John Walters is a political columnist for VTDigger.
Dr. Mark Levine, Vermont’s public health commissioner, spoke to the Legislature’s Joint Rules Committee on March 30, delivering a strong, clear outline of how America’s COVID-19 testing strategy was inadequate from the very beginning. He repeated the narrative in a phone interview the following day.
If only his other public statements had been so forthright.
“Oh, completely,” Levine said in that interview, when asked if limited availability had shaped US testing policy. “It’s been shaped by sheer unavailability.” Levine explained that a national shortage of testing kits and processing capacity meant that the United States could never pursue containment — the strategy that’s been successful in South Korea and other countries that aggressively tested as many people as possible.
Instead, he said, the Centers for Disease Control and Prevention advised states to limit testing to people with severe coronavirus symptoms. And ever since, he said, we’ve been playing catch-up. He delivered the same message to the members of Joint Rules. “From the very beginning, the country has had trouble with capacity for testing,” Levine testified. “It put us behind the 8-ball with understanding the extent of the pandemic and conducting containment.”
Meanwhile, in a series of televised briefings by Gov. Phil Scott, Levine has consistently asserted that there’s no need for expanded testing.
“The availability of tests has not prevented us from testing appropriate people,” Levine said on March 13, the day Scott declared a state of emergency. At that point, the state was still following the CDC guidance — which was predicated on a nationwide shortage of tests.
On March 27, when Vermont had received more tests and gained access to more processing capability, Levine expanded the guideline to include those who had mild or moderate symptoms. Still, he said, “Testing will still be prioritized, and patients who have no symptoms will not be tested.”
At the time, Vermont was beginning to experience COVID-19 clusters, most notably among health care workers and in senior residences. In a March 30 briefing, Levine was asked if there was a need for broader testing at two COVID-19 epicenters: Burlington Health and Rehab and Pinecrest at Essex.
“We’re going to abide by what I mentioned in my opening comments, that testing is not treatment, and testing will occur for those who become symptomatic, in consultation with their health care providers,” he responded.
Well, of course “testing is not treatment.” But testing of asymptomatic staffers and residents could limit the spread of the virus — and ease the concerns of some rightly worried people.
The following day, the administration ordered blanket testing of staff and residents at Burlington Health and Rehab. The day after that, the order was extended to include Pinecrest.
They saw the horses bolting the barn, and tried to lock the doors.
On Thursday, the health department released details on Vermont’s COVID-19 cases up to March 20. The information suggests that we are far beyond the point where narrowly targeted testing is sufficient. Of the state’s first 36 known cases, only three had confirmed contact with another COVID-19 patient. And only nine had traveled outside Vermont before contracting the disease. Those are strong indications that even as early as March 20, the virus was well-established in Vermont and spreading predominantly through community contact.
In response to questions about broader testing, Levine has posted a false dichotomy. “I don’t think we would do just blind testing of places that have no reported cases, no reported illness,” he said in the March 13 briefing.
Again, no one is suggesting “blind testing.” Knocking down that idea, however, allows Levine to avoid addressing the benefits of broader, targeted testing.
Remember his other comment from March 13: “The availability of tests has not prevented us from testing appropriate people.” That’s technically true, but it rests on the definition of “appropriate people.” If the definition is too restrictive, the statement is misleading. And we know, because Levine himself has said so, that an infected person can be asymptomatic for up to two weeks — spreading the virus before becoming sick enough to qualify for testing.
Levine is deliberately obfuscating the truth when he speaks directly to the public. Here’s how he put it in the March 31 interview: “Ideally, I think a population could be tested in the pre-symptomatic or asymptomatic state because we know to some degree that the virus is transmitted from people who have no idea they have it. This won’t get at that, I completely agree with you.”
In plainer English, Levine acknowledged that testing asymptomatic people would provide valuable information — but testing capacity still doesn’t allow it.
At almost every briefing, Scott has said something like “Our decisions are based on science.” That’s comforting. But it’s not true.
As Levine has acknowledged, the administration’s decisions are — first and foremost — dictated by circumstance, severely limited by the federal government’s failures. Containment was a lost opportunity. Levine and Scott are dealing with the hand they were dealt. But they should stop claiming that their policy is based on science, or that they wouldn’t be doing any more testing even if they could.
When asked if he deliberately soft-pedaled aspects of the situation when speaking to the press, Levine responded, “I wouldn’t say that.” But then he went on to kinda-sorta acknowledge that there’s a soft-pedaling element involved:
“I think there are times you have to do that because the question you got implies that people should have a greater level of panic about something,” Levine said. Which would explain why he deflects questions about the usefulness of broader testing.
In a way, it’s understandable. Levine was dealt a bad hand. He’s doing the best he can. But he should have a little more faith in our ability to comprehend, and give us a less filtered version of the truth.
