So many horror stories on how long it takes to get a covid test to how intrusive it is to stick something through your nose….yet I have posted on so many advancements in testing from not just no name companies but big ones such as Roche….but yet here we are…. https://www.bloomberg.com/amp/opinion/articles/2020-07-22/coronavirus-testing-is-broken-and-there-s-no-plan-to-fix-it?

“Federal agencies such as the Centers for Disease Control and Prevention, state labs and hospitals all provide testing services, but commercial labs dominate the market. The clinical testing business, which generates annual revenue of about $80 billion, has a number of big players, including ARUP Laboratories, BioReference Laboratories, Mayo Clinic Laboratories, and Sonic Healthcare Ltd. But two aggressive competitors, Quest Diagnostics Inc. and Laboratory Corporation of America Holdings, dominate the field.

Quest earned $858 million on revenue of $7.7 billion in 2019. The company says its operations “touch the lives” of 30% of the U.S. adult population and it boasts of relationships with about half of all physicians and hospitals in the country. LabCorp earned $824 million on revenue of $11.5 billion last year. It says it interacts with 3 million patients weekly, controls proprietary data derived from 35 billion lab test results (which includes about 50% of the U.S. population), and has contributed to the development of all 50 of the country’s top-selling drugs.

Both companies were assembled through decades of mergers and acquisitions, diagnostic ingenuity and an unrelenting focus on expanding their market share. Quest and Labcorp are preferred or exclusive providers for many of the largest private health insurance companies in the U.S., and they process a large portion of tests covered by Medicare and Medicaid.”

“Smaller competitors have complained over the years that Quest and Labcorp’s tight relationships with insurers and the federal government make it hard for them to break into health care networks to offer alternatives. Some consumers have alleged that the companies charge exorbitant prices for tests administered to uninsured patients, and both companies have drawn scrutiny for possibly overbilling Medicare and Medicaid (charges that they’ve denied).”

“A three-to-five-day turnaround time for test results they announced at the end of June gave way to a four-to-five-day delay by the first week of July. After announcing the second delay, Quest said it didn’t expect to get any faster until the coronavirus stopped spreading nationally. Don’t expect that to happen anytime soon. In an interview with the Financial Times on Tuesday, a senior Quest executive said “it will be impossible” for his company “to increase coronavirus testing capacity to cope with demand during the autumn flu season.””

“New York’s Andrew Cuomo, a Democrat, has advised his state’s residents to patronize local labs rather than Quest or LabCorp to get timely test results. About 70% of New York’s tests are now processed by 200 local labs that return results in one to three days, the state said.”

“Smaller labs around the country have excess capacity they’re unable to deploy because they haven’t been able to break into the insurance networks dominated by the big guys. And labs of all sizes struggle to operate at full capacity because a balkanized supply chain forces them to compete against one another for frequently scarce resources.”

The author of the article argues for a lot of federal govt. interaction into the market place. I would agree but the govt. actions should involve breaking down the barriers of competition and removal of large lobbying interest not expanding their power and oversight. Who would lose if there was a test you can buy and do it yourself or even submit yourself to be checked? Labcorp and Quest are both at their 52 week high. They are proud of their connection to doctors/hospitals/ and drug manufacturers – who like their distribution network. How much money are the equipment manufacturer getting, the lab, etc…what is the money trail – is it worth the cost – can we do statistical sampling to get a better wholistic picture – similar to polling? We want to fast track vaccine but seem to not care to fast track testing that has shown quite effective.

Reported a few days ago: A new test – the all in one test – that can produce results in 20 minutes and tell if you are currently infected and if you had it! https://www.scmp.com/news/asia/australasia/article/3093608/australian-researchers-invent-20-minute-coronavirus-blood

“Their test, using 25 microlitres of plasma from blood samples, looks for agglutination, or a clustering of red blood cells, that the coronavirus causes.

While the current swab test is used to identify people who are infected with the coronavirus, the agglutination assay – or analysis to detect the presence and amount of a substance in blood – can also determine if someone had been recently infected, after the infection is resolved, they said. Hundreds of samples can be tested every hour, the researchers said, and they hope it can also be used to detect antibodies raised in response to vaccination to aid clinical trials. ”

I referenced the study noted in this report back in 6/2/20 (https://covid19mathblog.com/2020/06/covid-6-2-20/) – yet its taken this long to show up in media – nonetheless on FoxNews – pointing out his conclusion that its political drug not a medical drug – https://www.theblaze.com/news/yale-professor-hydroxychloroquine-100-000-lives

“Yale epidemiology professor Dr. Harvey Risch said Tuesday that he believes the President Trump-touted drug, hydroxychloroquine, could save up to 100,000 lives if used properly to treat the coronavirus.”

“Speaking with Fox News’ Laura Ingraham Monday night, Risch insisted that the controversial drug is proven to be effective against the disease and safe for people to use, but lamented that it has become the victim of a "propaganda war."

"It’s a political drug now, not a medical drug," Risch said. "I think we are basically fighting a propaganda war against the medical facts, and that colors not just population people, how they think about it, but doctors, as well.

"There are many doctors that I’ve gotten hostile remarks [from] saying that all the evidence is bad for it and, in fact, that is not true at all," he said. "All the evidence is actually good for it when it’s used in outpatient uses.”

“All in all, Risch asserted that "75,000 to 100,000 lives would be saved" if the drug was used widely and perhaps as a prophylactic, meaning in a preventative manner.”

“Since then, a new study conducted by the Henry Ford Health System found that "treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19."”

Ugh where is the mass media retraction or at least an investigation of this. Lets put the politics aside and save some lives? Lets hope a vaccine that is shown to work – Trump doesn’t endorse it – else it’s going to be trashed.

Speaking of vaccine – https://www.reuters.com/article/us-health-coronavirus-usa-vaccines-price/moderna-merck-say-they-will-not-limit-price-of-coronavirus-vaccines-to-company-cost-idUSKCN24M2PP

“Moderna Inc and Merck & Co on Tuesday told a U.S. Congressional panel that they expect to profit from their coronavirus vaccines once approved, amid concerns the vaccines may not be accessible to all.”

“Executives from Johnson & Johnson and AstraZeneca Plc testified that they will price their respective potential vaccines at no profit while the pandemic rages on.”

“Pfizer Inc has said the company intends to make a profit from its potential coronavirus vaccine if approved. However, Pfizer Chief Business Officer John Young, testified: “We recognize that these are extraordinary times and our price will reflect that.””

“AstraZeneca said its vaccine would be provided at no profit under its agreement with the United States for allocation of some 300 million doses.”

No profit – doesn’t mean it doesn’t come with return on capital – technically a return on capital allocated one could argue is part of the “no cost”. ROC on pharma is quite high.

Back to 1K plus for Brazil and US – but averaging the past 2 days US would be under. India is accelerating their confirmations. Note they are using HCQ as preventive to their medical folks.

The leader in death is FL at 134. Confirmation leader CA

It’s the same counties

Fatality rates continue to fall for LA.

I keep seeing scare articles noting how ICU in Texas are like war zone etc… I am sure they are awful but to put things in perspective they are no way near what had happened in NYC. Yesterday I showed state view – lets dive into the county view and you cant even see Harris County in terms of death. I had to cut the criteria to 10 to just get Harris county to be plotted along these other regions. Even LA, Maricopa, Miami Dade is dwarfed by NYC. Can you imagine the hospitals in NYC when they were over 500 deaths a day (peak 1079 deaths a day 4/19) – and now these counties are complaining at less than 100 deaths a day (Harris county 16 deaths/day)? The extrapolation of what happened in NYC just cannot be used to represent other breakouts. No doubt error after error had to have occurred in NY. Other hotspots at that time did not get that bad. We are working on getting state data in foreign countries to compare with NY. LA is getting close to the level being confirmed in NY but the deaths are nowhere near NYC.

Without NYC in the chart – Harris County still much lower than LA, CA.

Speaking of Houston/Harris county – the miracle continues with ICU beds availability flat lining and improving in the face of growing confirmations. Fatality rate observing a slight rise but still the envy of the world at less than 1%.