Public/Global Health

Slow testing rollout sets back US coronavirus response

Bonnie Cash

The extremely slow rollout of tests to identify coronavirus cases in the United States is hampering the country’s response to the outbreak and preventing health officials from knowing how far the virus has already spread.

The Trump administration has come under fire from lawmakers, public health officials and medical experts for testing kit missteps that have widely been seen as setting back the country’s ability to respond to the pandemic.

Dr. Anthony Fauci, a top official at the National Institutes of Health, even acknowledged Thursday in a congressional hearing that “it is a failing” that there is not widespread testing available in the United States.

The harmful effect of the testing failure, experts say, is that there is no way of knowing for sure how far the virus has spread domestically.

“It’s been completely, unacceptably slow,” said Angela Rasmussen, a virologist at Columbia University.

The consequence of that, added Tara Smith, a professor of public health at Kent State University in Ohio, is that “we have really no handle on spread in the United States.”

“We are still fumbling in the dark,” she said.

Amid the mounting criticism, President Trump gave a press conference Friday at the White House and announced new actions to try to increase the availability of tests, relying on a partnership with the private sector. Administration officials said they have approved a new test from the drug company Roche, and said they hoped to have drive-thru testing sites available soon.

But Trump said he did not take responsibility for the slow rollout of tests that has caused anxiety among the American public.

“I don’t take responsibility at all,” he said, citing “specifications from a different time” that his administration had to change. More tests would be available “very quickly,” Trump said, without giving a firm timeline.

As a result of the testing failures, there is no verified count of how many people in the United States have or had the virus.

Dr. Amy Acton, the director of Ohio’s state health department, said Thursday that there are more than 100,000 people in the state with the virus. “Our delay in being able to test has delayed our understanding of the spread of this,” Acton said.

Smith, of Kent State University, said she thinks that number is “too high,” but said there could be 1,000 undetected cases just in Ohio right now.

Acton clarified her remarks on Friday, saying it was more of a “guesstimate.”

Ashish Jha, director of Harvard’s Global Health Institute, told MSNBC on Friday morning there could be 10,000 or more Americans infected.

“And we can’t identify who they are, we can’t take care of them and we can’t use a testing based strategy to get ahead of this virus,” he said. “The federal response really just has been a fiasco. We’ve had two months to get ready and we’re the only major country in the world that cannot test people far more readily than we are.”

Experts say the virus has now spread far and wide in the United States to the point that more drastic steps like banning large gatherings are needed to slow its spread and avoid overwhelming hospitals.

An investigation by The Atlantic found that as of Monday, only 4,384 people had been verified to have been tested for coronavirus in the United States, compared with more than 100,000 people tested by South Korea, which can test 15,000 people per day.

There are some signs the situation is starting to improve in the U.S. In addition to the approval of Roche’s test, the administration announced on Friday it was allowing more labs in New York state to test. The administration also appointed Brett Giroir, an assistant secretary from Health and Human Services, to coordinate testing efforts.

New York state on Friday opened its first drive-thru testing center near a major outbreak in New Rochelle. Colorado opened its first drive-thru testing center earlier in the week.

Experts, however, say they have been puzzled by administration pronouncements about increased testing capability that have not matched the situation on the ground, where possible patients cannot widely get tests.

Trump repeatedly sought to downplay the risk of the virus before declaring a national emergency on Friday. The previous day, he said “frankly, the testing has been going very smooth,” even as other officials in his administration acknowledge that is not the case.

Trump also claimed on a March 6 visit to the Centers for Disease Control and Prevention (CDC) that “anybody that wants a test can get a test.”

“The president says anybody who wants to be tested can be tested, but that’s self-evidently not true,” said Lawrence Gostin, a public health expert at Georgetown University.

Experts pointed to a variety of missteps that delayed testing. The Trump administration decided to develop its own test rather than rely on one approved by the World Health Organization, but some of the initial tests developed in the United States did not work properly.

The CDC had strict criteria for who could be tested, requiring recent travel or known contact with someone with the virus, and the Food and Drug Administration did not ease rules to speed the ability of private labs to start testing until the end of February.

“It has not worked as well as we would like,” Health and Human Services Secretary Alex Azar acknowledged Thursday when asked by Fox News host Sean Hannity about the testing problems. “We have 4-and-a-half million tests out there — there are a surplus of tests out there — but the connection from the patient, doctor, hospital to those lab tests and the labs has not been as seamless as we like.”

“It’s getting better and better every day,” Azar added. “We’re getting the private sector involved and that’s going to make it a more seamless experience.”

Gostin, of Georgetown University, warned that serious action is now needed to slow the virus’s spread. About 80 percent of people who get the virus are not thought to need hospitalization, but the virus can be especially deadly for older people and those with underlying health conditions.

“Our lives are not going to be back to normal for many weeks to come so we have to look after the vulnerable,” Gostin said.

Tags Coronavirus Coronavirus testing Donald Trump Sean Hannity testing kits
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