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May 21, 2020 07:59 PM

Science, not wishful thinking, must prevail

Merrill Goozner
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    Merrill Goozner

    Round two in the fight of the century is about to start. In one corner, science sits slumped on a stool, bloodied and bowed. In the opposite corner, wishful thinking dances from issue to issue, ready to give science another beating.

    Large swaths of the country are reopening their economies. Yet few places have sufficient testing capacity, the first bullet point in the Centers for Disease Control and Prevention's guidelines for ending shelter-in-place orders.

    With testing hovering around 350,000 people daily, the U.S. is still six weeks away from having enough kits to test 1% of the population each week. Epidemiologists say that level is needed to adequately track and trace the disease and prevent future outbreaks.

    Epidemiologists estimate it will take anywhere from 100,000 to 300,000 new public health workers to find people who were exposed to disease-carrying individuals—so-called contact tracing. Community colleges are offering tracer training classes. States are deploying National Guard units and public health personnel, already in short supply.

    We're nowhere near the necessary number. The bipartisan United States of Care has called for $46 billion in federal aid to supplement inadequate state efforts. Senate Majority Leader Mitch McConnell says new legislation won't be discussed until mid-June at the earliest. Opposition to "bailing out" states is mounting.

    Several recent studies offer a clear warning as to what will happen when regions reopen before seeing a sustained decline in new cases. University of Iowa researchers looked at neighboring counties on either side of the Mississippi River. Illinois issued a shelter-in-place order on March 21. Iowa did not. Over the next 30 days, the Iowa counties had 30% more COVID-19 cases per capita than the Illinois counties.

    A new CDC report shows how fast things can spin out of control when institutions that involve mass gatherings—churches, sports arenas, bars and restaurants—reopen without proper social distancing and masking. The pastor of an Arkansas church developed symptoms in early March after attending church-related events. Within days, 35 parishioners had COVID-19. Three died. Contact tracing turned up another 26 cases in the community.

    One way to downplay the pandemic is to fudge the numbers. Some governors are taking their cues from President Donald Trump, who recently said that "testing is, frankly, overrated. … If we didn't do any testing, we would have very few cases."

    A day later, Florida Gov. Ron DeSantis fired the data manager for the Florida Department of Health. She told an Orlando television station she was removed because she wouldn't "change data to drum up support for the plan to reopen." Similarly, Georgia's public health department published a graph showing new COVID-19 cases in decline by arranging the data in descending, not chronological, order. It was later rescinded.

    The ultimate tools for fighting COVID-19 will be treatments and a vaccine. While headlines suggest there have been major advances on both fronts, the scant science behind those pronouncements is disturbing.

    When Moderna announced that eight patients in its vaccine safety trial showed an immune response, the stock market soared. That night, the company, which doesn't have a single approved product, concluded a $1.8 billion stock sale. Yet the release contained no information about 37 others in the trial.

    When the National Institute of Allergy and Infectious Diseases announced Gilead Sciences' experimental drug remdesivir had shown a modest reduction in how long patients stay sick, it stopped the trial before learning if the drug reduced mortality, a more important measure. The Food and Drug Administration used the partial data to issue an Emergency Use Authorization for the drug.

    The fight between science and wishful thinking goes on. But one outcome is already known. Ignoring science won't end the economic downturn. It will only prolong it.

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