• U.S.
    The New York Times

    CDC Test Counting Error Leaves Epidemiologists 'Really Baffled'

    WASHINGTON -- As it tracks the coronavirus's spread, the Centers for Disease Control and Prevention is combining tests that detect active infection with those that detect recovery from COVID-19 -- a system that muddies the picture of the pandemic but raises the percentage of Americans tested as President Donald Trump boasts about testing.Now that serology tests, which look for antibodies in the blood of people who have recovered, are more widespread, CDC officials said Friday they would work to separate them from the results of diagnostic tests, which detect active infection. One of the agency's data tracker websites has been lumping them together.Stunned epidemiologists say data from antibody tests and active virus tests should never be mixed because diagnostic testing seeks to quantify the amount of active disease in the population. Serological testing can also be unreliable. And patients who have had both diagnostic and serology tests would be counted twice in the totals."It just doesn't make any sense; all of us are really baffled," said Natalie Dean, a biostatistician at the University of Florida.Epidemiologists, state health officials and a spokeswoman for the CDC said there was no ill intent; they attributed the flawed reporting system to confusion and fatigue in overworked state and local health departments that typically track infections -- not tests -- during outbreaks. The CDC relies on states to report their data.If the agency intended to bolster the testing numbers for political purposes, the advantage to Trump would be minimal. The Atlantic reported that on Monday, one of the CDC's trackers reported that 10.2 million viral tests had been conducted nationwide since the pandemic began. On Wednesday, after the CDC stopped differentiating virus tests, the number went to 10.8 million.A spokeswoman for the CDC, Kristen Nordlund, said viral testing was much more common than antibody testing in the pandemic's early days, and some states combined the virus tests together with the few antibody results they had."Now that serology testing is more widely available, CDC is working to differentiate those tests from the viral tests and will report this information, differentiated by test type, publicly on our COVID Data Tracker website in the coming weeks," Nordlund said.State health officials in Virginia, Texas, Georgia and Vermont also said they were beginning to disaggregate their testing data."This is not an intentional misuse of information -- it's part of the fog of the infectious disease war," said Michael Osterholm, a University of Minnesota professor and former state epidemiologist who was sharply critical of the disease control centers early in the pandemic. "We've done surveillance for cases, and now we're all trying to do testing, and it presents unique challenges."Whatever the reason, the numbers are fueling Trump's frequent -- and inaccurate -- boasts that the United States is doing more testing "than all other countries combined," a claim that the fact-checking website PolitiFact has declared "pants on fire wrong." Governors rely on testing in deciding how far to go in reopening their economies. With all 50 states moving to reopen, accurate tracking is essential."We're like the blind epidemiologists trying to understand the elephant," said Michael Levy, a professor of epidemiology at the University of Pennsylvania. Health officials, he said, need good reporting to "understand the relationship between the epidemic that we can't see and the data that we can see."Scott Becker, the executive director of the Association of Public Health Laboratories, said there was another reason states were tracking testing: Trump wants the numbers."We've never needed to capture test volume. That is what the White House wanted to know, how many tests were being done," Becker said, adding, "Ordinarily this all works through the public health system, but in this response, there's been a drive to have data numbers, at multiple levels."Like Nordlund at the CDC, health officials around the country say diagnostic tests, which detect the presence of the virus, had initially far outpaced antibody tests, so agencies grouped them together. While both numbers are helpful in assessing the scale of the outbreak, only viral test numbers can indicate a state's ability to identify people who currently have the virus.Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, said mixing the two numbers would distort the picture of the coronavirus outbreak in various parts of the country. In most places outside of New York City, the center of the outbreak in the United States, the proportion of people who have been exposed to the virus, and who would produce a positive result on an antibody test, is likely to be lower than 10%."What that means is that those tests are more likely to come back negative, which means that you could end up with a misleading picture overall," he said. "You'll think there is less disease there than there actually is. That is not something that is not going to be helpful, to say the least."The mixing of the results was first reported by The Atlantic and local news outlets, like the Richmond Times-Dispatch, the Texas Observer, the Columbus (Georgia) Ledger-Enquirer and WLRN, a radio station in Miami. Virginia first faced criticism for combining its test results this month but has since stopped the practice, effective May 14, the state's health department said Friday.Clark Mercer, the chief of staff for Gov. Ralph Northam of Virginia, a Democrat, initially defended the strategy last week at a news conference, saying that it was important for the state to report totals that included antibody tests in order to be ranked properly compared with other states."If we are going to be compared to all 50 states," he said, "I want to make sure it is apples to apples."But a few days later, Northam, who is a physician, said he had only recently learned that the data was being combined and had since directed the health department to disaggregate the results. Serology, or antibody, tests accounted for 9% of tests in Virginia, Northam said -- a figure that Dr. Lilian Peake, the Virginia state epidemiologist, said would not have drastically changed the state's overall results."For the 20 years that I've been a public health leader, we've never focused on testing, and this is a new virus, so we are still learning about it," Peake said Friday. "The tests are being developed, and we are still learning how to interpret them."Health officials in Texas also announced this week that they had made changes to exclude antibody tests from its tally of total tests, and Vermont previously removed tests for antibodies from the numbers on its website."If we include serology, we inflate the denominator," Erik Filkorn, a spokesman for Vermont's health operations center, said in a statement Friday, adding that the effect had been minimal. Serology tests accounted for 4% of all tests in Vermont, he said, and including them may have increased the percent positive rate by "a fraction of one percentage point."In Georgia, a state that is being closely watched after it became one of the first to reopen businesses last month, officials said they were working to improve transparency after reports that up to 15% of the state's tests were antibody tests. While Georgia's coronavirus caseload has remained more or less the same in recent weeks, the latest developments raised questions about the accuracy of the numbers."The integrity of our data is absolutely our No. 1 priority," Dr. Kathleen Toomey, the commissioner of the Georgia Department of Public Health, said at a news conference Thursday.The Pennsylvania Department of Health is still using a small number of positive antibody tests to inform the state's total case numbers, a spokesman, Nate Wardle, said Friday. But he said those antibody tests were not skewing results -- they represent less than 1% of total cases in the state, he said -- and were not being used to decide whether regions should reopen.Wardle said patients who had a positive antibody test as well as symptoms or a high-risk exposure had been included in the state's "probable" test count, based on guidance from the CDC, which allowed the state to track whether patients who had symptoms early on may have had the virus."We think the way we are reporting the data is correct," he said, adding that the probable cause cases were broken out and kept separately from confirmed cases. "We are not using our probable cases in any of our decision-making."This article originally appeared in The New York Times.(C) 2020 The New York Times Company

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  • Style
    Footwear News

    Kourtney Kardashian Has Photoshoot in the Shower Wearing a Leather Trench + New Balance Sneakers

    This Kardashian sister wears these athletic shoes for every activity.

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  • Politics
    The Wrap

    Chris Wallace Condemns Kayleigh McEnany for Questioning White House Reporters’ Faith

    Chris Wallace was back to challenging the Trump administration on “Fox News Sunday” this week, criticizing Press Secretary Kayleigh McEnany for impugning the faith of reporters who questioned the president’s push to reopen places of worship.On Friday, Trump threatened to “override” the authority of governors if they did not reopen religious buildings that have been closed in an effort to control the spread of COVID-19. When reporters told McEnany that the president had no legal authority to do so, she responded by saying she found it “interesting to be in a room that desperately wants to seem to see these churches and houses of worship stay closed.”McEnany then told the White House press corps what questions they should be asking, specifically, about Mike Flynn.Watch the video clip above.Also Read: Fox News' Jedediah Bila Defends Chris Wallace Against Trump Attack: 'Just Stop'“I spent six years in the White House briefing room covering Ronald Reagan,” Wallace began on his Sunday broadcast. “I have to say, I never — and in the years since too — I never saw a White House press secretary act like that. I have to say that if Kayleigh McEnany had told Sam Donaldson and me what questions we should ask, that would not have gone well.”He went on: “Kayleigh McEnany isn’t acting like she’s working for the public. She acts like she is what she used to be, which is a spokesperson for the Trump campaign.”Wallace also questioned Dr. Deborah Birx, one of the lead members of Trump’s coronavirus task force, about the White House’s push to reopen the economy. All 50 U.S. states have reopened to various degrees as of this weekend, leading some COVID-19 models to predict the U.S. death toll to rise from around 100,000 today to 150,000 by the end of August.Also Read: Fox News' Chris Wallace Challenges Surgeon General for Downplaying Coronavirus Compared to Smoking, Opioid Deaths“A month ago, you are saying we were going to come down below the low end of the model, which is 100- to 240,000, to 60,000,” Wallace said. “So, I guess my question is, in this last month, did you underestimate the strength of the virus? Did we reopen too soon? Did we reopen without sufficient restrictions?”Birx responded by saying that the White House task force has used different models to understand how the virus is impacting both the U.S. and other countries.“We understand that our mortality rates are less than those three countries, and that’s really due to the incredible work of our front-line hospital workers,” she said. “But we understand that these number of infections has led to this level of mortality, and our job now going forward is to do everything we can to prevent additional hospitalizations and additional mortality.”Wallace has become a regular critic of Trump throughout his term, accusing him last year of “direct sustained assault on the freedom of the press.” Trump has struck back at Wallace via Twitter, calling him a “Mike Wallace wannabe” last month and saying he was “worse” than MSNBC anchor Chuck Todd.Read original story Chris Wallace Condemns Kayleigh McEnany for Questioning White House Reporters’ Faith At TheWrap

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  • Lifestyle
    Storyful

    Large Alligators Fight on South Carolina Golf Course

    Matthew Proffitt came across an incredible sight while golfing with friends at the Hilton Head Lakes golf course in Hardeeville, South Carolina, on May 20.As Proffitt and his group approached the 18th tee, they spotted two large alligators fighting on the fairway.“They would lay still for a few minutes, with their jaws locked on each other, and then try to roll or shake,” Proffitt told Storyful, adding that while gators are common in the area, he had never seen anything like this. “The fight went on for about two hours.”Alligators are more active during mating season from April to June.The Golf Club at Hilton Head Lakes originally posted the video on their Facebook account and warned patrons in their caption, writing, “Sudden death playoff on the 18 yesterday! Keep your eyes open out there, the course is full of wildlife!” Credit: Matthew Proffitt via Storyful

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  • Lifestyle
    Epicurious

    43 Grilled Salmon Recipes (and Other Summery Salmon Options)

    Salmon shines in the summer—whether it's charred on the grill, smoked and draped over salads, or shaped into burger patties and stuffed between bread.Originally Appeared on Epicurious

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  • Celebrity
    Elle

    Carrie Underwood Shows Off Her Abs in Poolside Quarantine Photo

    She's kicking off her summer with a little pool time.

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