Trump Has Captured the CDC
Universities are innovating; the Trump administration is obfuscating.
Before we get started, one final coda about John Thompson: You should treat yourself to Tom Boswell's beautiful remembrance of the man for lots of reasons, but also for these two stories:
Thompson’s pride was the impact he had on his players. And if they didn’t want to receive the full weight of that impact, they could move along — out of Georgetown. The Hoyas’ graduation rate for four-year players was 97 percent, because they knew that, no matter what their academic challenges when they entered, they only had two years to prove they were serious about using school to prepare themselves for life — or give somebody else the chance they were wasting. . . .
One of his former players, from one of the meanest D.C. neighborhoods, once phoned me at home. He had averaged two points per game at Georgetown. I expected a sob story. Instead, he said he was a broker at EF Hutton and asked if I needed an investment counselor. He left his phone number, told me his financial specialties and said if I ever changed my mind to call.
When 7-foot-2 Dikembe Mutombo was recruited from Kinshasa, Congo, the usual skeptics wondered about his academic credentials. Thompson asked if I wanted to interview him. It was a setup. To my first question, Dikembe answered in four different languages, then, finally, in English, as Thompson split his sides.
That image just kills me. What a man.
So let's move on and talk about testing again.
On Friday we talked about the approval for a new antigen paper test, which can be processed in 15 minutes and is so easy to manufacture that we should be able to scale it up to 50 million tests per month.
That was great news.
Also great news: The University of Arizona was running an innovative program testing dorm waste-water for virus, and had headed off an outbreak on campus even before it started.
Taken together, these two items showed how we can aggressively attack the pandemic.
Now I want to give you two more items, one good and one bad.
The good one comes from the University of Illinois, which has stood up another innovative testing program. Here's how the Fighting Illini are fighting COVID: Everyone on campus—students and faculty—do a rapid saliva test twice a week. The results go to their smartphones. And positive results are then contact traced.
Here's U-I chemist Martin Burke, who developed the saliva test, explaining:
Martin Burke: So back in April, we launched a project to try to figure out how to stand up and strategically deploy standard testing as part of the university’s effort to reopen as safely as possible. And we quickly realized that the standard nasal swab viral transfer media RNA isolation was not going to be sufficient. [It would be] too slow, too expensive, and have too many supply chain bottlenecks. So I teamed up with my colleague Paul Hergenrother [another chemist at the university] and launched kind of a Manhattan Project–style effort to find a way to test cheaper, faster, and without the supply chain bottlenecks.
Paul led an extraordinary team of students and postdocs and a bunch of us together and found we could skip the RNA isolation step, go directly from saliva to PCR, and thereby get rid of most of the supply chain bottlenecks, dramatically increase the speed, and reduce the cost. . . .
The testing itself is not a silver bullet—we wrap around it frontier data science to figure out who to test and how frequently to repeat it. And then on the backend [we have] rapid communication to a new app that was created for the phone by Bill Sullivan and his team so that you get your results immediately pushed straight to your phone in a HIPAA-complaint and fully privacy-protected manner as well as digital exposure notifications. So between all of that is this test. And we had to get to 20,000 tests per day in order to be able to meet the demand of twice per week for 60,000 people. . . .
We ran a pilot over the summer with all the student staff who were here. And actually in mid-July, we had a spike. There was a social event that led to an increase. But then by just having frequent testing across the summer, over the next two weeks, we watched it fall down so I think that was our first indication that this really had a shot.
We knew we were going to get a bump when all the students came back. We got it, just as we predicted with the modeling. And I’m so excited to tell you, we’re watching it fall as we do the frequent repeat testing on the population right now. We really hope that this is going to continue to show a way which we could get society reopened.
Why is the saliva test important? Because as much of an improvement as the rapid paper test is over tests that have to be sent to a lab off-site, it still has one bottleneck: You need a provider to administer it. People aren't going to effectively swab their own nasal cavities.
Once you move to a saliva test, you eliminate the need for a provider. People can spit into a test tube all the live long day and drop the tubes off at a local processing facility where they can be run quickly and at scale. (I bet Jeff Bezos could figure out a way to automate the entire thing.)
The University of Illinois is another example of how we could be innovating our way through this crisis. And at individual institutional levels, that's what places like the University of Illinois and University of Arizona are trying to do.
The federal government is not.
Which brings us to the second item, which is not good news at all.
The federal government isn't just "not innovating." It is—still—actively treating COVID-19 as a political crisis for Donald Trump, rather than a public health crisis for America.
This piece of whistleblowing by Harold Varmus and Rajiv Shah is incredibly depressing:
We were startled and dismayed last week to learn that the Centers for Disease Control and Prevention, in a perplexing series of statements, had altered its testing guidelines to reduce the testing of asymptomatic people for the coronavirus.
These changes by the C.D.C. will undermine efforts to end the pandemic, slow the return to normal economic, educational and social activities, and increase the loss of lives.
Like other scientists and public health experts, we have argued that more asymptomatic people, not fewer, need to be tested to bring the pandemic under control. Now, in the face of a dysfunctional C.D.C., it’s up to states, other institutions and individuals to act.
In an effort to mitigate the political problem Donald Trump faces from COVID-19 eight weeks before the election, the CDC is now suggesting less testing.
So while private institutions are innovating and searching for ways to bring the country back with more and better testing, the Trump administration is prolonging the nation's pain in the hopes that it can fool enough voters to get reelected.
It's sickening, but not surprising. Because it's been the mode of Trump's entire response to the pandemic, from the very start.
(2) We’re Not a Tech Company . . .
I've heard iterations of this joke a hundred times:
Hasbro is secretly owned by Duracell. The toys are just a loss-leader for battery sales.
Kodak only sold cameras so that they could sell film.
Amazon isn't a retailer, it's a logistics business.
These analogies never get old for me. And Can Druk at the Margins has a beauty:
One of the jokes at Uber was that if things ever did not work out as a ridesharing app, we could just pivot to becoming a law or a consulting firm since we were so good at introducing ridesharing to many cities and finding creative ways to increase awareness and gain market share. The darker way to read the joke is that Uber is less of a tech company, but a financial entity composed to find regulatory arbitrage opportunities and suck the profits dry until it can find other sources of revenue.
As Can says: It's funny because it's true.
(3) Insurance Fraud
I know: You hear "insurance fraud" and you want to take a nap. But this Texas Monthly story is bonkers:
In high school, T. R. began skipping class and playing pranks, once covering a teacher’s car with AOL CD-ROMs, another time dumping out a teacher’s Diet Coke and replacing it with regular Coke, just to mess with him. A friend whom T. R. met later in life remembered discussing with T. R. a realization they’d both come to when they were young, that the rules of business were man-made and thus, perhaps, fungible. “I mean, he has always been an arrogant prick,” a childhood friend said with affection. “We felt we were smarter than most people . . . I wouldn’t call that a negative thing. I would call that identifying the market.”
T. R.’s confidence helped him build a lucrative career at a very early age. According to T. R., it began like this: At sixteen, he worked at a kiosk in the local mall, selling cellphone accessories, but around two years later, when the kiosk’s parent company went under, his boss told him that as his last payment he could have all the remaining inventory, signs, and displays from two kiosks—the value of which he estimates at $80,000. He sold that inventory and some additional merchandise and invested the proceeds in setting up more kiosks. By his nineteenth birthday, he said, he had $4.5 million, all of which he invested in a kiosk company he called Wright Marketing Group, spread over forty locations. He eventually broadened sales to novelties and games—“all kinds of stupid gifts, with a two-thousand-percent markup.”
The venture escalated on a kiosk-buying trip to the Shenzhen International Toy and Education Fair, in China, where, T. R. claimed, he came up with an idea for a console for pirated video games called Power Player that would plug into a TV and allow users to play classics like Space Invaders and Galaga. He decided to focus on selling Power Player wholesale. It was a huge hit, T. R. said, until the FBI began arresting the biggest Power Player retail operators. Panicking, he abandoned his business and left the United States with $8,000 to travel in Europe.
And that's just the set up. The actual insurance fraud itself? Amazing. Read the whole thing.