By Jeff Overley

Law360 (August 13, 2020, 10:32 PM EDT) -- The nation's coronavirus testing czar Thursday forcefully rebutted complaints about turnaround times and declining volume, a top health official cited "a really important clue" that might explain why some COVID-19 patients don't get very sick, and fireworks flew in the presidential campaign over a nationwide mask mandate.

Thursday's events unfolded five months after March 13, which many Americans recall as the last day they went into the office and the first day they saw grocery store shelves emptied of toilet paper. Since then, the novel coronavirus has killed 167,000 people in the U.S. and infected 5.2 million people, although the federal government says the true infection count could be many times larger.

Here are three developments to know.

'Shotgun Testing' Not Needed, HHS Official Says

Brett Giroir, the Trump administration's COVID-19 testing czar, came out swinging at a Thursday briefing, asserting that some people are playing "statistical shell games" to question a recent drop in confirmed infections.

There's been a roughly 17% drop in the seven-day average of daily confirmed cases over the past two weeks. That drop has coincided with a roughly 10% drop in daily tests, raising questions about whether there are fewer cases because there are fewer tests.

But Giroir insisted Thursday that a falling rate of positive tests and a dip in total hospitalizations show that cases really are in decline.

"It is clear that the number of cases is decreasing and that decrease is real," Giroir, an assistant secretary at the U.S. Department of Health and Human Services, told reporters.


Daily tests surprisingly surged Thursday after Texas reported nearly 125,000 new tests, more than it had reported in the prior five days combined, according to the COVID Tracking Project.

During Thursday's briefing, Giroir also downplayed the importance of testing volume. He said that mask wearing, social distancing and targeted testing of vulnerable Americans, such as nursing home residents, are more important for preventing outbreaks.

"You beat the virus [with] smart policies supplemented by strategic testing," he said. "You do not beat the virus by shotgun testing everyone all the time."

Giroir also sought to clarify his past statements that the U.S. by September would have the capacity to perform 50 million tests per month, saying it was "misconstrued to mean that the goal was 50 million tests."

"It is just a false narrative, and I'm really tired of hearing it [from] people who are not involved in the system, that we need millions of tests every day," Giroir said, nonetheless adding that monthly test capacity is now expected to reach 85 million in September and 110 million in October.

Giroir also assailed widespread reports of major delays in test processing, saying it's a "disservice of public health … to keep saying things like there's 10- and 14-day turnarounds. I see it on television news, and it's just not true."

The testing czar said that delays have primarily occurred at major commercial labs, and that hospital laboratories usually deliver results within 24 hours.

But even if that's generally accurate, there's readily available evidence of real delays across the testing spectrum. As one example, New York-based Northwell Health, which runs hospitals, outpatient clinics and its own laboratory, on Thursday was advertising on its website that "test results will be available in the patient portal as soon as they are available, approximately 10-14 days."

Northwell Health recently sent its patients an email with the subject line "Update: COVID-19 Test Result Delays." The email said that because of "the significant volume of tests," it had begun sending samples to lab giant Quest Diagnostics, only to be informed that Quest was facing "a longer than average turnaround time," which led Northwell to redirect tests to other labs.

Giroir on Thursday did acknowledge a rising death toll. The seven-day average of daily fatalities has hovered slightly above 1,000 fatalities in August. That compares to the recent low point of about 500 daily deaths in early July.

"Mortality is unfortunately a lagging indicator," Giroir said, predicting that significant declines in deaths probably won't happen for another week or two.

Common Cold Exposure Might Give Protection

At a separate briefing Thursday, officials discussed the latest progress with Operation Warp Speed, the federal government's multibillion-dollar effort to swiftly develop COVID-19 vaccines and treatments.

Francis Collins, director of the National Institutes of Health, told reporters that researchers are studying "very interesting" data indicating that some people previously exposed to other coronaviruses — such as ones that cause the common cold — may have some level of immunity against the novel coronavirus that causes COVID-19.

Specifically, white blood cells known as T-cells have in some people "now have been activated and seem to be very specifically able to recognize" the novel coronavirus, Collins said.

That could be "a really important clue as to why some people are relatively less likely to get very sick if they get exposed to this, because they already have partial immunity, whereas others don't," Collins said.

Collins said the issue is an active area of NIH research, but he also cautioned that it's too early to know whether any treatments will emerge as a result. He added that being able to identify patients with partial immunity could help government officials direct vaccines to more vulnerable patients when COVID-19 inoculations become available.

Paul Mango, a deputy chief of staff at the HHS, said during the same briefing that officials are hoping to have "tens of millions of doses of vaccines" available by January. No vaccine funded by Operation Warp Speed has yet finished clinical trials, much less won an approval or emergency authorization.

Also Thursday, Mango addressed the U.S. Department of Defense's anticipated role in distributing a future COVID-19 vaccine. He said the department would utilize private contractors and coordinate with the Centers for Disease Control and Prevention on logistics.

That description seemed different than the role outlined at a briefing two weeks ago, when a senior administration official said that the DOD would be "handling all the logistics of getting the vaccines to the right place at the right time in the right condition."

In an email after Thursday's briefing, HHS officials provided a statement from Mango that said, "With few exceptions, our commercial distribution partners will be responsible for handling all the vaccines."

That's notable because some observers quickly questioned the arrangement after it was first reported. As one example, former CDC Director Tom Frieden wrote on Twitter that "DOD has zero experience sending vaccines to doctors in the US."

Pandemic Politics Kicks Into High Gear

On the political front, former Vice President Joe Biden, the presumptive Democratic challenger to President Donald Trump, appeared with his newly selected running mate, Sen. Kamala Harris, D-Calif., and called for a national requirement to wear masks for the next three months.

"This is not about Democrat, Republican or independent. It's about saving America's lives," Biden said. "So let's implement a mask mandate nationwide starting immediately."

A Fox News poll released Thursday found that 74% of respondents favored a requirement that all Americans wear masks when leaving their homes. The support broke down to 90% of Democrats, 67% of independents and 58% of Republicans.

Trump waited until July 21 to clearly endorse mask-wearing that the CDC had recommended since early April. At a Thursday night briefing, the president rejected Biden's call for a coast-to-coast mask mandate.

"He thinks it's good politics, I guess," Trump said, suggesting that mask requirements shouldn't be imposed in states with small numbers of infections.

The president, who briefly claimed absolute power earlier this year to override stay-at-home orders issued by governors, also questioned Thursday "why we would be stepping on governors around our country" by requiring masks everywhere.

The pandemic has largely crowded out discussion of other issues during the presidential campaign, and Trump on Thursday delivered a possible preview of his reelection strategy on that front, asserting that "at every turn, Biden has been wrong about the virus."

Biden has previously touted his work with former President Barack Obama on the Ebola epidemic in 2014. Ultimately, only 11 people with Ebola ended up being treated in the U.S., according to the CDC.

And in late May, Biden called attention to a tweet he sent in October — long before the coronavirus pandemic — arguing that "we are not prepared for a pandemic" and that "Trump has rolled back progress President Obama and I made to strengthen global health security."

--Editing by Bruce Goldman.

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