Illustration: Sarah Grillo/Axios

Coronavirus testing capacity is still lagging far enough behind demand that the U.S. continues to only test the sickest patients — a bad omen for future efforts to return to normal life.

Why it matters: Diagnostic testing is the cornerstone of any containment strategy. To even begin talking about resuming social and economic activity, we would have to get testing right first.

The big picture: Testing failures allowed the coronavirus outbreak to spread in the U.S. without detection, almost certainly making it worse than it would have been otherwise.

  • And if we fail to create a stronger testing infrastructure before Americans ease back into public life, history could easily repeat itself.

Driving the news: The Trump administration said yesterday that at least 1.79 million tests have been completed.

  • More than 665,500 samples were tested last week, according to an HHS spokesperson.
  • "HHS and FEMA are coordinating with manufacturers and laboratories to provide the necessary resources and support for continued expansion of our testing capacity," the spokesperson added.

At the same time, tests are still generally being saved for those who need them the most, namely the sickest patients and health care workers — indicating a shortage.

  • For people who do get tested, the wait for results is often several days.

Between the lines: The problem boils down to overwhelming demand and testing supply shortages, the New York Times reports.

  • Private labs have swarmed the market, and some — like LabCorp and Quest — are running thousands of tests a day.
  • But Quest's test backlog is still 80,000, and LabCorp says it's caught up but still requires a four- to five-day turnaround time.
  • Shortages of key testing materials like swabs, reagents and test kits limit how many tests can be done.
  • LabCorp "is now able to perform about 35,000–40,000 tests per day and expects capacity to increase assuming supplies are available," the company says on its website.

What's next: The goal of social distancing is to drastically reduce the number of confirmed cases, by limiting people's interactions with one another. But once we've done that, testing is crucial for identifying new outbreaks and determining who has already been infected before they spread the virus further.

  • To successfully transition our national strategy into this case-based intervention phase, we need to be able to complete at least 750,000 tests per week, according to a report by former FDA Commissioners Scott Gottlieb and Mark McClellan, John Hopkins' Caitlin Rivers and Crystal Watson, and Tempus' Lauren Silvas.
  • Global demand for testing supplies isn't likely to decrease anytime soon.

The bottom line: It's hard to see the country being able to shut down twice. That means we only have one more shot at getting this right, and the clock is ticking.

Go deeper

Dion Rabouin, author of Markets
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Americans' trust in the Fed keeps falling

Data: Axios/Ipsos poll; Note: ±3.3% margin of error; Chart: Axios Visuals

Americans' trust in the Federal Reserve fell again in October, with just 34% saying they have a fair amount or a great deal of trust in the central bank in the latest Axios/Ipsos poll.

What's happening: While trust in the Fed rises with age, income level and among those who say they know more about the institution, there was not a single group where even half of respondents said they trusted the Fed.

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Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Politics: Trump calls Fauci a "disaster" on campaign call.
  2. Health: Coronavirus hospitalizations are on the rise — 8 states set single-day coronavirus case records last week.
  3. States: California to independently review FDA-approved coronavirus vaccinesWisconsin judge reimposes capacity limit on indoor venues.
  4. Media: Trump attacks CNN as "dumb b---ards" for continuing to cover pandemic.
  5. World: Ireland moving back into lockdown as cases surge — Argentina becomes 5th country to report 5 million infections

USA Today breaks tradition by endorsing Joe Biden

Photo illustration: Aïda Amer/Axios. Photo: Win McNamee/Getty Images

USA Today, one of the largest newspapers by circulation in America, gave Joe Biden its first-ever presidential endorsement on Tuesday.

The big picture: A slew of media companies are endorsing a candidate this year for the first time ever, citing the unprecedented nature of this election.

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