Health Care

Pressure builds on White House to increase tests

Pressure is building on the Trump administration to further increase the nation’s production of coronavirus tests, as experts say the country is still nowhere near the level it needs to be to safely reopen the economy. 

Several recent leading estimates say the United States needs to at least triple its testing capacity. 

Harvard researchers said Friday that the country needs between 500,000 and 700,000 tests per day, up from about 150,000 currently. Scott Gottlieb, President Trump’s former Food and Drug Administration chief, said Monday that the country needs a similar figure or about 3 million tests per week. 

Tom Frieden, the former director of the Centers for Disease Control and Prevention, released a report finding the U.S. could need as many as 20 times more tests than it is now producing, with a minimum need of three times what it now produces.

The White House has said it believed the country is already producing enough tests to enter phase one of the administration’s plan to reopen the economy. 

But prominent public health experts are arguing loudly that the White House is wrong.

“What you need is a federal government that’s deeply engaged, helping states,” Ashish Jha, one of the Harvard researchers behind that estimate, said Monday on CNN. “Right now, we have a federal government that keeps giving the wrong message to the American people. They keep saying ‘We don’t need any more testing, we don’t need any more testing.’ That’s just wrong.”

He said the projection that the U.S. will need 500,000 tests a day is itself a “very conservative” estimate. 

Ross McKinney, chief scientific officer for the Association of American Medical Colleges, offered a simple “no,” when asked Monday if there are enough tests for the first phase of reopening.

“We still need more,” he said. 

Labs at the academic medical centers his group represents still face shortages of testing supplies, “whether it be swabs, whether it be reagents, whether it be the little plastic tubes,” McKinney said.

President Trump has repeatedly said it is states’ role to increase testing capacity, not his. 

In tweets Monday, Trump noted that governors were previously clamoring for more ventilators, but their calls have now died down as the highest projections for ventilator need did not come to pass. 

“Now they scream ‘Testing, Testing, Testing,’ again playing a very dangerous political game,” he tweeted. “States, not the Federal Government, should be doing the Testing – But we will work with the Governors and get it done. This is easy compared to the fast production of thousands of complex Ventilators!”

The Trump administration has started to take some steps to try to increase testing capacity.

Trump announced Sunday that he would use the Korean War-era Defense Production Act to direct a company to increase production of swabs by 20 million per month, helping address one of the key shortages of testing supplies, though he did not provide more details on the order. 

Governors had been calling for Trump to take that step for weeks. Trump declined to use the authority to increase production of another key testing supply, a chemical known as reagent. 

“Reagents and swabs are so easy to get,” Trump said when asked about the chemicals. 

Coronavirus task force coordinator Deborah Birx said Friday she is leading a team that is calling labs across the country to find out what supplies each of them needs. 

“They’re calling lab by lab to find out what are the technical difficulties to bring up all the platforms that exist in your lab. Is it swabs? Is it transport media?” she said. 

McKinney said his group is “glad” Trump took action on swabs and hopes they can be distributed soon, but that there still needs to be more “coordination” from the federal government to get supplies to the labs that need them. 

“Various parts of the country are missing different things,” he said. 

New York Gov. Andrew Cuomo (D) likewise said Monday that while states could lead the testing effort on the ground, there are certain supply issues that they need help from the federal government to solve. 

“I can’t solve for the national manufacturers not being able to produce the volume to sell to my state labs,” he said. 

Virginia Gov. Ralph Northam (D) told CNN on Sunday it is “delusional” for the White House to say there is enough testing. 

Maryland Gov. Larry Hogan (R) on Monday announced the extraordinary move that his state had spent weeks negotiating with South Korea to obtain 500,000 tests, since, on testing supplies, the federal government had said “we have to go out and do it ourselves.”

Gottlieb said Monday morning in an interview on NBC that the country is going to have to take a risk by starting to reopen in May before testing is at the level it needs to be, which he said would not be the case until September. 

“It’s a risk, there’s no question it’s a risk,” Gottlieb said. “I mean we won’t have the testing that we want until September.”

But he said it’s “just not going to be possible” for society to wait until the fall to start to reopen, so states need to “take this very slow.”

“Since we don’t have all the screening that we want in place and we don’t have very sensitive measures out there to detect an upsurge in cases, we probably have to take it slower than we otherwise might have if we had broader testing in place,” he said. 

Experts say more testing is needed so that infected people can be isolated and people they have been in contact with can be found. They describe these as steps needed to contain the virus from spreading as blunt stay-at-home measures are eased. 

“If we open up and you go out to your Dunkin Donuts and pick up a coffee, you want to be pretty sure the person serving you coffee isn’t infected and shedding virus,” said Jha, the Harvard researcher. “The only way we’re going to be able to know who’s got the infection and who’s not, who’s shedding and not, is if we’re doing a lot of testing.”