5 Takeaways from Birx, Fauci Remarks at White House COVID-19 Briefing

President Donald Trump, Vice President Mike Pence, and top economic advisor Larry Kudlow spoke today at the White House COVID-19 briefing. But here we are focusing on remarks by Deborah Birx, MD, the response coordinator of the White House Coronavirus Task Force, and Anthony Fauci, MD, a member of the task force and the director of the National Institute of Allergy and Infectious Diseases. Birx and Fauci have emerged as the most visible  health officials d

People who have left New York metro area need to self-quarantine for 14 days.

The SARS-CoV-2 virus that causes COVID-19 is circulating more in New York City and the areas the city than any other place in the country. Birx said the New York City metro now accounts for 60% of the new cases of COVID-19 and 31% of the deaths related to the disease. People are leaving New York City because of the high number of cases there. Birx (and Fauci) made a plea for people who have left New York City to self-quarantine for 14 days. “Because of the rate of the number of cases, you may have been exposed before you left New York,” Birx said. She continued, “Everybody who was in New York should be self-quarantining for the next 14 days to ensure that the virus doesn’t spread to others no matter where they have gone, whether it is Florida, North Carolina or out to the far reaches of Long Island.” 

Self-sampling would free up PPE. And self-sampling is not home testing.

The FDA put a stop to home testing last week, and in this afternoon’s press conference,  Birx, made a point of emphasis that self-testing, as she was using the term, is not home testing. Rather, she said, “we are working on the ability for people take their own sample.” Birx said people would be able to gather the sample for COVID-19 testing from the front of their noses (presumably under some sort of supervision). “That will allow all the drive-throughs to be very sparing on PPE [personal protective equipment]” and for PPE to be dedicated to hospitals, she said.

New case counts are affected by labs working through a backlog.

The cumulative number of cases of COVID-19 have soared in the last few days and as of noon today, the CDC was reporting cumulative total of 44,183 cases. Birx said at the press conference that  surge in new cases in this country will continue but mentioned that a backlog may be skewing the numbers. “We will be in touch with the laboratories after this press conference to really find out how many are still in backlog and how many were run in the last 24 hours.” Birx continued, “Until we can get into a 24-hour cycle we are going to have disproportional number of new cases compared to the actual new cases, and we will let you know when we reach that equilibrium.”

The possibility of a containment strategy in areas of the country that are not hot spots.

Fauci mentioned the need for data about the “penetrance” of COVID-19 in the areas of the country that aren't currently reporting a lot of cases. “We need to put a light on those dark spots.” He also mentioned that with the broader availability of testing it mght be possible to use a "containment strategy" in places other than the hotspots of New York, California, and Washington state. “They [other parts of the country] still have a window of significant degree of being able to contain. In other words, when you test, you find somebody, you isolate them, you get them out of circulation, and you do the contact tracing.”

It’s not just the antimalarials. Other treatments are in the pipeline.

Without identifying them by name, perhaps in response to reports of hoarding and shortages, Fauci mentioned the off-label use of the antimalarials, hydroxychloroquine and chloroquine. They “haven’t been definitely proven to work but they might have some hope.” But Fauci said he also “didn’t want anybody to forget that simultaneously with our doing that we are also doing randomized clinical trials on a number of candidates” and that those trials can are definitely determine the safety and effectiveness. Fauci said, “We are talking remdesivir, other drugs, immune sera, convalescent sera, monoclonal antibodies-all of these are in the pipeline now.”