Thinking Citizen Blog — Thursday is Health, Health Care and Global Health Policy Day
Today’s Topic — Mask Mandates, Testing, Tracing — what are the right questions? answers?
So will Biden, if elected, issue a national mask mandate? Does he have the power to do so? Will he boost testing capacity? by how much? what kind of tests? Will he boost contact tracing? by how much? What are the right questions? What are the right answers? Best articles you know of that provide the most up-to-date data? Experts — please chime in. Correct, elaborate, elucidate.
MASKS — how much can a President do? how do compliance rates vary state by state? what difference has it made? What Governor has gotten it most right? What Mayor?
1. “During an August 2020 campaign appearance, Democratic presidential nominee Joe Biden proposed a national mask mandate of at least three months as part of his platform, explaining that it could “save over 40,000 lives […] if people act responsibly”, and that “it’s not about your rights, it’s about your responsibilities as an American.”
2. “On September 16, Biden stated that he believed the president had the legal authority to mandate masks nationwide via an executive order.”
3. However, during a CNN town hall the next day, Biden stated that he could not mandate masks nationwide, but could do so on federal property, and that he would urge governors to follow suit at the state level.”
CONTACT TRACING — how much is being done? how much could be done? what’s the problem?
1. “Privacy concerns have prevented measures such as those imposed in South Korea where authorities used cellphone tracking and credit card details to locate and test thousands of nightclub patrons when new cases began emerging.”
2. “Funding for contact tracing is thought to be insufficient, and even better-funded states have faced challenges getting in touch with contacts. Congress has allocated $631 million for state and local health surveillance programs, but the Johns Hopkins Center for Health Security estimates that $3.6 billion will be needed. The cost rises with the number of infections, and contact tracing is easier to implement when the infection count is lower.”
3. “Health officials are also worried that low-income communities will fall further behind in contact tracing efforts which “may also be hobbled by long-standing distrust among minorities of public health officials”.
NB: “As of July 1, only four states are using contact trading apps as part of their state-level strategies to control transmission.” What are the updated numbers?
TESTING — which tests are best? PCR tests? Anti-gen tests? Anti body tests?
1. PCR tests: “False negatives — that is, a test that says you don’t have the virus when you actually do have the virus — may occur. The reported rate of false negatives is as low as 2% and as high as 37%. The false positive rate — that is, how often the test says you have the virus when you actually do not — should be close to zero.” (See link below.) But the true positive could be deeply misleading — you could have small trace amounts of the virus and be at very very low risk.
2. Antigen tests: “The reported rate of false negative results is as high as 50% which is why antigen tests are not favored by the FDA as a single test for active infection. However, the FDA recently provided emergency use authorization for a more accurate antigen test.”
3. Antibody tests: “Having an antibody test too early can lead to false negative results. That’s because it takes a week or two after infection for your immune system to produce antibodies. The reported rate of false negatives is 20%. However, the range of false negatives is from 0% to 30% depending on the study and when in the course of infection the test is performed.”
CONCLUSION; “Unfortunately, it’s not clear exactly how accurate any of these tests are.” Reasons: None of these tests officially approved by the FDA. There are 170 versions of the PCR test, 37 antibody tests, and 2 antigen tests. Variation in results could be considerable. No precise measures of accuracy. How samples are collected and stored can vary.
For the last three years of posts organized by theme:
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history….Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.
This is your chance to make some one’s day. Or to cement in your mind something really important.