Sara’s Diary, Day 60 without baseball: The economics of access to COVID-19 testing

I started this diary two months ago when professional sports abruptly closed down after Utah Jazz center Rudy Gobert tested positive for the novel coronavirus. When the Jazz-Thunder game was suspended on March 11 it wasn’t just that one player had tested positive. After all, if it had just been about Gobert he likely could have self-quarantined and the season could have continued. The reason everything was shut down was uncertainty. All the NBA knew was that at least one player had tested positive. That meant other players, coaches, and members of the media had been exposed. The dearth of testing combined with the long incubation period of the novel coronavirus meant that there was no way to isolate that one player, or even the teams that player had come in contact with, the entire operation had to hit pause.

It is still stunning to me that in general the first movers on shutting down due to the COVID-19 pandemic weren’t government entities, they were sports leagues and private universities. The only government actions that occurred prior to NBA Commissioner Adam Silver making that call were sporadic. Ohio had declared a state of emergency and cancelled the Arnold Classic, Washington State had banned gatherings over 250 people, and Massachusetts had a declared state of emergency, but most states didn’t move until after organizations like the NBA, MLB, NCAA, NASCAR and the Boston Marathon suspended operations first.

On March 11 there were 1,205 cases and 40 deaths due to COVID-19 according to State Health Reports. As of yesterday that same database showed 1,320,621 cases and 73,891 deaths.

And amidst all of this, we still don’t have enough tests. Last Friday the Atlantic reported that while the number of tests being performed have increased they are nowhere near the level we need to remove the uncertainty that shut everything down two months ago:

The heightened focus produced results. From the second week of March to the first week of April, the number of Americans tested daily increased roughly 45-fold. Month over month, the comparison was even more staggering: 80 people were tested for the coronavirus on March 1, according to CDC data. More than 100,000 people were tested on April 1.

Then, in mid-April, progress stopped. “We went up to about 150,000 tests a day, and then we plateaued there for a few weeks,” Jha, the Harvard professor, said. Only in the past two weeks or so has the country resumed increasing its capacity. States reported more than 300,000 new test results both today and yesterday, but it is unclear if that trend will be sustained into the next week.

What caused the plateau? Nobody is certain. “Some places had reagents, but not enough swabs. Some places had swabs but not the medium you transport them in … And some places had enough capacity, but they hadn’t changed their policies from when only the sickest people could get tested,” Jha said. This week, governors have continued to say they lack enough tests. In the District of Columbia, where the number of new cases is increasing, Mayor Muriel Bowser said at a press conference today that the city only had enough reagents to test about 1,500 people a day.

The lack of certainty clearly persists and the raw number of tests isn’t as helpful as a strategy to deploy those tests where they are needed most. That is obviously complicated by some places needing different things. The maddening part is that all of these are solvable problems but they require coordination and two months into the pandemic the United States just doesn’t appear to be doing a great job at coordination.

Then there is the question of who has access to tests and when.

Over the weekend the results of a Stanford study of 5,603 MLB employees who participated in antibody testing were announced. It’s the largest COVID-19 antibody test group to date, and while I should caution this particular test isn’t approved by the FDA at this point in time, it is a good sign that at least one industry that would like to reopen is getting comprehensive data. It’s not a great sign that only 0.7 percent of those tested employees had antibodies for COVID-19 as the Athletic reported:

The Stanford study that tested 5,603 MLB employees for the presence of COVID-19 antibodies found just 60 positive cases, the lead researcher said on Sunday. After adjusting for potential testing error, the researchers reported a positive rate of 0.7 percent.

The majority of those who tested positive were asymptomatic or had mild symptoms, said lead researcher Dr. Jay Bhattacharya of Stanford University.

“I was expecting a larger number of people to test positive,” Bhattacharya said. “These numbers indicate the virus hasn’t spread very far. But at the same time, we have had a zero percent mortality rate.”

This study represents the largest COVID-19 antibody test conducted in the United States to date.

The thing that keeps jumping out at me is who can get tested without symptoms and who needs to have symptoms, get a doctor’s order, line up for hours in their cars and hope there are enough tests for them to access one on a given day. I want baseball to return safely more than just about anything on the planet, but we shouldn’t live in a world where baseball players can be tested multiple times over the course of a summer for the sake of a game while everyday people can’t access tests. No person in their right mind thinks that 1,500 tests per day for Washington, D.C. is adequate. How does our society justify restarting any sport, even our nation’s pastime, while that is true?

EDITOR’S NOTE: Please, if you make comments that include references to politics, keep them non-partisan and not personal. Thank you.