the global coronavirus pandemic has stopped the world in its tracks daily
life has screeched to a halt and people in entire countries and in some US
states have been ordered to stay inside their homes the outbreak that was first
reported in central China in December 2019 has now traveled around the world
infecting and killing people throughout Asia the Middle East Europe and
eventually landing on American shores the first u.s. case was confirmed in
late January 2020 in Washington State and the virus has since spread to every
state in the country infecting thousands and devastating local businesses along
with the national economy on March 11th 2020 a congressional doctor told Capitol
Hill staffers that up to 150 million Americans could contract covet 19 the
disease caused by coronavirus scientists doctors and public health officials at
every level of government have been working overtime to slow the epidemic
and keep people safe but there's one critical piece of the containment puzzle
that has been seriously lacking testing it seems almost inconceivable that the
United States would have a shortage of tests we always talk about how how our
health care system is the best in the world the country's top doctor himself
told Congress the American system had failed it is a family let's admit it
between a lack of supply and a maze of bureaucratic red tape the United States
the biggest economy in the world found itself trying to combat a
contagious and deadly epidemic without enough tools to determine who is and
isn't sick and this testing shortage has caused widespread confusion throughout
an already fearful American public anybody right now
and yesterday anybody that needs it gets a test suite they're there they have the
test just Providence st. Joseph's Health have enough tests or enough testing
capability at this point to test all those people you just mentioned No yeah
yeah
testing is a critical tool to understand the true scope of the spread of the
virus we cannot stop this pandemic if we don't know who is infected robust
testing is particularly essential after early cases are confirmed in order to
identify and trace potential points of contact and tamp down on the outbreak so
you have an index case you'd want to know everyone that was around that
individual to see how many of them actually got sick because that tells you
an awful lot about what happened dr. Hawkman runs Providence st. Joseph's
Health the hospital system that treated the first positive kovat 19 case in the
u.s. in Washington state information that you get from that tells you a lot
about doesn't spread how sick the people get and is that incidental contact is
there something different about different individuals that seemed to
spread virus more they shared virus more readily than others where literally
weeks and months behind where we should be the koban 19 test uses fairly
straightforward testing procedure it's called PCR or polymerase chain
reaction and it's actually a pretty basic testing technology so why the
bottleneck in the US a few reasons the first red tape at the beginning of the
u.s. outbreak the CDC sent out test kits to public labs around the country these
were the only tests that were authorized by the FDA to test for kovat 19 but
there were a few problems the biggest one the tests were faulty the CDC
developed a test the same way it does for every pandemic situation the same
way it did for h1n1 the same way it did for the Zika epidemic typically that
system works really well something went wrong when the CDC delivered those tests
for verification at the public health labs some of them were returning
inconclusive results and so the CDC had to scramble and send out new kits or
figure out a workaround they did that but it led to delays another issue those
tests were only sent to public health labs leaving many other types of labs
back collabs clinical labs commercial labs
without any approved kits and unable to jump in and help meet testing demand and
one of the things was we you know as a clinical lab we couldn't obtain the CDC
test it was you know really squarely for the public health arena so you know we
couldn't really qualify to get be able to receive it and so that was that was
what it was and also for many weeks the CDC issued extremely strict parameters
determining who was eligible to receive one of the few available working tests
these guidelines dictated that a test could only be administered to patients
who had a fever were symptomatic with either a cough or shortness of breath
and had either recently traveled from China or had close contact with a known
kovat 19 patient or someone who's currently being tested one of the
frustrating things was you had to have the unknown contact of someone who had
kovat 19:00 we weren't testing for kovat 19 so that link criteria like really
didn't you never really trip the wire there at the very end of February 2020
two things happened the first the FDA granted emergency use authorization to a
lot of other labs the ones that had been excluded from receiving that original
CDC test so labs like the biology lab at the University of Washington the one
that's located right in the epicenter of the Seattle outbreak that clinical lab
that had been stuck on the sidelines was finally able to authorize its own kovat
19 tests and start testing people and the second the CDC relaxed those
stricter rules about who could and couldn't be tested but even though those
eligibility requirements had been removed it's still super unclear even
today who can get a test and who can't to get tested it really is a local
policy decision different medical systems have different policies the CDC
policy the federal policy now is if your doctor wants to test you for it doctor
can test you for it the confusion surrounding these decentralized testing
requirements is compounded by the fact that testing only started ramping up in
this big way about six weeks after the first confirmed case in the United
States and throughout that time daily life in the US was pretty much business
as usual people were working at offices together traveling through airports and
socializing and restaurants I do think that this virus has been circulating now
for several weeks in the US and even though the u.s. is now continuously
trying to add testing capacity the country's healthcare system is running
into another problem it's running short of basic supplies needed to conduct the
Cova 19 tests health officials and multiple states are running low on
things like swabs pipettes and reagents those are the chemical materials mixed
with a patient sample during the testing process and even though test makers like
Roche are supplying hundreds of thousands of tests to laps around the
country the demand is just overwhelming the entire world is sort of on fire from
a demand standpoint right like Italy wants tests Germany wants tests the UK
wants tests France wants tests China wants tests India wants tests you know
Latin America wants tests and then there's South Korea the country made
headlines in February 2024 it's Swift and aggressive measures to test as many
people as possible the koreans had bad memories of the MERS outbreak in 2015
that's Middle East respiratory syndrome and they didn't want history to repeat
itself during that epidemic South Korea reported the largest number of MERS
cases outside of the Middle East they they had a mini a mini crisis in 2015
when they had the MERS coronavirus sort of fly in from Saudi Arabia in the
Middle East and it really caused them to invest in preparedness so when the
corona virus epidemic hit the koreans acted quickly according to a Reuters
investigation the koreans urged medical company executives to design their own
tests just days after the first case was discovered South Korea then quickly
approved these tests rapidly ramped up capacity to test thousands of people per
day and even set up drive-through testing facilities I think they'd listen
to their scientists and it got in front of it they said we're gonna get ready if
it's happening in Wuhan it's gonna happen in Seoul so they really from the
public health standpoint did exactly what they should do in comparison the
United States had those rigid restrictions in place for weeks about
which tests were authorized and who could be tested America's top health
officials acknowledged they had fallen behind the testing prowess of other
countries like South Korea the idea of anybody getting it
the way people in another country are doing it we're not set up for that do I
think we should be yes what we're not the u.s. has since set up those
drive-through testing sites in several states but they resemble the confusing
patchwork of rules and regulations of the entire American testing effort
depending on the state or municipality in which the drive-through is located
the requirements for testing are different some require a doctor's note
to receive a test and others do not almost all have extremely long lines of
people waiting in their cars the drive-through stuff kind of it makes for
good TV but it's not going to get us there so we're trying to say is that the
usual places where people get their care are probably better places for people to
be tested and be able to get the information that they need on March 16th
2020 the w-h-o said that it had one message for every country on Earth
test test test but the u.s. is still playing catch-up after falling so far
behind and in the meantime people who are worried that they are sick still
can't get tested Daniel Goldman a former federal prosecutor and MSNBC legal
analyst has one of those stories on March 11th he started tweeting that he
was experiencing kovat 19 symptoms but he couldn't fight a healthcare
professional in New York City who could give him a test I got tested for the flu
which has very similar symptoms and was negative I got a full viral panel to see
if it was anything else that was negative and once that came back I was
told by the New York Presbyterian Hospital that I had to go home and self
quarantine because my symptoms were not bad enough to be admitted into the
hospital and unless you're admitted you don't get a test I finally just wouldn't
take no for an answer and I drove at 5:00 in the morning to Connecticut to
get a test that came back positive and his isn't the only example op-eds are
popping up detailing the trying experience of attempting to get a Coppa
19 test in some major USA's these testimonials illustrate the fact that
there are simply not enough tests to meet the demands of the scare
American public the highest priority for those patients that have been admitted
to the hospital that are sick enough to be admitted to the hospital that have
presumed kovat 19 then you step back from that two people who are sick who
don't need to be admitted to the hospital but let's say 101 temperature
they've got a cough then the step down from there are the folks that have been
exposed just Providence st. Joseph's help have enough tests or enough testing
capability at this point to test all those people you just mentioned no yeah
what's important now is that testing in the u.s. is ramping up public health
labs in all 50 states currently have testing capacity an increasing number of
commercial and academic labs are testing now as well LabCorp says it has the
ability to perform 20,000 kovat 19 tests per day fellow lab giant quest
Diagnostics has increased capacity as well right now we're actually doing
25,000 per day thermo Fisher one of the test makers that received one
of those emergency use authorization from the FDA has started to ship some of
the 1.5 million tests it's already produced to 200 labs across the country
the testing procedure may also evolve potentially eliminating the need to go
to an overwhelmed emergency room to request a test Abbott Laboratories
submitted to the FDA today a request for approval of a point-of-care test this
would be the kind of test where you could go to your doctor you could get
the tests done there at your doctor and have the results in no more than 15
minutes and the federal government may be using the defense production act a
law from the 1950s to acquire thousands more tests on March 24th the head of
FEMA said that the White House plans to use its powers as designated in that law
to procure 60,000 more test kits but one critical question remains will us be
able to ramp up testing and thwart the spread of the virus before too many
people get sick and the country's health care system can't treat everybody put
simply do we have enough time well let me refer to your question but
you're focused on testing in terms of what's gonna change the curve the
testing itself is helpful but it doesn't it's really the behavior changes you
know these sort of social distancing measures closing the schools
you know everyone work from home these sort of social distancing measures are
the thing that will show up two to three weeks out from now in the number of
cases that we have yeah I think we'll get there and it's gonna be a mix of
demand and supply right as we sort of bend that curve and reduce number of
cases just like China has just like South Korea has mean it's possible right
it's possible the time periods that we missed those three weeks from that
initial sentinel case I got to get over it I think most of us are getting over
over how much valuable information we lost we hope that we fall somewhere
between Korea and Italy that we hope we've done enough things early enough to
avoid what we're seeing in Italy