So you kind of 0:10:25.400 --> 0:10:29.360 repeat the process case by case, chasing down their contacts, 0:10:29.600 --> 0:10:32.120 asking people to isolate, finding out who that who else 0:10:32.160 --> 0:10:34.880 they might have been in touch with. And that's really 0:10:34.920 --> 0:10:39.040 what's UM essential to breaking the chains of transmission for 0:10:39.080 --> 0:10:43.760 the virus. So your article focuses on a new software 0:10:44.040 --> 0:10:47.439 UM that's that's being developed and currently being implemented, called 0:10:47.520 --> 0:10:49.760 Sarah Alert, And I was wondering if you might just 0:10:50.120 --> 0:10:54.439 explain how does sarah alert work. It's really a tool 0:10:54.480 --> 0:10:58.280 for public health to kind of track and isolate people 0:10:58.600 --> 0:11:01.800 who may have of COVID nineteen or people who may 0:11:01.800 --> 0:11:04.600 have been exposed. So, uh, you know, when a public 0:11:04.600 --> 0:11:08.840 health worker gets UM, they basically developed lists of UM 0:11:08.960 --> 0:11:11.640 contacts from known cases, right, all the people that you 0:11:11.679 --> 0:11:14.560 may have been UH in touch with in the period 0:11:14.640 --> 0:11:18.480 when you were potentially infectious and spreading the virus. Those 0:11:18.520 --> 0:11:22.040 contacts are entered into a system. Health workers reach out 0:11:22.040 --> 0:11:26.079 to them and ask if they've experienced any symptoms, and 0:11:26.400 --> 0:11:29.360 you know, may recommend testing or treatment based on their answers. 0:11:29.520 --> 0:11:32.840 Whether software basically does automate much of the process of 0:11:32.920 --> 0:11:35.560 checking in on them. They can decide whether they want 0:11:35.640 --> 0:11:40.079 to be contacted by text message, by email, by voice call, 0:11:40.480 --> 0:11:44.560 and then every day they are contacted automatically UM they're 0:11:44.559 --> 0:11:48.880 asked to report symptoms. People who do report symptoms get 0:11:48.960 --> 0:11:52.000 flagged for public health workers that they may need more 0:11:52.559 --> 0:11:55.840 follow up, and people who don't respond at all also 0:11:55.880 --> 0:11:58.640 get flagged UM that they may need a human intervention. 0:11:58.679 --> 0:12:02.120 So basically it it's kind of automates much of the 0:12:02.240 --> 0:12:07.800 manual work done by public health departments. Right now, and 0:12:07.840 --> 0:12:13.360 who is using SARAH alert? So the first three UM 0:12:13.400 --> 0:12:16.480 places to start using it in April where the State 0:12:16.520 --> 0:12:22.479 of Arkansas, the city of Danbury, Connecticut, and the Territory 0:12:22.640 --> 0:12:28.000 of the Northern Mariana Islands uh A, US Commonwealth in Pacific. 0:12:28.400 --> 0:12:31.360 And you know, those were I think chosen as sort 0:12:31.400 --> 0:12:33.880 of test cases so they would have it in you know, 0:12:33.920 --> 0:12:38.560 three very different types of jurisdictions, A state, local, and 0:12:38.640 --> 0:12:42.640 a territory. So how do these two different prongs of 0:12:42.720 --> 0:12:48.240 testing inform each other? Testing itself and contact tracing? Yeah, 0:12:48.320 --> 0:12:50.880 I think I mean both are important, right, I mean 0:12:50.880 --> 0:12:54.080 I think one one without the other is probably not 0:12:54.120 --> 0:12:56.160 going to get us there, and there's lots of sort 0:12:56.200 --> 0:13:00.520 of basic public health activity around testing and contact tracing 0:13:01.000 --> 0:13:04.400 um that we need to do, and we need to 0:13:04.440 --> 0:13:07.640 do much better and much faster, I think, than than 0:13:07.960 --> 0:13:10.800 we have you know, in the United States. This is 0:13:11.000 --> 0:13:16.000 work that's sort of distributed across many different local, county, 0:13:16.240 --> 0:13:20.199 state government entities, and some are better equipped to do 0:13:20.240 --> 0:13:22.319 it than others, and I think, you know, they're all 0:13:22.360 --> 0:13:25.920 being kind of strained by the current situation. So you know, 0:13:26.040 --> 0:13:31.560 the scale of the undertaking ahead is pretty astonishing, and 0:13:31.679 --> 0:13:33.920 you know, we're we're sort of still finding out where 0:13:33.920 --> 0:13:36.839 those stress points and fractures in the system and our 0:13:36.880 --> 0:13:44.199 ability to respond. Our that was Bloomberg Reporters and the 0:13:44.320 --> 0:13:51.800 Court and John Tazzi, and that's our show today. For 0:13:51.920 --> 0:13:54.920 coverage of the outbreak from one and twenty bureaus around 0:13:54.960 --> 0:14:00.719 the world, visit Bloomberg dot com slash Coronavirus and if 0:14:00.760 --> 0:14:03.439 you like the show, please leave us a review in 0:14:03.520 --> 0:14:08.000 a rating on Apple Podcasts or Spotify. It's the best 0:14:08.040 --> 0:14:13.120 way to help more listeners find our global reporting. The 0:14:13.200 --> 0:14:17.280 Prognosis Daily Edition is hosted by me Laura Carlson. The 0:14:17.320 --> 0:14:21.600 show was produced by Me tophor Foreheaz, Jordan Gospoure, and 0:14:21.800 --> 0:14:26.160 Magnus Hendrickson. Today's main story was reported by Emma Court 0:14:26.360 --> 0:14:31.920 and John Tozzi. Original music by Leo Sidrian. Our editors 0:14:31.960 --> 0:14:37.200 are Francesca Levi and Rick Shine. Francesco Levi is Bloomberg's 0:14:37.240 --> 0:14:39.800 head of podcasts. Thanks for listening.