If the coronavirus outbreak in the U.S. gets really bad — if it stretches on longer than we anticipated, if huge numbers of people get sick, if the disruptions to daily life become even more severe — early flaws in the testing process will bear a lot of the blame, Axios health care editor Sam Baker writes.
- The big picture: You probably know that there were some early problems with testing, and that they’re getting better — which they are. But those early failures will help define the entire scope of this pandemic, and there’s not much we can do now to reverse the damage.
Why it matters: Because we haven't been doing enough testing, we don’t actually know how many people in the U.S. have coronavirus. We know the official count is too low, and that the number of confirmed cases is likely to explode in the coming weeks as testing improves.
- But that's not the only problem. The lack of testing hasn't just left us in the dark about how bad the situation is. It has also made that situation worse.
By the numbers: Independent researchers estimate that the U.S. has completed about 20,000 coronavirus tests as of Friday.
- By contrast, South Korea — a success story in controlling the coronavirus — has performed an estimated 250,000 tests.
- And the U.S. population is more than six times bigger than South Korea's (327 million vs. 51 million).
Widespread, accurate testing has been a key component of other countries’ success in bringing their outbreaks under control.
- So the virus has probably been spreading undetected in the U.S. for weeks.
- More people than we know about are infected, which means more people than we know about are spreading the virus.
Between the lines: This makes other interventions, including individual "social distancing" and the cancellation of big events, even more important.
What’s next: Testing capacity in the U.S. is improving quickly. Nationwide, we now have the ability to test about 26,000 people per day, former FDA Commissioner Scott Gottlieb tweeted.
- He expects that capacity to "rise substantially" this week.
How we got here: The testing shortfall has been a multi-phase failure.
- For reasons that remain unknown, the U.S. did not rely on the World Health Organization’s coronavirus test in the earliest days of the outbreak. Instead, the CDC set out to make its own.
- But the CDC’s test didn’t always work. Manufacturing had to be relocated following a possible contamination. And it has taken time to come up with a new one.
- Regulatory red tape slowed down academic labs that wanted to jump in and develop their own tests, and capacity among private-sector labs is still ramping up.
In the early days, testing was focused narrowly on people who had traveled to China. That was probably the best way to triage limited resources. But it was never going to be sufficient.