America’s COVID-19 Testing Has Stalled, and That's a Big Problemhttps://arstechnica.com/tech-policy/2020/04/americas-covid-19-testing-has-stalled-and-thats-a-big-problem/One of America's biggest fumbles in the early weeks of the coronavirus crisis was inadequate testing. Thanks to a series of poor decisions by federal officials, the United States had far too little capacity to test for COVID-19 throughout the month of February, hampering our ability to contain the spread of the virus.
In early March, things seemed to be turning around. According to data from COVID Tracking Project, daily testing grew exponentially from a few hundred tests on March 5 to 107,000 tests last Friday, March 27.
But since then, progress has stalled. The US has been testing a bit over 100,000 people a day for the last six days—including 101,000 yesterday. And that's a cause for concern because the US will need to do considerably more testing to get its coronavirus outbreak under control.
... Governors in the United States say that a shortage of testing supplies is hampering their fight against the virus. The New York Times recently obtained audio of a call between governors and President Trump:
Gov. Steve Bullock of Montana, a Democrat, said that officials in his state were trying to do "contact tracing"—tracking down people who have come into contact with those who have tested positive—but that they were struggling because "we don’t have adequate tests."
"We have a desperate need for testing kits," Washington Gov. Jay Inslee told CNN on Sunday
When testing resources are scarce, health professionals prioritize testing people with obvious COVID-19 symptoms.
If testing capacity were growing faster than coronavirus infections, we would expect more testing of people with milder symptoms or no symptoms at all. That should lead to a declining rate of positive test results.
Instead, the fraction of positive test results has been steadily rising over the last two weeks. The week of March 15, around 13 percent of coronavirus tests produced positive results, according to COVID Tracking Project data. Last week it was 17 percent. So far this week, 22 percent of coronavirus tests have produced positive results. Yesterday's figure was more than 25 percent.... It suggests that our testing capacity isn't significantly outpacing the number of infections. And a 25 percent positive testing rate also suggests that we don't currently have enough testing capacity to truly bring the virus under control, because thorough contact tracing is going to require testing a lot more than four people for every infection.
The situation in the hardest-hit states underscores the broader problem we've already discussed. Very high rates of positive test results suggest that states are focusing on testing patients with obvious COVID-19 symptoms, leaving few tests available for broader efforts to slow the spread of the virus.
New York has done 220,000 coronavirus tests. That's more than one test for every hundred New Yorkers, the highest per capita testing rate of any state. But the state's 84,000 positive results translates to a 37 percent positive rate. Similarly, New Jersey has performed 52,000 tests—well above average on a per capita basis. But its rate of positive tests was 42 percent—the second highest figure in the nation.
Michigan has the dubious distinction of the highest rate of positive coronavirus tests, at 44 percent. Michigan has more than 9,000 confirmed coronavirus cases and has had 337 coronavirus deaths—the third highest after New York and New Jersey. But unlike those states, Michigan has a below-average testing rate, with only about 0.2 tests per hundred people. Michigan desperately needs to test more.
It's not clear why the growth of testing has stalled out in the last week. On a basic level, the nation's testing laboratories probably just aren't set up to deal with sudden, massive spikes in demand. The dramatic differences in testing numbers from state to state also suggest a lack of national coordination to match health care facilities with the greatest need to labs with spare capacity.
A deeply reported piece in The Atlantic this week casts some light on America's testing predicament. It argues that private testing labs, which "now dominate the country's testing capacity" simply haven't been able to keep up with surging demand. "Testing backlogs have ballooned," Alexis Madrigal and Robinson Meyer write.
The writers report that Quest, one of the nation's two largest private testing companies along with LabCorp, has struggled to scale up its operations. Its primary testing lab is based in California, which might help explain why that state has such a backlog of pending tests.
... "The average turnaround time nationally is four to five days, from the time where we collect the specimen to when we report the results out," she said—though she admitted that some results take "several days" longer.
... Every additional week that people are forced to stay at home costs the nation's economy tens of billions of dollars. Large-scale testing is going to be an essential part of any strategy for putting the nation back to work promptly while keeping the spread of coronavirus under control.
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... We're going to have a lot more cases than 200,000.
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