Dr. Matija Snuderl has spent the last couple of months poring over tissue samples collected from the bodies of the recently departed.
As a neuropathologist at NYU Langone Medical Center in New York City, he’s usually diagnosing brain tumors and other brain diseases. But this effort goes beyond his typical duties: Snuderl is among a group of medical experts around the country on a detective-style hunt for missed cases of COVID-19.
“At this point, it is critical to better understand the silent spread that was happening before the outbreak officially began [in New York],” Snuderl said.
As cases surge in some parts of the country, doctors like Snuderl are working to better understand the early trajectory of the virus in hopes of discovering unseen patterns that could help inform future public health policies.
“I think if we better understand how the disease was spreading early on, when the next thing like this happens, we’re going to be better prepared, and we’re going to be able to act hopefully faster,” Snuderl said.
Currently, there is no coordinated national effort to understand how early and how widely the virus may have been spreading, but this patchwork approach has begun in at least seven other states. Initiatives vary greatly and few teams are working at the directive of state governments. Some have told NBC News they lack staffing or funding to conduct this type of research, which requires special materials to preserve samples for retesting days after an autopsy.
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City and county medical examiners and coroners are taking up the bulk of this retrospective work, retesting blood and tissue samples preserved from autopsies to potentially uncover cases that may have gone undetected when testing was less available.
Not only could newly revealed positive results upend the timeline of when COVID-19 took hold throughout the U.S., their efforts could help prevent future deaths by identifying communities that contact tracers and containment strategies should target. Medical examiners like Dr. Thomas Gilson say their insights are a crucial part of the long-term public health surveillance mechanism.
“If all I had for information was how many health care workers tested positive and how many people who were really sick test positive, I really have the potential to miss a lot of people out in the community who either aren’t that sick or are sick and don’t access the health care system,” said Gilson, who oversees the efforts in Cuyahoga County, Ohio, the county with the second-highest number of infections in the state.
Thanks to funding from the county, Gilson and his team have been able to perform antibody testing on 350 deceased people. About 3% came back positive, but additional testing on tissue samples pulled from the same bodies came back negative. He believes the antibody tests were false positives and cautions against relying on antibody testing for retrospective research.
“These results indicate that the number of people infected in our community is still relatively low,” Gilson said.
A similar effort is underway in California, which is the only state to have requested that all of its medical examiner offices re-examine past cases.
“People are dying at home without any medical diagnosis — we’re the last chance to catch those people and make sure that steps are taken to help contain the virus and spread,” said Dr. Christopher Young, the Ventura County chief medical examiner, who has started reviewing files as far back as December.
The initial look-back request was issued by Gov. Gavin Newsom and the state Department of Health in late April and asked teams to reconsider cases dating back to December 2019, before China announced the identification of the virus.
The effort was triggered by Santa Clara County’s identification of two deaths on Feb. 6 and Feb. 17 as positive for SARS-CoV-2, the virus that causes COVID-19 — predating the first established death in the country by weeks.
“As a physician and a forensic pathologist, I definitely would like to make sure we have accurate causes and that’s why we do all the tests that we do on any case: to try to come to the right conclusion,” Young said.
Some medical examiners have access to facilities that can test autopsy tissue samples. California health officials send their specimens to the Centers for Disease Control and Prevention for testing, but certain criteria must be met and results can take up to eight weeks, the officials said.
The effort has been slow to bear results — diminished in part by the state’s recent record daily numbers, as teams work to keep up with the flood of new cases.
“We are still very, very much in the thick of things,” said Andrea Bowers, spokeswoman for the Imperial County Public Health Department. “So, we’ve had to bring in additional contact tracers, case investigators and epidemiology staff, and so they really have not had a moment to kind of look backwards.”
As caseloads swell across the U.S., teams in Washington, Nevada, New Mexico, Massachusetts and Illinois are also re-examining blood and tissue samples to identify any potential COVID-19 cases that were overlooked.
Snuderl, of NYU Langone, is convinced the virus was spreading in New York well before the first official case was announced on March 1. His theory was bolstered by a recent finding by Mount Sinai Hospital researchers that some New Yorkers had COVID-19 antibodies present in their blood more than a week before the first case was announced in New York City.
“We cannot go back in time, we can’t turn the clock back and we cannot change what happened,” Snuderl said, “but I think it will definitely help us to prepare for the next pandemic.”
Inside Lakers Practice: LeBron James & Anthony Davis Prepare For NBA Return – Lakers Nation
“The Bachelor” is one of the biggest franchises in television history. It has also faced enormous criticism over the years for its lack of diversity.
James is known to Bachelor Nation for his friendship with fan-favorite alum Tyler Cameron, who competed on Hannah Brown’s season of “The Bachelorette.” James was initially cast to be a suitor on the upcoming season of “The Bachelorette” with Clare Crawley, which was supposed to begin airing this past May, but when production on “Bachelorette” was halted due to the coronavirus pandemic, ABC began to think of a bigger role for James.
Last weekend, a former “Bachelorette” Rachel Lindsay — the first Black lead of the entire franchise in its nearly two decades on air — said she would cut ties with the ABC reality show if a Black bachelor was not cast. “The Bachelor” debuted in 2002, has numerous spinoffs, and is one of television’s highest-rated and most sustainable franchises. Through 24 seasons of “The Bachelor” and 15 seasons of “The Bachelorette,” Lindsay has been the only Black star.
Despite mounting pressure on “The Bachelor” for its lack of diversity, as pointed out by Lindsay, especially over the past week in the wake of George Floyd’s murder and amid Black Lives Matter movement protests, the network had its eye on James prior to the recently-heightened criticism, ever since he came in for casting early this past winter.
“He would have been on Clare’s season if it started in March. When we realized the shutdown was going to extend through the summer, we started thinking about how we were going to choose our Bachelor,” says ABC’s top unscripted executive, Rob Mills, who oversees “The Bachelor” franchise at the network. “Matt was somebody who was on our radar and we were thinking about him. We were thinking do we announce him early, or do we put him on Clare’s season and then announce him later, if it doesn’t work out with Clare? We didn’t make a final decision until recently, but this has been talked about for quite some time.”
The ABC executive maintains that casting James was not in response to Lindsay’s recent criticism.
“It wasn’t a response to that. We could have made this announcement earlier or later,” Mills says. “Certainly no one is blind to what is happening in the world, so hopefully this announcement serves as a bit of optimism during a time that we can really use this. But I don’t want this to look like we’re patting ourselves on the back or taking a victory lap. We don’t want this, in any way, to seem like a cure-all and seem like, ‘Hey! Look what we did here!’ We know this is a few grains of sand in a very big hourglass. It’s taken a while to get where we are and we will continue to go further, and I acknowledge it may not be enough. In the last few years, I believe it’s gotten better and with the announcement of Matt, I hope it keeps getting better. We are very excited about Matt.”
James has already garnered a large fanbase among the reality show’s audience because he is friends with Cameron, who was a runner-up on Brown’s season of “The Bachelorette.” Before his announcement as the next “Bachelor” on “Good Morning America” on Friday, James had nearly 190,000 Instagram followers, and he was on the shortlist of fans’ wish lists for a possible a Black star for the next season.
Mike Johnson, another fan-favorite alum, was nearly cast as “The Bachelor” last season, which ended up selecting Peter Weber. Many viewers have considered that move a snub, one that ended up further highlighting the show’s diversity problem.
“We had a very close race between three people — Tyler, Peter and Mike — and at the end of the day, there were the same reasons we had for anyone else,” Mills explains. “At that time, we just thought that Peter was the best guy for the job.”
When James came in for conversations about possibly becoming the next star of “The Bachelor,” the network made it clear that he was not being chosen for the color of his skin.
“There is that mantle that you are the first, and it’s been a long time coming, so there are additional pressures. Matt knows that he’s going to be asked about this and he’s ready,” Mills admits. “But what you never want is for somebody to feel like they are ‘The Bachelor’ because they are checking off a box. The same way with Mike, there were so other things that would have made him a great Bachelor, and it was the same thing with Rachel. Yes, she was the first Black ‘Bachelorette,’ and there has been a lot of weight that’s been put on her shoulders, but she was ‘The Bachelorette’ because, first and foremost, she was a great Bachelorette.”
Mills does admit its unfair that Lindsay, who met her husband on her season of “Bachelorette,” has taken on the role of unofficial spokesperson for diversity within the franchise.
“It is hard not to feel bad because everybody within the show and at the network loves Rachel. We don’t want her to be upset or to feel like more can be done. The best thing to do is listen to her, and take this seriously,” Mills says. “As she said in Women Tell All [last season], she looks around and she’s the only person that looks like her. She is the one that everybody goes to for comment and she is the one teaching everyone. I certainly I thought her comments after the Hannah situation were really insightful and informative to me. We’re so lucky to have her. But I don’t think it’s fair that the burden has been solely on her shoulders, and we’re going to do everything to make sure that it doesn’t stay that way.”
Over the years, the franchise has focused more on diversity, specifically by widening the pool of contestants, who often filter into the next season to become the lead. But while the contestants have diversified, the stars of the show have not.
ABC is not making up any excuses for why it took so long to cast a Black lead.
“There are a lot of different ways I can answer that, but it always rings false because honestly, I think we should have, and everyone agrees we should have had a Bachelor of color before this time,” Mills says.
In announcing James as the lead for Season 25, Karey Burke, president of ABC Entertainment, addressed the franchise’s duty to diversify. “We know we have a responsibility to make sure the love stories we’re seeing onscreen are representative of the world we live in and we are proudly in service to our audience,” Burke said in a statement. “This is just the beginning and we will continue to take action with regard to diversity issues on this franchise. We feel so privileged to have Matt as our first Black Bachelor and we cannot wait to embark on this journey with him.”
One benefit of announcing James early as “The Bachelor” — which the network hopes will premiere in Jan. 2021, pending on the ongoing pandemic — is that casting for James’ suitors can begin early.
And as for Crawley’s season of “The Bachelorette,” which should head into production this summer? “I think where this is really great for Clare is that every guy who will be on her season will know there is no chance of becoming ‘The Bachelor,’ so they should really all be there only for Clare,” Mills points out.
After James’ season, the franchise’s diversity efforts will continue, and the executive assures that the network will not fall short in its commitment to representation on-screen. “Everyone agrees we can be doing better and we will work to do that,” Mills says. “I do think there have been some strides made — small and maybe not enough, but there has been a commitment and that will continue.”