Ed Yong: COVID Testing One of Biden Admin’s “Key Failures”

CHRISTIANE AMANPOUR: Now, getting to the Omicron variant, which is surging in almost all 50 states and the CDC has come under fire for shortening the isolation period from 10 to five days. That’s for those who’ve tested positive for corona virus but don’t actually show any symptoms. The Atlantic science editor and writer, Ed Yong, tells Walter Isaacson that this could have a devastating impact on U.S. health care. Their conversation though took place before updated CDC guidance, which is expected imminently.

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WALTER ISAACSON: Thank you, Christiane. And, Ed Yong, welcome to the show.

ED YONG, STAFF WRITER, THE ATLANTIC: Hi. Thanks for having me again.

ISAACSON: What did you make of the CDC’s recommendation that we shorten the quarantine to five days?

YONG: I certainly think that shortening the quarantine without any kind of testing out procedure is just nonsense. Like, that doesn’t seem to have any solid public health rationale to me and that seems to be a push to — you know, like — they are under a lot of pressure and that there are a lot of reasons why someone would make a decision like this. But from a public health standpoint, it doesn’t make sense. I mean, adding a testing component at the end of it is just a no brainer. Now, the only reason to not do that is that because of this — I mean, I think this is one of the administration’s key failures is that the testing of the structure is still abysmal. It is still very difficult to contest and especially now that we’re in the middle of another surge and rapid tests, which could have been readily and mass deployed across the country have not been. And that is a problem. Like, how you — you know, do you make a recommendation for people to isolate until they can test negative if there are no tests available? I understand the bind there, but I think you actually — if that is part of the rationale for making that decision, you have to be honest with people. I also think that a lot of this has been incredibly (INAUDIBLE) with the idea — you know, the actually — the rule is that if you — you know, if you leave quarantine after five days — so, you leave isolation after five days, you have to wear a mask for five days. OK. Fine. But let’s be real about human behavior and what that actually signals to people. Like, you say, you know, you can go out and about after five days. You’re basically telling people that they’re in the clear. Again, like this is, I think, the basic element of public health by trying to understand how your messaging is going to land with people and to, you know, be very clear about that, that it’s odd to see the CDC do making these kinds of mistakes.

ISAACSON: Overall, how do you think the CDC has been doing?

YONG: I am very disappointed with its performance over the last year. I think that a lot of people, public health folks, you pandemic journalists were excited about the prospect of having a newer administration that claims to be science-led, a new, you know, leadership at this public health agency that had always been the gold standard but have been really taking a battering in terms of its reputation and its credibility. And I think it has made a number of bad decisions, beginning with the decision to lift the indoor masking restrictions for vaccinated people in the middle of last year. A decision that many of the public health folks I spoke to, you know, argued quite rightly, I think, privileged the most privileged people, the people with resources to protect themselves, the people who had already have the easiest and earlies access to vaccines rather than the most vulnerable groups whom a public health agency, the leading public health agency should be laser focused on that at all times.

ISAACSON: What data is it that you feel is not being collected well enough?

YONG: I mean, you can take your pick. We’re sort of in an informational vacuum here. Like test — just the — OK. Some basic stuff. Let’s think about the numbers of infections that are out there. We have undercounted throughout the pandemic. We’re likely undercounting now. That seems a bit ridiculous given how sharply ascending the epidemiological curves are and yet, I’m pretty sure that is only a fraction of the total number of cases that are out there. The same goes for things like deaths. No one is counting long COVIDs. It’s not like there is even a number for me to point out and say it’s an underestimate. And here’s the thing that I really want to talk about today. What we do not have is a clear indicator of the health or poor health of the health care system. Everyone looks at hospitalization numbers, whether they’re going up or down, how high they are, that is inadequate because those numbers say nothing about the — so, those numbers tell you about the demand on the health care system kind of. They’re only a partial reflection. They tell you nothing about the supply side. They tell you nothing about how many health care workers are off sick right now. How many have quit over the course of the pandemic. How many are demoralized and burned out and exhausted. They don’t tell you anything about how few beds there actually are because there aren’t enough staff to care for all the patients that you can see to be in those beds.

ISAACSON: This is something you’re reporting on right now. Tell us what you’re finding.

YONG: Yes. It’s frankly not good. Health care — what we cannot do is treat the health care system as something that could conceivably be overwhelmed in the future if there are enough hospitalizations. What we need to understand is that the health care system is overwhelmed right now and has been for some time. They have been pummeled by surge after surge for the last two years. And in between surges, when hospitalizations and cases are down and everyone else is breathing a sigh of relief, health care workers are then playing catch-up, they’re dealing with all the surgeries and procedures that were postponed because of COVID. So, you — like, if you want to think about pressure on the health care system, it was a sharp incline in the spring of 2020 and then a plateau. They have been facing relentless work (INAUDIBLE) and droves of them have quit their jobs, which have made it incredibly hard for those who have left behind. We have — you know, I regularly hear things about nurses working with no — you know, I don’t know, three or four patients in an ICU when previously they might have — they might really be wanting to just deal with one or two. You know, nurses doing — dealing with like six or seven patients. People just working conditions where it’s impossible to give the kinds of — provide the kind of care that they actually want and need to be able to provide. And this isn’t just about COVID anymore. This is just going to affect health care in all areas of medicine. This is — we are entering a phase where some places are already struggling to provide adequate care for everything, full stop, let alone COVID. And other places are on the path to that. And this is why we need to be really careful if we’re talking about a milder variant, because mildness matters for the individual, if the variant is milder, that’s probably good news for us. But the milder and more transmissible variant is extremely more transmissible variant, which is what Omicron did, is an absolute disaster at the collective level, because the sheer number of cases is so high that even if a smaller proportion of them is severe, that is enough to completely overwhelm a health care system that is already overwhelmed. And that is what we’re seeing now and that is what we’re going to see in the next two weeks. And that’s why I take no solace from the fact that it is milder because my individual risk might be lower. But collectively as a society, we are looking at dark times, and that is going to rebound on me as an individual if I happen to get sick with something that’s not COVID.

ISAACSON: So, tell me about that. What happens to the non-COVID patients? How does this affect them?

YONG: I think you can expect treatment to be delayed. We are already seeing stories of people waiting for hours to get emergency care for things that are actually urgent. You — if it gets really bad, people might just die before they get care for things like heart attacks, for things like strokes, for things like car accidents. This almost sounds unbelievable. Like, it sounds like such a difficult reality to pass that I keep on asking health care workers I talk to, like, is that real? Like, is that really what you’re telling me? And honestly, the best I’ve heard is some people saying that, we’re still making it work, we’re finding ways to see people. It takes a lot of time but we are trying to make it work. I don’t know what’s going to happen in the next month if these case rises still go up to the extent that we’re seeing. It’s not just the number of COVID patients in hospitals, right? It’s the fact that health care workers much more so in this surge than the previous surge of getting sick themselves because Omicron can cause breakthrough infections in the vaccinated and especially the vaccinated who aren’t boosted. That takes health care workers out of the pool of possible people who can provide care, and that is happening now across the country at far greater levels than we’ve seen before. And that means there’s fewer people around to care for this growing number of patients. There’s also a higher number of non-COVID patients. There’s people who deferred surgeries, (INAUDIBLE) past surgeries and can’t defer anymore. You know, there’s just an enormous pressure on our health care system at a time when it has never been — like, it is weaker now than it has ever been in the past two years of this pandemic because so many people have left, because the ones who are staying now are going to leave during this surge or they’re going to leave after this surge. The system is weakening by the week and I think most people don’t really understand that that’s happening or the consequences of that for all of us.

ISAACSON: Is there a health care worker that stands out from your reporting?

YONG: You know, I have many of them that I am deeply fond of, but I don’t want to single any person out. Like, I think that the whole problem with this pandemic is that we’ve been too focused on individuals. And the problem is that systems, right, the pandemic is a collective problem. It requires us to take collective responsibility. It requires our political leaders put in policies that protect the health of populations and then, it requires us as individuals to think about our neighbors, about the entire society of which we are an inextricable part and to make decisions now just about personal risk but the consequences of our actions onto our collective risks. So, you know, it’s the healthcare system that is struggling and its health care workers as a community that are doing their best and that are slowly being crushed by everyone else’s actions and inactions.

ISAACSON: Tell me about long COVID. What do we know about how many people have it? What can you do about it?

YONG: Frustratingly, we know very little because there is still a huge amount of dismissal of the condition and the people who have had it. I’ve started working with long COVID about two years ago in the late spring of 2020 when it didn’t have a name and when most people didn’t even recognize that it existed. Of course, the people who had it knew that something was going on. They were getting months of debilitating and this are symptoms including crushing levels of fatigue, physiological (INAUDIBLE) that got worse after even mild forms of physical activity, brain fog and other cognitive problems, neurological problems. These was very real for them, and it is very real. But a lot of these folks are still not treating it as such. I think now there’s more acknowledgment. There’s been formal acknowledgment from the CDC, the NIH, they’ve got (INAUDIBLE). But still, there is a lot to discuss (ph). A lot of people with long COVID are struggle to get care for themselves because the number of long COVID clinics that have opened are still very small in number and the number of law orders (ph) is vast. We don’t have an exact count because, again, no one is counting this because there is still this pervasive idea that it’s either health or death that are the outcomes that matter and there’s not enough recognition of the long-term disability that can result from a brush with not just, of course, this virus but other viruses too. This is something that people with conditions like M.E. and dysautonomia have been talking about for many, many decades. But they too have been dismissed, and that is the problem, unfortunately, that a lot of long ballers (ph) continue to face. And meanwhile, they’re struggling to work, they’re struggling to get on with their normal lives. You know, a lot of them have struggled to get onto disability benefits because of the problems we’ve talked about before. The disability part of the pandemic is still under discussed and hugely important.

ISAACSON: We were clearly not prepared for this variant. What can we do to prepare for the next one?

YONG: A lot of experts and journalists like myself have been talking about the possibility of a variant like that would arise, that will either or be more transmissible or that would evade some of our immune defenses. That was always on the cogs. I think that what was surprising about Omicron is how different it is to past variants. I think, everyone — a lot of people expected the next one to be a kind of variant — a variant on Delta — kind of Delta plus, bells and whistles on it. Omicron is not (INAUDIBLE). Omicron is an older version of the virus that’s somehow evolved a large number of mutations on its own and ended up being something quite different. Unless we actually take the pandemic seriously and more seriously than we have done in the last two years under two different administrations now, we’re going to see more of this. We need to prioritize setting up the kinds of systems that will actually control the spread of COVID. And by that, I mean things that people have been calling for for two years now. Social protections that allow people to take actions that will protect their livelihoods and their lives, things like paid sick leave, hazard pay, universal health care, if we can swing that. That would be great. But also, system for tracking viruses. You know, it is ludicrous that we are now in 2022 and that we still have testing shortages. It is ludicrous that hospitals still lack in some basic equipment and medicine that supply chains have been bolstered. I — there – – we always — and just finally, we need to take global vaccine equity much more seriously than we have done. The Biden administration keeps on talking about the number of doses that it’s donated, but we see those doses arriving too late. We see too few of them. We a lot of doses that are close to their expiry date and can’t be used. If we don’t actually commit to vaccinating the rest of the world as quickly as possible as people have been calling for the last year, we’re going to see more of these variants and we’re going to see more of these same problems. And as I say, I cannot stress enough that the problems are cumulative. It’s not just what the health care system is facing right now, it’s the fact it’s been facing it for two years now that’s breaking it.

ISAACSON: Ed Yong, thank you so much for joining us.

YONG: Thanks for having me.