Coronavirus testing in the US is increasing. It’s still not enough.

The number of coronavirus tests in the US picked up this past week, although the figures are still far from what experts say is necessary to combat the current Covid-19 pandemic.

The number of new tests on Thursday, April 23, came in at more than 191,000, based on the Covid Tracking Project. That was up from the average in the previous week, when there were about 147,000 new tests a day. Since the start of April, America has averaged about 156,000 new tests a day.

There was an unusual spike in tests on Wednesday, April 22, with close to 314,000 new tests reported. But according to the Covid Tracking Project, that appeared to be a result of California clearing its backlog and reporting the batch all at once. “We’re not sure why they are batch processing like this, but it’s the second time it has happened,” the group tweeted.

Excluding Wednesday, testing was still slightly up this week so far, with about 158,000 tests done a day. It remains to be seen if the gains will continue or if testing will stagnate, as it did for the first few weeks of April.

Whatever the case, even the best days of testing in the US are still far from what experts say is necessary to allow the country to safely reopen the economy. On the low end, experts say the US should be able to do a minimum of 500,000 tests a day. At the high end, some have called for much more — up to the tens of millions a day.

So far, America isn’t even getting close to the low-end requirement.

America is still failing on testing

Testing gives officials the means to isolate sick people, track and quarantine the people whom those verified to be sick came into close contact with (a.k.a. “contact tracing”), and deploy community-wide efforts if a new cluster of cases is too large and uncontrolled otherwise. Without it, the only way to deal with the outbreak is more social distancing, which further hurts the economy, or letting the disease run its course — at the cost of potentially hundreds of thousands or millions of lives.

The continued shortfall rebukes President Donald Trump’s claim that US testing numbers are fine. Earlier this week, Trump claimed that America has done more tests than every other country combined; in reality, the US makes up roughly a fifth of all reported tests.

America’s testing rates also fall behind Germany, Italy, and Canada when controlling for population. Germany alone, widely praised for its quick response to Covid-19, has tested at nearly double the rates as the US.

The national numbers also mask massive variation between the states. Rhode Island has tested 39 people per 1,000, and New York, the state hardest hit by the pandemic, has tested about 34 per 1,000 — while Kansas, Virginia, Texas, and Arizona have all reported testing rates below 8 per 1,000.

The struggle to get testing up to much higher levels has led even some federal officials, including those on Trump’s coronavirus task force, to cast doubt on the US’s capabilities.

“We need to significantly ramp up not only the number of tests, but the capacity to perform them,” Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, told Time magazine. “I am not overly confident right now at all that we have what it takes to do that.”

Dr. Anthony Fauci steps away after speaking during the daily White House Coronavirus Task Force briefing on April 17.
Alex Wong/Getty Images

The current testing gaps are driven by shortages in supply and strict rules around who can get tested. Experts argue the federal government needs to relax criteria for testing, invest in new supplies and labs, and better coordinate supply chains to address, among other issues, chokepoints. States, with limited resources and little control of the national supply chain, simply can’t do this all on their own.

The Trump administration has taken some steps to address the issues, like its move this week to use the Defense Production Act to boost testing swab manufacturing. But it has also suggested the issue is on the states, tweeting, “The success of the phased approach will rely on preparedness and planning by states—safe and efficient screening, sufficient [personal protective equipment] supplies, and the ability to mitigate any rebound.”

Along with testing, America needs more contact tracing

Experts say the US will have to hire many more contact tracers to, along with testing, track not just the people confirmed to be infected but also their close contacts. Aggressive contact tracing has been a crucial component for other countries, like Germany and South Korea, that have managed to control their outbreaks.

The Johns Hopkins Center for Health Security and Association of State and Territorial Health Officials released a report this month calling for hiring 100,000 contact tracers at the cost of about $3.6 billion in emergency funding — which may seem like a lot, but it pales in comparison to the cost of life from the coronavirus pandemic and the cost of having to keep the economy locked down.

But there’s little sign the federal government is going that big. The Centers for Disease Control and Prevention this week said it will hire 650 contact tracers. Some states are acting — like Massachusetts’s move to hire 1,000 contact tracers — but states likely can’t handle the costs and coordination required on their own.

A public health care worker, right, collects a nasal swab at a coronavirus drive-through testing site in Montclair, California.
Irfan Khan/Los Angeles Times via Getty Images

A phone app could help mitigate the need for quite as many tracers, but it’s unclear that Americans have the appetite for an app that will effectively track their every move.

This is one reason the plans to end social distancing are so grim: Not only do they suggest that some level of social distancing will be needed for the next year or so (until a vaccine or a similarly effective treatment is widely available) — which we don’t know if the country can sustain — but they call for a level of surveillance and testing the US simply hasn’t yet shown the ability and willingness to build and manage.

The US could get a lucky break; there’s still a lot about the coronavirus that we don’t know, and maybe as we learn more, we’ll realize the country can be spared the worst. (That’s optimistic, given the outbreaks we’ve already seen across the globe, but it’s possible.) The Trump administration and states also still have time to ease testing criteria and scale up capacity in the coming weeks.

But for now, America is far from where it needs to be, with only faint signs that’s changing — even as thousands of coronavirus deaths have been reported on a daily basis.

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