Why has coronavirus testing in the US been such a disaster? Guardian UK
The Trump administration is scrambling to provide more testing, leaving many to wonder how it got its Covid-19 response so wrong
Fri 13 Mar 2020 18.37 EDTLast modified on Fri 13 Mar 2020 21.14 EDT
America’s failure to provide quick and easily accessible testing to people suspected to have the coronavirus has been a central thrust of criticism about the US response to the threat from the global pandemic.
That has left many wondering how the US could have got its coronavirus response so wrong, though it appears that steps are now being taken to try and catch up with the outbreak’s spread.
The Trump administration is scrambling to provide more testing for Covid-19. What is happening?
New measures are being introduced that should speed up access to test kits. Roche, the manufacturer of state-of-the-art testing machines that are 10 times faster at getting results than other models, has just been given approval by the US Food and Drug Administration to produce a new coronavirus test which should see 500,000 or so additional kits available from next week. New York state, which is an epicenter of the coronavirus outbreak, has also been given permission to run its own testing operation using both public and private laboratories.
At a White House press conference on Friday, Donald Trump said the federal government was working in partnership with private laboratories such as Quest Diagnostics to sharply increase capacity.
All of this is good news, as it is should bring much more testing capacity on stream.
So now there will be more testing available the crisis is over, right?
The US is woefully behind the curve in tackling the novel coronavirus, especially in terms of testing. It is now thought the disease may have first emerged in China as early as November though Chinese authorities only revealed the crisis in January. Even so, Trump was only putting crucial elements of the US testing strategy in place on Friday, almost two months after the scale of the danger was fully known. With a virus that is as contagious and lethal for vulnerable populations as Covid-19, that is unthinkably slow.
What explains this abysmal failure?
“Failure” is right. That’s precisely the word that Dr Anthony Fauci, one of the top US officials dealing with the crisis, used to describe the testing fiasco on Thursday.
A number of problems contributed to the disaster. The Centers for Disease Control and Prevention (CDC), which is marshaling federal testing, botched its rollout of test kits in February, sending out faulty materials. A bottleneck then ensued, with states all having to send their samples to the CDC’s headquarters in Atlanta for analysis which slowed results down.
The federal government was also too controlling of the process, preventing states and private laboratories running their own decentralized efforts. The criteria for testing was set far too tightly. Doctors were initially told they could only test people who had traveled to China or had close contact with infected individuals. Only now can doctors freely offer testing, and even so there are simply not enough kits to go round.
So how bad is the shortfall?
Extremely bad. A few statistics put it in perspective. South Korea, which is increasingly being seen as a model of good practice, has been testing up to 15,000 people a day – and has reached more than 230,000 people.
In the US, the total number of people who have been tested is still only about 11,000. That’s a per capita rate that is about 130 times lower than in South Korea.
This matters. South Korea’s blanket testing has helped the country turn the corner of the epidemic. The number of new cases reported in South Korea every day is now falling, suggesting good policy and strong leadership can beat the virus. The US had neither.
Basic question: why is testing important?
The even more basic answer is that Covid-19 is invisible and can easily go undetected. It also spreads very quickly, and can be passed along by people who themselves have no symptoms. Trying to combat the disease without testing is like running through a forest blindfolded – it’s not going to end well.
The only way to get to grips with the disease, experts say, other than locking down entire cities like China and Italy have done, is mass testing. This allows doctors and government to operate on two levels: they can identify carriers of the virus who can then be quarantined until they are no longer infectious, and they can also carry out random sample testing in communities to spot localized outbreaks that can then be targeted as “containment zones”. New Rochelle outside New York city is an example, where the National Guard was sent this week to deliver food to quarantined families.
How do the tests work?
Swabs are taken from the mouth or throat and then sent to laboratories. The aim is to gain a match with Covid-19’s genetic sequence. The new Roche test takes only four hours to get results, but earlier versions can take up to 48 hours which slows things down.
So who is to blame for the lethally late push for testing?
With a health crisis of this dimension, the buck stops at the top, and that’s Trump. From the outside, medical experts say, he has taken the wrong approach, thinking of Covid-19 as an outside threat to be dealt with by closing borders rather than an inevitable and already existing fact of life inside the US that must be dealt with through testing and isolation. This week, in his Oval Office address to the nation, Trump called it the “foreign virus” which is a dangerously misleading concept. Remarkably, he continued to talk on Friday about combating coronavirus through “a very strong border policy”, when the disease has almost certainly been prevalent inside the US undetected for weeks.
The bottom line is that Covid-19 is happening on Trump’s watch. He may find his usual techniques for deflecting criticism – lying, adopting conspiracy theories and blaming others – may not spare him the consequences this time.
- Update: A previous version of this story referenced a Google site which Trump announced on Friday would advise individuals on how to gauge their symptoms and, if needed, steer them towards new drive-in testing facilities. Despite Trump’s announcement of such a service, that service does not appear, with a subsequent statement by the Google-adjacent company in question, to be real. The company Verily, which shares a corporate umbrella with Google, released a statement after Trump’s press conference announcing that it was developing a Covid-19 triage test tool, but the tool “is in the early stages of development”, and the company is “planning to roll testing out in the Bay Area”, not nationally.