News Brief: WHO Funding, Reopening The U.S., Antibody Tests
RACHEL MARTIN, HOST:
President Harry Truman famously kept a sign on his desk that said, the buck stops here - meaning, as president, he was the guy who took responsibility. As President Trump faces criticism for his handling of the coronavirus pandemic, he says the buck stops at the World Health Organization.
STEVE INSKEEP, HOST:
And he wants to stop the bucks from flowing to the WHO. At a news briefing yesterday, the president said he wants to suspend WHO funding until the international organization is investigated for its response to the coronavirus.
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PRESIDENT DONALD TRUMP: Had the WHO done its job to get medical experts into China to objectively assess the situation on the ground and to call out China's lack of transparency, the outbreak could have been contained at its source with very little death.
INSKEEP: Now, there is some debate over whether the president has authority to withhold the money to the WHO. Vermont Senator Patrick Leahy compares suspending funds to refusing ammunition to an ally in wartime.
MARTIN: For more, we're joined by NPR's global health and development correspondent Jason Beaubien. So Jason, the president pretty much blamed the WHO for the coronavirus becoming a global pandemic...
JASON BEAUBIEN, BYLINE: Yeah.
MARTIN: ...In the first place. He says the WHO helped China cover up the seriousness of the outbreak. I mean, is there any truth to what he is saying?
BEAUBIEN: So you know, in that piece of tape that you just played, there's two main assertions. One is that the WHO's job was to get medical experts into China to assess the situation. So the WHO's job and their role is to assist member countries - to offer guidance and technical expertise and to convene international experts to assess international health threats. You know? It's an arm of the United Nations. And it operates inside that system, and it operates at the will of its member states.
And the head of the WHO did go to Beijing in January to discuss the situation. And they did send in a team of experts right after that. The second assertion is that this virus could have been contained at its source. I think most epidemiologists would disagree with that, particularly seeing how well this virus spreads at the moment. You know, viruses don't respect borders. I think that most people, particularly looking back at it now, would say that it was quite likely that this virus was going to spread out of China. And people were even saying that at the time.
MARTIN: And I mean, again, does the WHO even have the authority to go into a country if it's not invited?
BEAUBIEN: No, it does not. It does not have that authority. So it needs China's invitation in order to go in.
MARTIN: So the funding question - President Trump says...
MARTIN: ...He wants to cut U.S. funding to the WHO. What is the current contribution of the United States to the WHO?
BEAUBIEN: It's a bit confusing. There are different funding streams in the way that it goes. But basically, we are spending about $500 million a year in funding to the WHO. That particular money is not directly allocated by Congress. It's part of a larger budget that's put out. He does have a lot of leeway. He can halt these payments. But traditionally, since the WHO was founded, the United States has been the largest funder of the WHO. And you know, it's something that the WHO relies on heavily, this money coming from the United States.
MARTIN: So again, the suggestion from the president would be to cut funding to the World Health Organization in the middle of a global pandemic, something that would be unprecedented, to say the least.
MARTIN: NPR's Jason Beaubien. Jason, we appreciate it. Thank you.
BEAUBIEN: You're welcome.
MARTIN: So who does have control to open state economies back up? The answer is clear - the states do. The Constitution says so.
INSKEEP: But the president is insisting that is his call to make, and that's what he said a couple of days ago. After pushback from all corners, including Republican lawmakers, the president now says he is going to give states permission to make their own decisions about when to reopen - again, permission the states do not need.
MARTIN: NPR White House correspondent Tamara Keith is with us. Hi, Tam.
TAMARA KEITH, BYLINE: Good morning.
MARTIN: What's the president saying now?
KEITH: Well, you know, it's not clear what caused this reversal. But President Trump's posture over a 24-hour period completely shifted. He went from claiming total authority to saying it was up to the governors. He says, we have one country, but we have a lot of different pieces. It's a puzzle. We have beautiful pieces. And then he says that he's not going to put pressure on any governor to open, that they will be able to open when they want to or when they see fit.
The White House did not respond to requests for information about what legal authority the president had been claiming in the first place. But it appears that he is now looking to pass some of the responsibility for what President Trump has described as the biggest decision he'll ever make to the 50 governors.
MARTIN: You talked to some governors about this. How are they responding?
KEITH: Yeah, this was setting up to be another classic Trumpian outrage cycle - but this one in the middle of the pandemic. And then the governors just didn't really take the bait. They are working on coming up with plans. They have been working on coming up with plans for how to reopen, setting benchmarks - you know, the number of coronavirus cases, the availability of testing and contact tracing. And they've been coordinating together, in fact - some formal consortium, some just texting with their regional colleagues.
Republican Governor Mike DeWine from Ohio told me that he's thinking a lot about what the future will look like. But in the absence of a vaccine, reopening doesn't really mean returning to life as we all know it.
MIKE DEWINE: No matter what I order or the president orders or any governor orders, if people don't feel safe about going to a restaurant, they're not going to go. If they don't feel safe about going to a ballgame, they're not going to go.
KEITH: The most important thing, he said, was figuring out how to keep people safe. Otherwise, the rest of it doesn't really matter.
MARTIN: Right. And a lot of governors have talked about the need for comprehensive testing as a prerequisite for opening up.
President Trump also said he's going to announce this council this week which is focused on reopening the economy, which is separate from his health-focused task force. What do we know about that group?
KEITH: Yeah. The reopening the country council was supposed to be announced yesterday with the names announced. Instead, the president announced the Great American Economic Revival Industry Groups, which was a very long list of business leaders and others. It seems to have morphed from a council into a series of conference calls. As he at the briefing yesterday was listing all the people he'll be talking to, it took 10 minutes - literally 10 minutes of the president ticking off names with a couple of diversions in the middle.
MARTIN: NPR White House correspondent Tamara Keith. Thank you, Tam.
KEITH: You're welcome.
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MARTIN: OK. Even though the U.S. is still struggling to do large-scale testing to diagnose coronavirus cases, blood tests to detect past exposure are starting to hit the market.
INSKEEP: Currently, these tests do not need approval from the FDA, and there are dozens of manufacturers making them. And even though some of the tests claim to be more than 90% accurate, they often miss the mark. So what good are these tests right now?
MARTIN: We've got NPR science correspondent Richard Harris on the line to help explain. Hi, Richard.
RICHARD HARRIS, BYLINE: Good morning.
MARTIN: So can you just explain how these tests are meant to work?
HARRIS: Yeah. The tests cannot be used to diagnose the disease. Instead, they identify the antibodies that appear in your blood about a week after you've been infected. These antibodies are part of your immune system's reaction to the virus. Scientists do not know whether people with antibodies are definitively protected from the disease and, if so, for how long. But that's the hope; that's the prospect. And that's what's driving excitement around these tests.
Now, I talked to a doctor who runs a mobile health service in Austin, Texas. He's using a supply of antibody tests made by a major Chinese manufacturer that claims a specificity of 99%, which means it only falsely says a blood sample has antibodies in it when it doesn't just 1% of the time. But despite that impressive statistic, a test like that is not 99% correct. And in fact, in some instances, it could be much, much worse.
MARTIN: Why would that be the case?
HARRIS: Because here's the thing - the tests don't depend just on the technology. Oddly enough, they also depend upon how common a disease is in the population you're sampling. Here's a simple way to look at it. Say you were running a test that gives you five falsely positive results to 100 people. Sounds like pretty good odds, right?
HARRIS: But consider this - if only 5% of the population is infected and you run the test on 100 people, you should get five of those true positives, but you'll also have five false positives. And there's no way to know which is which. So your positive result is basically a coin flip about whether it's true or not.
And it gets worse because the Food and Drug Administration does not regulate these tests, as you mentioned, but the White House Coronavirus Task Force has set an informal standard. These tests are supposed to have no more than 10 false positives per hundred. If you were to use a test that meets that standard, though, in a population where only 1% of the population has been infected, a positive result would actually be wrong a shocking amount of the time - like 9 times out of 10. And by the way, there's a calculator on npr.org so you can run your own numbers if you're interested in sort of exploring this.
MARTIN: So is there any way to get around this problem?
HARRIS: Well, using a really good test helps some, of course. But the best strategy is actually to focus on populations where the disease is more common. Dr. Jordan Laser, a pathologist at Northwell Health on Long Island, N.Y., says it would make sense to start with health care workers. But even there, he says, you can't really trust the results.
JORDAN LASER: Definitely don't use these tests to change your practices in terms of personal protective equipment. Definitely do not become more comfortable in doing your job in taking care of COVID patients. It really would be more of a psychological benefit.
MARTIN: I mean, which is useful, I guess, Richard. But what's the point if these things can't even change behaviors?
HARRIS: Right. Well, clearly, it falls short of being that imagined golden passport that would let individuals get back to business as usual and ignore the coronavirus. But you know, they still can be incredibly useful as long as individual false positive results don't matter. And one situation where that is the case is actually if you're surveying broad populations. If these tests could answer really critical questions - like just where is the coronavirus now and just how common is it? - that would be fantastic. And in fact, that is exactly how the scientists are rolling out these tests to use them right now.
MARTIN: All right. NPR science correspondent Richard Harris unpacking the efficacy of these new tests. Richard, thanks for your explanation. We really appreciate it.
HARRIS: Sure. Good to be with you.
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