Test shortages hinder reopening

Labs say more supplies needed to ramp up virus screenings

A medical worker directs traffic for free coronavirus testing Thursday in Mound Bayou, Miss.
(AP/Rogelio V. Solis)
A medical worker directs traffic for free coronavirus testing Thursday in Mound Bayou, Miss. (AP/Rogelio V. Solis)

WASHINGTON -- The United States is struggling to test enough people to track and control the spread of the novel coronavirus, a crucial first step to reopening parts of the economy, which President Donald Trump is pushing to do by May 1.

Trump on Thursday released a plan to ease business restriction that hinges on a downward trajectory of positive tests.

But more than a month after he declared, "Anybody who wants a test, can get a test," the reality has been much different. People report being unable to get tested. Laboratories and public officials say critical supply shortages are making it impossible to increase testing to the levels experts say is necessary to keep the virus in check.

"There are places that have enough test swabs, but not enough workers to administer them. There are places that are limiting tests because of the [Centers for Disease Control and Prevention] criteria on who should get tested," said Dr. Megan Ranney, an emergency doctor and associate professor at Brown University. "There's just so many inefficiencies and problems with the way that testing currently happens across this country."

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Trump's plan envisions setting up "sentinel surveillance sites" that would screen people without symptoms in locations that serve older people or minority-group populations. Experts say testing would have to increase as much as threefold to be effective.

The plan pushes responsibility for testing onto states.

"You know, the federal government shouldn't be forced to go and do everything," Trump told reporters Thursday.

But state and local officials as well as lab managers say they cannot expand testing until there are more supplies.

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This week, governors, physician groups and laboratory directors called on the Trump administration to address shortages of swabs, protective gear and highly specialized laboratory chemicals needed to analyze the virus's genetic material. Hospitals and state health departments report scouring the globe to secure orders, competing against each other and their peers abroad in a system that Gov. Andrew Cuomo, D-N.Y., described as "mayhem."

"The federal government cannot wipe their hands of this and say, 'Oh, the states are responsible for testing,'" Cuomo said Friday as he complained of a shortage of chemicals manufactured in China. "I don't do China relations. I don't do international supply chain."

The U.S. is currently testing roughly 145,000 people daily, for a total of 3.4 million results reported, according to state data compiled by the Covid Tracking Project. Public health experts say capacity needs to be much higher, in part to repeatedly test essential workers and to isolate those who test positive and to track down their close contacts to prevent new outbreaks.

"We still probably need to be doing three times more testing than we're doing now," said Dr. Ashish Jha, director of the Global Health Institute at Harvard. "I don't see America getting by anytime soon with 100,000 to 150,000 tests."

Trump has denied that the U.S. has fallen short, asserting that the U.S. has the "most expansive and accurate testing system anywhere in the world." Vice President Mike Pence told reporters Monday that if governors "would simply activate" underused high-capacity testing machines, "we could double the amount of testing in the U.S. literally overnight."

"That is not the experience in Rhode Island," said Gov. Gina Raimondo, D-R.I.

Democratic Gov. Laura Kelly of Kansas, whose state has one of the lowest per-capita testing rates in the country, told CNN it has been difficult to get testing supplies. Gov. Jim Justice, R-W.Va., a Trump ally, said testing needs to be stepped up before he can lift restrictions.

Jennifer Rodriguez, a pharmacy technician at a major retail chain in California, said she was sent home by her employer last week after coming down with symptoms. Her company would not test her, and she spent hours on the phone trying to find a place that would, she said.

The San Luis Obispo County health department can test only 50 samples per day, and a spokeswoman said those tests are reserved for people who are hospitalized, first responders and those who have had contact with people who tested positive. Rodriguez didn't qualify under those rules.

Another clinic told Rodriguez she might have to pay $150 if it determined she did not fit its test criteria.

"I just feel like medical workers, or even people on the front line, they should have some kind of priority," Rodriguez said.

Lab officials and health experts told The Associated Press that supply shortages have prompted them to limit who can be tested. That can leave out people who have symptoms but aren't sick enough to be hospitalized, or people who have no symptoms and might unwittingly spread the virus. Experts say it will be crucial to test those people if the economy is to reopen.

Ed Thornborrow, medical director of the University of California at San Francisco Clinical Microbiology Laboratory, said he wants to run 3,000 tests per day, but he can do only 100 to 250 now because he lacks enough nasal swabs. He works constantly to find more.

"That's what I spend most of my time on these days," he said.

Meghan Delaney, chief of pathology and lab medicine at Children's National Hospital in Washington, says shortages of chemicals known as reagents are constraining how many tests her lab can perform.

Vendors are restricting what hospitals can buy, said Dr. Robin Patel of the Mayo Clinic's infectious disease laboratory.

"It's a little bit like rationing," Patel said.

A Section on 04/18/2020

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