ArgumentThe Four Key Reasons the U.S. Is So Behind on Coronavirus Testing

Published 16 March 2020

The COVID-19 outbreak has been a confusing time for Americans, but one thing has been glaringly clear: The U.S. is way behind when it comes to testing people for the coronavirus. Testing is essential for identifying people who have been infected and for understanding the true scope of the outbreak. Yet, among the numerous failures of the Trump administration to deal effectively with the COVID-19 outbreak, the lack of testing equipment stands out. Olga Khazan writes that bureaucracy, equipment shortages, an unwillingness to share, and failed leadership doomed the American response to COVID-19.

The COVID-19 outbreak has been a confusing time for Americans, but one thing has been glaringly clear: The U.S. is way behind when it comes to testing people for the coronavirus.

Testing is essential for identifying people who have been infected and for understanding the true scope of the outbreak. Yet, among the numerous failures of the Trump administration to deal effectively with the COVID-19 outbreak, the lack of testing equipment stands out.

Olga Khazan, writing in The Atlantic , details four main reasons why the testing issues have been so bad:

1. The FDA has a protocol called emergency use authorization, or EUA, through which it clears tests from labs around the country for use in an outbreak. During past outbreaks, EUAs could be granted in just a couple of days. But this time, the requirements for getting an EUA were so complicated that it would have taken weeks to receive one, Alex Greninger, the assistant director of the virology division at the University of Washington Medical Center, told Khazan.

2. Labs and companies need samples of the virus itself in order to make their tests, but delays in getting access to samples further slowed down the test-development process. Many researchers have had difficulty getting their hands on samples even as the virus has spread. Expert say it would help if researchers, governments, and companies firmed up pathogen-sharing contracts in advance of an outbreak, but so far that hasn’t happened.

3. Certain advanced tests, called lab-developed tests, but labs require special instruments that extract and then amplify the RNA that makes up the virus. However, labs across the country—like those at many county hospitals—don’t have the tools to do this. They can only run a simple type of test called a sample-to-answer test. Even though some hospitals actually have the new, functional CDC tests, the extraction machines and reagents that are used to perform them are in short supply.

Many of these problems could have been addressed and resolved had it not been from President Trump’s approach to outbreak, Khazan writes:

4. “For months, President Trump has made light of the coronavirus, telling attendees at a Black History Month reception, for instance, that perhaps the virus could miraculously disappear. He claimed on Twitter that the U.S. has done a ‘great job’handling the outbreak. Such a cavalier attitude seems unlikely to have motivated health officials to take things seriously. It also contradicted advice from most public-health experts. Even Scott Gottlieb, who recently resigned as Trump’s FDA commissioner, wrote in The Wall Street Journal on February 4 that ‘it’s time to start testing more people.’”

….

Though Trump has proposed a payroll-tax break, as my colleague Peter Nicholas has pointed out [“The Coronavirus Outbreak Could Bring Out the Worst in Trump: Virology isn’t politics,” The Atlantic, 18 February 2020], “Much of what he’s said publicly about the virus has been wrong, a consequence of downplaying any troubles on his watch.”

Khazan writes thatthere’s reportedly been tension and infighting between the president and his HHS secretary, Alex Azar, as well as between the FDA and the CDCPolitico reported that Vice President Mike Pence, who has no background in public health, repeatedly sidelined Azar from the coronavirus-response task force, and the White House appears to be blaming Azar for any failures in its coronavirus response. 

Khazan concludes:

It’s possible that all of these other hurdles could have been cleared if officials at the highest levels of government had been working together smoothly. Instead, we’ve seen confusion, doubt, and even more delays.