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Calling scientists idiots, mocking masks, holding rallies with no social distancing, organizing a super spreader event at the White House, discouraging testing, making states compete for vital medical supplies, failing to organize a federal contract-tracing system — these purposeful actions and inactions are why we are seeing articles counting Trump Deaths from Trump Flu. But there is disagreement even within the anti-trump “fake news” world about the number of Covid-19 deaths that can be directly attributed to the president and his administration
The New York Time’s David Leonhardt puts Trump’s personal death count — the Covid-19 deaths for which he’s personally responsible — at 145,000 and growing. His colleague, Ross Douthat, disagrees. Leonhardt, Douthat says, can’t fairly do what he does — blame Trump for not achieving the average performance of other developed countries. The US, Douthat says, has unique conditions and countries following similar policies have experienced very different outcomes. Moreover, Americans don’t comply with public ordinances as well as, say, South Koreans. Indeed, getting them to comply with public health measures to the extent needed was never going to happen. The implication is that under a Biden Presidency, we’d have lost fewer, but not that many fewer lives and we’d still have millions more unemployed, if not the actual extra 10 million unemployed. Biden, Douthat’s argument suggests, would also have presided over a major, if not the actual 33 percent, rise in commercial bankruptcies.
Accusing the president and his associates of negligent homicide in killing tens of thousands of people, millions of jobs, and tens of thousands of business is not something to do lightly. It requires identifying one or more specific, low-cost policies that were clearly known or readily knowable to the Covid Task Force and the president, that could easily have been implemented, and that, had they been implemented, would have ended Covid’s deaths and economic devastation in short order.
The policy at issue is universal weekly household group testing, which can enormously economize on what was and remains limited PCR testing capacity. Group or pooled testing, which dates to the WWII group testing of military recruits’ blood samples for syphilis, involves swabbing, say, 50 people and testing all their swabs in one fell swoop. If the test is negative, you’ve used 1, not 50 tests to certify all 50 as virus free. It represented a magic bullet for getting us to the gold standard of testing — testing every American every day. Doing so would let us find out in real time who was positive and quarantine those individuals. Those who tested negative would use confirmation of their test result as a passport to attend school, go to work, board an airplane, make reservations in a restaurant, etc.
The first public mention of group Covid-19 testing in the US appears to be my March 29 column in Forbes, entitled “Group Testing Is Our Surefire Secret Weapon Against Coronavirus.” On March 3, two French economists, Olivier Gossner and Christian Gollier, wrote a prominent Washington Post column on group testing. Its title was, “A Temporary Coronavirus Testing Fix: Use Each Kit on 50 People at a Time.” Another group testing article appeared on March 31 in The Hill. It was co-authored by my brother, Michael Kotlikoff, a scientist and Provost at Cornell, and me. Its title was “ How to Get the Economy Safely Back to Work in Two Weeks.” On May 3, seeing no movement on group testing by the White House, I wrote a column in Forbes entitled, “Drs. Fauci and Birx: Here’s a Way to Contain Coronavirus and Reopen the Economy in as Little as One Month.” This column linked to a straightforward protocol, developed by Cornell Operations Research Professor Peter Frazier, for testing all American households once a week. The protocol makes highly conservative assumptions about testing accuracy as well as compliance with voluntary test-taking and voluntary quarantining. Still, it shows that group testing could have ended Covid-19 in a month. It still can.
I was in direct and repeated contact with the White House task force about group testing starting at the end of March. This included a meeting I organized on group testing between the task force and top scientists, epidemiologists, and the provosts of Harvard and Cornell. There is no question that the well-meaning White House officials with whom I interacted on group-testing wanted to pursue it, but were blocked from doing so. Indeed, Dr. Birx and others on the task force worked for weeks seeking FDA approval of group testing. In the end, my brother who was also involved in these exchanges, helped the FDA finalize the wording of its FAQ that permitted using group testing for public health surveillance — to find out where it is and contain its spread.
Once the FDA approved group testing, Drs. Birx and Fauci made repeated public statements supporting it. Google group testing and you’ll see hundreds of articles and media discussions. The fact that nothing came of this internal and external support is surely due to the president’s desired to suppress testing, not make it nationwide. To date, only a handful of places are doing group testing. One is Cornell pursuant to the plan described in the Wall Street Journal in June by Cornell President, Martha Pollack, and provost. Cornell’s group testing combined with quarantining the infected and contact tracing has kept Cornell essentially Covid-free.
Group testing all American households every week starting last spring would have required a three-fold increase in our PCR-testing capacity. But as my brother and Jack Lipton, a neuroscientist at Michigan State University, pointed out recently in the Washington Post, our country has enormous untapped PCR testing capacity in universities and research labs, which could have met this need. And, yes, the Covid Task Force and, presumably the president, understood back in March all about this unused capacity.
Only about 10 percent of the US population has had Covid-19 to date. Hence, our situation today is much like it was in February, but with an at-risk population that’s 90 percent as large. Herd immunity, favored by the President’s new favorite pandemic “expert,” Dr. Scott Atlas, a.k.a Rasputin, is a formula for a million deaths.
As for effective therapeutics, they aren’t available yet unless you’re the president or a close friend. And no one knows the long-term consequences of having been “cured” of Covid-19. The president can and should announce immediately that since there is no prospect of victory by vaccine before the late spring, and since morbidity and mortality remain unacceptably high, and that morbidity and mortality could greatly worsen in the coming weeks and months, he will organize group testing of all households each week through the federal government. His failure to do so will simply add to what will surely come to be called Trump deaths.
Another solution pending a vaccine is repeat, rapid-home testing. Harvard epidemiologist, Michael Mina, and I discussed this in July and again this month. The FDA is extremely eager to approve at-home tests, provided they can be proven accurate. This should happen in the near term. At that point, the president needs to do a full court press to produce and ship rapid home tests — a year’s bi-weekly supply — to everyone in the country. Indeed, he needs to mobilize all industrial countries to mass produce rapid home tests for their own citizens and for inhabitants of the non-industrialized word.
If he doesn’t take these steps, he’ll be charged with more counts of negligent homicide. My current count is a conservative 75,000. If he does act, he’ll be heralded as the president who didn’t just speed up a vaccine and produce a ventilator miracle, but, after a terrible delay, realized that testing everyone every day was the only winning strategy for saving American lives and livelihoods until a vaccine delivering permanent immunity was developed and widely delivered.