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At-home testing could transform the fight against the novel coronavirus.
USA TODAY
Testing for the coronavirus that causes COVID-19 has dropped nationwide the past two weeks even as the evidence builds disease spread is picking up in many states.
Nowhere is the danger of the testing slowdown more evident than the South. In Mississippi, more than one in five tested for the virus in the past week were positive, the highest rate in the nation as of Friday. The average number of daily tests in Texas and Florida dropped but the ratio of positive tests in each state is more than double what the World Health Organization recommends.
Official case counts have dropped nationally but reporting problems and generally reduced testing in some states makes it hard to place any confidence that infection rates are improving. And in some states with more reliable data, testing slowdowns coincide with increasing or stable positive rates.
“The enhanced positivity rate is the thing that bothers people more than anything else,” said Dr. William Schaffner, a professor of preventive medicine and infectious disease specialist at Vanderbilt University School of Medicine. “Because it suggests this virus is circulating still very briskly, especially in certain parts of the country. In fact, much of the country.”
The WHO recommends 5% or fewer tests should be positive two consecutive weeks before a community loosens restrictions on businesses opening. If a positive test rate is above that benchmark, it’s a sign an area is only testing the sickest patients and not adequately tracking the virus.
The average number of coronavirus tests reached 793,000 per day in the last two weeks of July. But testing dropped to fewer than 650,000 per day during the first 12 days of August, according to figures from the COVID Tracking Project.
More than half of states nationwide have positive rates above 5%, and a dozen states are above 10%.
As testing has slowed, positive rates increased over the last week in 35 states as of Friday, according to Johns Hopkins University’s Coronavirus Resource Center.
“If testing is going down and positivity is going up, that is what you would expect in an uncontrolled outbreak,” said Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security.
Although positive rates are still too high, Adalja sees positive signs such as fewer hospitalizations and declining case counts.
Experts believe several factors are leading to a testing decline in parts of the nation.
A surge in testing demand in July showed more Americans sought tests than the nation’s labs could process in a timely manner. Even when people got tested last month at a doctor’s office, testing site or clinic, wait times ballooned – making it too late to trace contacts of an infected person.
More: ‘States duking it out for supply’: Lack of federal plan leads to coronavirus testing delays
More: ‘Totally unacceptable’: Testing delays force labs to prioritize COVID-19 tests for some, not others
Storms temporarily closed testing centers in states such as Florida, New York and New Jersey. And people might be more relaxed after an early summer surge in the South and West relented and case counts drop.
But experts say dropping case counts can be a deceiving sign when the share of positive tests holds steady or increases.
Texas probes higher positive rate
Texas Gov. Greg Abbott acknowledged this week testing had dropped and positive rates increased, but he announced more surge testing would help get the state’s positive rate back down to 10%.
In Texas, the one-week average for positive rates reached 24.5% before dropping to 16% on Wednesday. The rate dropped even more, down to 12%, as of Friday, according to the Texas Department of State Health Services.
The state health department is investigating the high rate of positive tests as the number of hospitalized COVID-19 patients decreases. The lab reporting system was upgraded Aug. 1 and a hospital lab and commercial lab resolved coding errors. Fewer people also visited community testing sites, a spokeswoman said.
The state also is working to clear a backlog of 1.1 million “pending” tests that had incomplete paperwork or were not assigned to the patient’s home county. Those cases already have been counted in the totals and would not affect positive rates, the spokeswoman said.
Angela Clendenin, an epidemiologist at Texas A&M University School of Public Health, said too many Texans don’t pursue testing because there’s still confusion over who’s eligible for testing. Other factors include a belief that things are safer after the governor ordered people wear masks, closed bars and limited restaurant seating.
“It’s a false sense of security,” she said.
Testing reluctance persists
Fatigue and skepticism also are factors, Clendenin said, especially among people whose social circles or communities have had few infections.
“If you don’t know anybody who’s been infected by COVID-19, why are you going to worry about it?” Clendenin said. “There’s been a lot of skepticism about the evidence and science behind the guidance we are providing.”
Although Texas case counts have dropped the last week, she said the drop in testing is concerning. “The high positivity rate is indicative of the fact all we’re doing is testing symptomatic people.”
Others cite an urban-rural divide on testing. Metro regions have abundant testing options, easy access and people more willing to get tested. But some rural resident are far more skeptical, especially if they live in a community where there are few known cases.
“There are still many parts of the country, and as you get more rural, the notion becomes stronger, they’re really questioning the validity of all of this information,” Schaffner said. They think, “‘Is this all really all just a hoax of some sort?'”
Schaffner sees the skepticism in Tennessee’s rural counties where “compliance just plummets” on proven strategies of social distancing, mask wearing and testing. The state’s testing has remained stable but the positive rate ticked up slightly in the past week to a still manageable 8%.
“If we had more testing, I think we’d find more cases, find more people who are genuinely sick and many who have only minimal symptoms, documenting that this is a virus that truly is circulating in rural communities, as all of us think it is,” he said.
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]]>A series of high-profile changes at the U.S. Postal Service and warning letters about delivering ballots on time for the November election have touched off a nationwide firestorm about the viability of the USPS during the coronavirus pandemic.
Democrats and activists have accused President Trump and new Postmaster General Louis DeJoy, a GOP donor and friend, of slowing down mail, removing equipment and underfunding the agency for election purposes.
USPS WARNS 46 STATES IT CANNOT GUARANTEE MAIL-IN BALLOTS WILL ARRIVE IN TIME FOR ELECTION
Now the USPS inspector general is investigating congressional concerns about the changes in the postal system, Fox News has confirmed.
In this May 5 photo, Jordan Smellie moves absentee ballots to be counted at City Hall in Garden City, Mich. (AP Photo/Paul Sancya, File)
Alarm bells went off nationally when Thomas Marshall, general counsel and executive vice president of the Postal Service, sent letters warning 46 states and the District of Columbia that USPS cannot guarantee all ballots cast by mail will arrive in time to be counted in the November election, the Washington Post first reported.
In his three months on the job, DeJoy has implemented a series of cost-cutting measures including a clampdown on overtime that postal workers had used to clear mail backlogs. He also approved the removal of 671 mail-sorting machines, roughly 10 percent of the inventory, the paper reported.
On top of that, there’s been a highly visible removal of blue mailboxes across the country that sparked an outcry on social media.
A spokesman for the Postal Service confirmed to an Oregon newspaper that it had removed four blue boxes from Portland and 27 from Eugene this week, with plans to remove a few more from Portland in the coming days.
“The reason we’re doing it is because of declining mail volume,” USPS spokesman Ernie Swanson told Willamette Week. “Ever since the pandemic came along, people are mailing less for some reason.”
Another 68 USPS collection boxes were set to be removed across Montana, according to NBC Montana. But NBC News reported that USPS would hold off the removal efforts until after the election.
Democrat Joe Biden addressed the USPS chaos at a virtual fundraiser Friday.
“I was joking earlier with a couple on the call. I wonder if you’re outside trying to hold down your mailboxes. They’re going around literally with tractor-trailers picking up mailboxes,” Biden said. “You oughta go online and check out what they’re doing in Oregon. I mean, it’s bizarre!”
House Speaker Nancy Pelosi Saturday accused the Trump administration of trying to “sabotage” the election.
“President Trump is openly working to destroy the Post Office and sabotage its ability to deliver absentee ballots in time to be counted,” Pelosi said.
A United States Postal Service (USPS) mail carrier walks through heavy rain as Tropical Storm Fay sweeps across the heavily populated northeastern United States in Jersey City, New Jersey, U.S., July 10.
The USPS had major budget problems before the pandemic. But the issue is especially in the spotlight now as tens of millions of Americans rely on the Post Office to cast their ballot for the November election. The USPS letter to the 46 states sent a dire warning about the Post Office’s preparedness: Even if voters meet every deadline and follow their state’s election procedures, their vote may not be counted.
Amid the sudden shift to mail-in voting triggered by the coronavirus pandemic, some states anticipate 10 times the typical volume of election mail. Six states and Washington received warnings that ballots could be delayed for a subset of voters. The other 40 states, including battleground states Michigan, Pennsylvania and Florida, were warned their current deadlines for requesting and returning ballots were “incongruous” with mail service and voters who send ballots close to the deadline could be disqualified.
POSTMASTER GENERAL VOWS ‘WE ARE NOT SLOWING DOWN’ VOTING BY MAIL
In addition, cash-strapped state and local governments already trying to devise the safest ways to conduct the presidential election now may have to pay higher rates to send out election mail. The USPS advised election officials they should send blank ballots out through first-class mail, rather than the less expensive market mail rate.
“Using Marketing Mail will result in slower delivery times and will increase the risk that voters will not receive their ballots in time to return them by mail,” Marshall wrote in a letter this week to Congress.
Democrats were stunned by the response and said it’s the practice of the Postal Service to prioritize the delivery of election mail — regardless of the class that was used to send it. In a letter to DeJoy, they said it’s “unacceptable” to change the standards and levy new costs on local officials just three months before Election Day.
“The Postal Service should not make changes that slow down the mail or in any way compromise service for veterans, small businesses, rural communities, seniors, and millions of Americans who rely on the mail—including significant numbers of people who will be relying on the Postal Service to exercise their right to vote,” Sen. Chuck Schumer, D-N.Y., and other congressional Democrats wrote in a 10-page letter.
PROTESTERS STAGE EARLY MORNING NOISE DEMONSTRATION AT POSTMASTER GENERAL’S HOME: ‘NO JOY FOR DEJOY’
The tensions over the U.S. Postal Service changes came to a boiling point in Washington Saturday morning when activists surrounded the condo building of Postmaster General DeJoy with noisemakers, pots and pans, and air horns designed to ensure the new head of the U.S. Postal Service couldn’t sleep in.
The theme for the noisy demonstration was “No Joy for DeJoy.”
The union representing the postal workers has blasted the “destructive” cost-cutting moves by DeJoy, which they say is a recipe for “severely delayed mail.”
“These initial actions include reducing hours in retail units including Saturday closings, delaying mail, slowing down service, further removal of mail processing equipment, arbitrarily reducing work hours and eliminating overtime,” the American Postal Workers Union board said in a statement last month. “With an already understaffed operation, reducing hours and overtime can only lead to severely delayed mail and packages.”
DeJoy acknowledged the problems in a letter to congressional Democrats on Friday. “I also recognize that there have been unintended consequences related to these efforts that have impacted overall service levels,” DeJoy said, adding that “the Postal Service is working feverishly to address service problems.”
Democrats want $25 billion in emergency relief funds to the Post Office as well as an additional $3.6 billion in election assistance to states, arguing the funds are necessary to stand up postal service infrastructure and to pull off a presidential election that will rely on mail-in ballots like never before.
But Trump has resisted any bailout to the Post Office, despite the polls showing it’s the most popular federal government agency. His opposition seems to stem from a belief that online retailers, namely Amazon, aren’t paying enough for shipping. Jeff Bezos owns Amazon and also the Washington Post, which Trump has long derided for critical coverage of his administration.
More recently, he’s equated money for the Post Office to funding for mail-in ballots, which Trump has repeatedly opposed, despite voting absentee himself.
Trump told Fox Business this week he disagreed with the Democrats’ demands for USPS funding because it would equip the Post Office to handle universal mail-in voting.
Trump softened his tone on Friday and said he’d sign legislation that included the USPS funds if Democrats made concessions on other priorities the White House wants in the next round of coronavirus relief funds.
This year, 91% of Americans had a favorable view of the USPS, according to the Pew Research Center.
On Saturday, Trump warned of “catastrophic” problems with widespread mail-in voting and defended DeJoy’s actions so far at the helm of USPS.
“He wants to make the Post Office great again,” Trump said.
Fox News’ David Spunt, Morgan Phillips and Allie Raffa contributed to this report.
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