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How accurate are the coronavirus tests used in the U.S.?Months into the outbreak, no one really knows how well many of the screening tests work, and experts at top medical centers say it is time to do the studies to find out.When the new virus began spreading, the Food and Drug Administration used its emergency powers to OK scores of quickly devised tests, based mainly on a small number of lab studies showing they could successfully detect the virus.That’s very different from the large patient studies that can take weeks or months, which experts say are needed to provide a true sense of testing accuracy.The FDA’s speedy response came after it was initially criticized for delaying the launch of new tests during a crisis and after the Centers for Disease Control and Prevention stumbled in getting its own test out to states.But with the U.S. outbreak nearly certain to stretch on for months or even years, some experts want the FDA to demand better evidence of the tests’ accuracy so doctors know how many infections might be missed.There have been more than 2 million confirmed coronavirus cases in the U.S. and more than 115,000 deaths, according to data compiled by Johns Hopkins University. Cases in nearly half of U.S. states are rising.In recent weeks, preliminary findings have flagged potential problems with some COVID-19 tests, including one used daily at the White House. Faulty tests could leave many thousands of Americans with the incorrect assumption that they are virus-free, contributing to new flare-ups of the disease as communities reopen.“In the beginning, the FDA was under a lot of pressure to get these tests onto the marketplace,” said Dr. Steven Woloshin of Dartmouth College, who wrote about the issue in the New England Journal of Medicine last week. “But now that there are plenty of tests out there, it’s time for them to raise the bar.”The FDA said in a statement that it has already asked multiple test makers to do follow-up accuracy studies, although it didn’t say for how many of the more than 110 authorized screening tests. The agency also said it is tracking reports of problems. Accuracy has also been an issue with blood tests that look for signs of past infections.No screening test is 100% accurate. So details on accuracy are routinely provided for tests of all types, including seasonal flu, hepatitis, HIV and cancers. For example, rapid flu tests are known to miss 20% or more of all cases, a factor doctors weigh when treating patients who have symptoms but test negative.For now, most COVID-19 tests in the U.S. don’t give data on real-world performance, including how often the tests falsely clear patients of infection or falsely detect the virus. That information is lacking for all but a few of the roughly 80 commercial screening tests available, according to an Associated Press review.The government’s emergency authorization process “requires a lower level of evidence,” the agency said. Makers need only show that a test “may be effective” instead of the usual requirement to demonstrate “safety and effectiveness.” They would have to meet that higher threshold once the U.S. government declares the emergency over.Many of the commercial test makers submitted results from 60 samples, the minimum number required and mostly used lab-produced specimens of the virus. The FDA now recommends the use of nasal swabs or other real samples from people screened for coronavirus.Experts say larger patient studies patients are needed to assess a test’s true performance.Lab testing bears little resemblance to actual — sometimes imperfect — conditions at hospitals, clinics and testing sites noted Dr. Robert Kaplan of Stanford University.“You’re testing people in parking lots, the patients themselves are extremely anxious and often unable to follow instructions,” said Kaplan, a former associate director of the National Institutes of Health.Kaplan and others say those differences could explain why some tests are not performing as expected.Last month, the FDA warned doctors of a potential accuracy problem with Abbott Laboratories’ rapid ID Now test, which delivers results in roughly 15 minutes. The test has been lauded by President Donald Trump and used to screen the president, his staff and visitors to the White House.The FDA alert followed a preliminary report by New York University that found Abbott’s test missed between a third to one-half of infections caught by a rival test in patients screened for the virus.Abbott rejected the findings, saying the researchers did not follow the instructions for using its test. The company pointed to alternate patient studies, including its own, that have found the test successfully detects between 91% and 95% or more of virus cases when compared to other tests.But similar problems with ID NOW’s accuracy have been flagged in preliminary reports by researchers at Stanford University, Loyola University and the Cleveland Clinic.For now, the FDA is requiring Abbott to conduct follow-up studies in several different patient groups.The FDA’s emergency standards “are still high but there is a significant difference in the body of work that what would go into a submission under the normal process,” said Abbott vice president John Hackett. “Our normal process takes years to bring these out.”Requiring bigger studies of all coronavirus tests could provide valuable information, but it could also strain the FDA’s already stretched staff and resources, said Dr. Daniel Schultz, former director of the FDA’s medical device center.Dr. Colin West of the Mayo Clinic worries doctors and patients have put too much confidence in the current crop of tests, when an unknown number of patients with COVID-19 are likely receiving false negative results.Even a modest error rate can have grave consequences during an outbreak like COVID-19. West gives the example of a test that is 95% accurate at detecting the virus and is used on 1 million people. That would still result in 50,000 people being incorrectly told that they don’t have the virus.“The negative test does not mean that I’m off the hook,” West said. “We just need to maintain that level of vigilance until we have a better sense of how good these tests really can be.”___Follow Matthew Perrone on Twitter: @AP_FDAwriter.___Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak.___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 6604

If you’re shopping for a car, you may already know that buying used is a smart move that greatly expands your choices. The key is knowing where to look for them.Buying a used car will not only save you money but also allow you to shop higher-end brands, says Ivan Drury, Edmunds.com’s senior manager of insights. For example, maybe you wanted a new Toyota Camry. Instead, he says, you can save about ,000 and get a 3-year-old Lexus.Because of the bankruptcy of Hertz rental car agency, along with the many cars coming off lease, there are a lot of used vehicles to choose from, says Jeff Huang, who attends auctions as the remarketing sales supervisor at Westlake Financial Services. “A good used car is a real value proposition — and there are definitely deals to be had,” Huang says.Shoppers looking for great bargains will find them in cars older than 7 years, says Mark Holthoff, used car editor at Klipnik, a website for used car enthusiasts. “That’s because the depreciation curve has mostly been flattened,” he says. For example, a 2014 Mercedes-Benz E-Class sedan, costing ,000 new, now sells for about ,000.Shop in the right placeNew cars are sold only by franchised dealers, but used cars can be purchased from a variety of sellers:Used car departments at new-car dealerships.Used car superstores such as CarMax.Online used car sellers such as Carvana, Shift and Vroom.Car rental sales lots.Independent used car lots.Private parties.Public auctions.You’ll typically find the newest and more expensive models at new-car dealers’ used-car lots, the only place to turn if you want a certified car with a warranty and factory financing. Prices are likely to be higher than other lots’ but negotiable.National used-car chains such as CarMax, online retailers and rental car agencies also offer newer cars, often with factory warranty remaining. You can also get a loan and buy extended warranties. Prices are typically no-haggle.Independent lots, private parties and public auctions typically deal in older or cheaper cars. The upside is that you may find a 20-year-old one-owner cream puff, cheap. It does happen. But most cars have had several previous owners, and a checkered past is not rare. Plus, you’ll have to arrange your own financing.Adjust your expectationsThere is a built-in risk-versus-reward element to used car shopping: The more you’re willing to spend, the less chance the car will need repairs and overdue maintenance. Here’s an overview of the three price levels of used cars:High-end used cars: If your budget is over, say, ,000, you might consider getting a certified pre-owned (CPO) car from a dealer. Shopping for a CPO car is easier because it’s pre-inspected and comes with an included warranty. While you’ll have to pay a premium, you’ll also be able to buy a car with more modern technology and safety features. Of course, you can always buy a non-CPO car and purchase an extended warranty.Midrange used cars: A sweet spot for used car buying is a 3-year-old vehicle coming off a lease. Many of these cars will sell for 40% of their original price and still retain a new-car feel, according to Drury. Another source of near-new bargain-priced vehicles is car rental lots. According to an iSeeCars analysis, Hertz vehicles are selling for an average of ,389 below market value.Older used cars: Many people are afraid that cars from 7 to 15 years old will require costly repairs. But Holthoff points out that new cars can effectively cost the owner ,000 a month in depreciation.“You might have to spend money on a repair, but depreciation is a constant,” he says.To offset repairs, set aside 0 a month so sudden mechanic bills won’t deplete your savings.It’s best to buy older cars from private-party sellers because you can get a better idea of the mechanical condition, Holthoff advises. A used car dealer will show you the vehicle history report, but a private party might have the service records and can answer many other questions.Look for unexpected valueThe used car market is vast and, if you can spot an outlier, you can save big money. Here are a few examples of how to find that diamond in the rough:Cars that haven’t been recently redesigned will sell for less. Check car sites such as Edmunds.com to find out when the last time major changes were made to a model.While there is a stigma to buying a used rental car, the vehicles are well-maintained and priced lower than buying from dealers, Drury says.If a car dealer’s vehicle history report shows you are looking at a former rental car, leave and buy a similar one directly from the rental agency’s sales lot. You’re likely to find it cheaper.Be willing to travel to an area where the car you want is less popular. For example, all-wheel-drive vehicles sell for less in the southern U.S., where winter driving isn’t a factor.Be willing to travel to a more competitive market. A Honda dealer with a city to itself has less pressure to dicker on a CPO vehicle than a dealer in a city with three or four rivals.Used luxury cars often offer the biggest savings, according to Holthoff. The money you save on the purchase can be used if any repairs are needed.More From NerdWalletDon’t Fall for COVID-19 Student Loan Relief ScamsGet Your Finances Ready to Refi Student Loans5 Reasons It’s Smart to Lease a Car Right NowPhilip Reed is a writer at NerdWallet. Email: articles@nerdwallet.com. Twitter: @AutoReed. 5428

In advance of hurricane season, Florida Power and Light is reviewing plans to make sure power is restored quickly after a storm. This week the company is holding its annual storm drill, simulating a Category 3 hurricane. During the drill, the company says it is incorporating lessons learned from Hurricane Irma, which knocked out power to 6.7 million electrical customers, according to the U.S. Energy Information Administration (EIA).EIA reports the rate of electric service restoration following Hurricane Irma was faster than Hurricane Wilma in 2005. Five days after Irma’s landfall, the share of customers without power had fallen from a peak of 64 percent down to 18 percent -- a recovery rate of about 9 percent of customers per day.Power outages during Wilma declined from 36 percent of customers to 16 percent by the fifth day after landfall. This is an average recovery rate of about 4 percent of customers per day. FPL credits the improvement to money spent on infrastructure improvements. Since 2006, more than 860 main power lines were hardened; within the next five to seven years FPL wants to harden all of them.Strengthened power lines perform approximately 40 percent better than non-strengthened lines, FPL said.This year, FPL plans to undertake the following additional initiatives to improve the reliabilityof service: 1416

HOUSTON (AP) — President George H.W. Bush said a lot with socks.A visit from friend and fellow former president, Bill Clinton, inspired him to wear a pair emblazoned with Clinton's face. He wore Houston Texans' socks when meeting with the head coach. At the funeral for his wife, Barbara Bush, he wore socks featuring books as a tribute to her work promoting literacy.Bush, who was a naval aviator in World War II, will be buried this week wearing socks featuring jets flying in formation — a tribute, his spokesman says, to the former president's lifetime of service. The mayor of Houston urged people attending a City Hall tribute to Bush on Monday evening to wear colorful socks in memory of the former president, who died Friday at age 94 .Michael Meaux, who worked in the U.S. State Department under Bush's son, former President George W. Bush, sported a pair of hot-pink socks as he waited for Monday evening's tribute to begin."I've had them for a while, but I've never worn them before," Meaux said, laughing.Bush was one of several a high-profile figures to adopt a menswear trend of using socks to add a bit of flash to an outfit. Others include Canadian Prime Minister Justin Trudeau. The trend hit a peak in the men's market four years ago, said Marshal Cohen, a chief industry adviser of the market research firm NPD Group.It has endured, with color and novelty driving growth in the market, he said. And as menswear became more casual, socks replaced the tie as a conversation piece."Year after year we got more and more casual and the fun novelty sock became an opportunity of expression," Cohen said. "As we got rid of ties, guys still wanted to be able to put some style to a navy suit or a black suit."The socks can add some fun and color to an outfit, while also making a statement.Bush embraced the practice, and gave it meaning.In March, the former president tweeted a photo of himself wearing a brightly colored pair of "Down Syndrome Super Hero" socks sent to him by John Cronin, a 22-year-old New York man with Down syndrome who with his father runs an online business selling socks.Cronin's mother, Carol Cronin, said her son and Bush became "kind of sock buddies." Not long after starting John's Crazy Socks , John Cronin learned of Bush's love of colorful socks and sent him a box. After Barbara Bush died in April, it was Cronin who sent Bush the socks featuring books that he wore at her funeral.Carol Cronin said that when her son learned that it was Bush who signed the Americans with Disabilities Act banning workplace discrimination of people with disabilities and requiring improved access to public places and transportation, he felt their connection was "meant to be.""The inclusiveness that is envisioned by that legislation has changed his life and every other person who has a differing ability for the better," said Cronin, who noted that the majority of employees hired for the business have differing abilities.She said her son's idea of starting a sock business turned out to be a successful and fulfilling one."I think it lets people express themselves in a subtle way," she said.___Stengle reported from Dallas. 3164

In a heartbreaking Instagram post, Chrissy Teigen shared Thursday that she had suffered a miscarriage."We are shocked and in the kind of deep pain you only hear about, the kind of pain we’ve never felt before," Teigen wrote.The model and TV personality and her husband, singer John Legend, announced in August that they were expecting their third child. But earlier this week, Teigen was rushed to the hospital shortly after revealing that she had been on bed rest and had suffered bleeding for about a month.In her Instagram post, Teigen wrote that doctors were unable to stop the bleeding and give her baby the fluids he needed "despite bags and bags of blood transfusions."While Teigen wrote that she and her husband don't pick names for their children "until the last possible minute," she said that she had been calling her unborn son Jack."He will always be Jack to us," she wrote. "Jack worked so hard to be a part of our little family, and he will be, forever."Teigen closed her post with thanks to "everyone who has been sending us positive energy, thoughts and prayers.""We are so grateful for the life we have, for our wonderful babies Luna and Miles, for all the amazing things we’ve been able to experience," Teigen wrote. "But everyday can’t be full of sunshine. On this darkest of days, we will grieve, we will cry our eyes out. But we will hug and love each other harder and get through it.""We love you, Jack," Legend added in a retweet of his wife's post. 1481

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