Local COVID-19 updates

[edschweppe]

As of 4PM this afternoon, the Commonwealth of Massachusetts is reporting 80 more deaths from COVID-19 (for a total of 6,288 to date), 805 new cases (for a total of 90,889) and 10,158 more tests reported (for a total of 511,644). The ratio of new cases to new test results is 7.9%.

Most of the state-wide numbers went in the "good" direction today (fewer deaths, fewer cases, lower positive test ratio). More happily, all four of the "Dashboard of Public Health Indicators" numbers went in the "good" direction (as two fewer hospitals are shown as "using surge capacity").

Massachusetts has one of the highest per-capita testing rates in the country, and Governor Baker has set an ambitious goal of tripling the test rate by July and quintupling it by December. There's apparently some disagreement among epidemiologists, however, as to whether even that expansion will be useful at combating the coronavirus. As the Boston Globe reports:

After weeks of racing to keep pace with infections, Governor Charlie Baker recently announced plans to drastically expand the state’s testing capacity to diagnose new cases of the coronavirus.

But his goal to more than triple the current number of daily tests by the end of July and increase it at least fivefold by December may come too late to make a significant difference in containing the virus’s spread, some epidemiologists say. It is both a more aggressive testing plan than most states have mustered, and also perhaps no match for the rampant virus.

"It’s like a dog chasing its tail," said Dr. Michael Mina, an assistant professor of epidemiology at the Harvard T. H. Chan School of Public Health. "You're constantly behind."

The state has already tested more than 500,000 people, and Massachusetts now has among the highest per capita testing rates in the nation, trailing only Rhode Island, New York, and North Dakota. But residents may have to be tested multiple times as society reopens and the risk of infection rises.

[ ... ]

Other epidemiologists, however, said ramping up testing remains critical to blunting the spread of the virus.

"For every person we can identify as infected before they transmit the virus to a new person, it will break the transmission chain and lower the overall spread of the disease," said Erin Bromage, a biology professor who studies infectious diseases at the University of Massachusetts Dartmouth.

Baker's plan is based on estimates there will be more than 4,000 new infections every day in July, and that an average of 10 people for every positive case will have to be tested — thus, the 45,000 test goal. In addition, it calls for identifying the contacts of those infected and isolating them until they’ve tested negative.

[ ... ]

The plan includes expanded eligibility for tests including those with mild symptoms; distributing more nasal swabs and plastic tubes to conduct tests; and creating more testing sites and lab space at everywhere from pharmacies to universities.

"Diagnostic testing ... with prompt contact tracing is a very important part of the risk reduction strategy in Massachusetts, in conjunction with guidance, such as social distancing, masking, hand washing, staying at home, and all the other measures that have been implemented," Dr. Catherine Brown, the state's epidemiologist, said in a statement.

[ ... ]

One reason the number of tests in Massachusetts has plateaued in recent weeks was an inability to extend a large number of tests to those who lack symptoms, epidemiologists say. With limited testing available, only those who had clear symptoms were eligible.

As many as 80 percent of people who contract COVID-19 are either asymptomatic or develop mild symptoms, according to the World Health Organization.

"These efforts will hopefully allow us to avoid returning to the blunt instrument of community quarantine, and instead enable us to respond commensurately to the virus, with smaller quarantines where needed," said Yonatan Grad, assistant professor of immunology and infectious diseases at the Harvard’s Chan School.

At the Broad Institute of MIT and Harvard, which can now process more than 25,000 tests a day, officials said the governor’s plan appears to be a viable path forward to allow society to begin reopening without a vaccine.

"Only by testing many more people — whether they have symptoms or not — can we cut off all these transmissions," said David Cameron, a spokesman for the Broad Institute, which expects to increase its testing capacity further in the coming weeks. "Otherwise, we are flying blind."

My two cents: the sooner we can test/trace/isolate, the better. (We should have been doing that months ago.) Serology tests (which detect antibodies to the virus, not the virus itself) would also be hugely valuable as a surveillance tool. If I'm reading between the lines of the Globe story, at least one of the doctors quoted is pushing for serology tests instead of expanded diagnostic tests; if that's the case, then I think this is one of those times to embrace the power of AND.

The town of Acton has yet to post an update today; yesterday at 10PM, the town reported 158 cumulative cases of COVID-19 in Acton with 56 individuals in isolation, 81 recovered and 21 fatalities. (That's two more fatalities than the previous day.) In addition, the town tweeted today that the traditional Memorial Day ceremonies on the town common will not be held this year. That's not something to be happy about, but making more dead citizens would be even less happy.