The key to stopping the spread of COVID-19 is knowing who has it. Yet testing in the U.S. has been a fiasco. What went wrong and how can we fix it?
Graeme Simpson, director of Interpeace USA. He developed a fever and a cough after returning from Spain. He’s an at-risk patient at 61 years old and has asthma. He first tried to get a COVID-19 test on March 3. (@Simpson_YPS)
Amesh Adalja, senior scholar at the Johns Hopkins University Center for Health Security, specializing in infectious disease and pandemic preparedness. Infectious disease and critical care doctor. (@AmeshAA)
Mark Jarrett, Northwell Health’s deputy chief medical officer and chief quality officer. The FDA approved Northwell to move from manual COVID-19 tests to semi-automatic tests last week, greatly increasing their testing capacity. Northwell operates 18 emergency rooms throughout New York City, Westchester and Long Island. (@NorthwellHealth)
Dr. Tom Frieden, president and CEO of Resolve to Save Lives, an initiative that aims to prevent epidemics. Former director of the Center for Disease Control and Prevention. Former commissioner of health for the City of New York. (@DrTomFrieden)
From The Reading List
The Guardian: “Dear President Trump: I need a coronavirus test right now. Where is it?” — “Americans have been told that all people who need Covad-19 tests will get them. That is a patently false claim. I am 61 years old and recently returned home to Brooklyn, New York, after a five-day work trip to Barcelona, Spain.
“Days after my return, I developed the classic symptoms of a dry cough and high fever. As a mild asthma sufferer – and therefore a high-risk person – I was particularly concerned, and so on the morning of Tuesday 3 March, I called ahead and then presented myself at my local ER to get tested for the coronavirus.
“After a cursory examination in which my blood pressure and temperature were monitored, a young physician’s assistant listened to my chest, there was some online exploration of the CDC guidelines, and after a brief discussion with an attending physician that I was not privy too, I was told that I did not qualify for the test because I had not traveled to any of the listed ‘global corona hotspots.’ I was asked to please wear the mask they had given me on my walk back home.”
Wired: “Everything You Need to Know About Coronavirus Testing” — “The state of Ohio has, as of this writing, five confirmed cases of Covid-19, the disease caused by the coronavirus SARS-CoV-2. If you ask Amy Acton, the director of the Ohio Department of Health, that’s the tip of the tip of a very dangerous iceberg.
“’We know now, just the fact of community spread says that at least 1 percent, at the very least 1 percent, of our population is carrying this virus in Ohio today,’ Acton said at a press conference on Thursday. ‘We have 11.7 million people.’ In other words, Acton was implying: 117,000 cases in Ohio alone.
“How could Acton know this? Well, technically, she can’t. She was extrapolating from what little data scientists actually have about the spread of the pandemic. Officially, there have been just shy of 130,000 cases of Covid-19 on Earth, so a six-digit toll among Ohioans would be terrible, with extraordinary implications for how many cases might be out there undetected in the rest of the country.”
The New Yorker: “What Went Wrong with Coronavirus Testing in the U.S.” — “On February 5th, sixteen days after a Seattle resident who had visited relatives in Wuhan, China, was diagnosed as having the first confirmed case of COVID-19 in the United States, the Centers for Disease Control, in Atlanta, began sending diagnostic tests to a network of about a hundred state, city, and county public-health laboratories.
“Up to that point, all testing for COVID-19 in the U.S. had been done at the C.D.C.; of some five hundred suspected cases tested at the Centers, twelve had confirmed positive. The new test kits would allow about fifty thousand patients to be tested, and they would also make testing much faster, as patient specimens would no longer have to be sent to Atlanta to be evaluated.
“The kits were shipped in small white cardboard boxes. Inside each box were four vials, packed in stiff gray foam, which held the necessary materials, known as reagents, to run tests on about three hundred people. Before a state or local lab could use the C.D.C.-developed tests on actual patients, however, it had to insure that they worked the same way they had in Atlanta, a process known as verification. The first batch of kits, sent to more than fifty state and local public-health labs, arrived on February 7th. Of the labs that received tests, around six to eight were able to verify that they worked as intended. But a larger number, about thirty-six of them, received inconclusive results from one of the reagents.”
Los Angeles Times: “Coronavirus testing lags in U.S., with only a fraction of suspected cases tested so far” — “Federal and state officials on Monday said they had finally turned a corner on the coronavirus pandemic and promised a massive expansion of testing, but hopes remained dim in hospitals and clinics as patients still awaited results and overworked doctors sharply questioned the government’s latest pledge.
“Some physicians in Los Angeles County said it is still nearly impossible to order a coronavirus test because the process is slowed by bureaucratic hurdles and shortages of key materials. ‘The testing spigot has definitely not opened up,’ said one L.A. County emergency room doctor. She still faces tight restrictions on which patients qualify for testing and then has to wait for results for five days, she said.
“Leigha Hodnet, 42, said she was still waiting for test results nearly one week after she and her partner were tested at a lab in Burbank. ‘We’re trying to self-quarantine, but it’s just really crazy,’ said Hodnet, who lives in Echo Park and said her symptoms included a fever, cough and extreme fatigue. ‘One way to stop it is to make sure everyone can get tested and self-quarantine. But if they can’t, that’s how this becomes a pandemic.’”
This article was originally published on WBUR.org.