Testing regime failing, says top infectious disease expert
Seven weeks have passed since the first United States case of coronavirus was announced, and the government is failing to account for what could be thousands of additional infections because of ongoing problems with testing.
‘‘The system is not really geared to what we need right now,’’ Dr Anthony Fauci, the top infectious disease expert at the National Institutes of Health, said. ‘‘That is a failing. It is a failing, let’s admit it.’’
The effort initially was hobbled by delays in getting testing kits out to public health labs, but the stumbles have continued, leading scientists to conclude that the virus has taken root in more places than government officials say.
US health officials, for example, promised nearly a month ago to tap into a national network of labs that monitor for flu. That is only just getting started.
Large-scale testing is a critical part of tracking the spread of infectious diseases and allocating resources for treatment. The lack of comprehensive figures means US health providers could quickly be overwhelmed by undetected cases.
As of yesterday afternoon, the Centres for Disease Control and Prevention reported about 1260 US illnesses – a number that trailed independent researchers, who are adding reports from individual states more quickly.
However, some experts believe any number based on test results of individual patients is a dramatic undercount. Researchers at Cedars-Sinai Medical Centre in Los Angeles this week estimated that the true count of infections was close to 9000 – about two weeks ago.
‘‘I expect there are more infected individuals now,’’ one of the researchers, Dr Jonathan Braun, said. ‘‘This means that the level of disease in the US is much greater than has been reported by actual testing.’’
The problem, these experts say: The US simply isn’t testing enough people.
There are no official numbers from the federal government on the country’s overall testing capacity. One of the only comprehensive estimates comes from Dr Scott Gottlieb, the former FDA commissioner who is now a resident fellow at the American Enterprise Institute, a conservative think tank.
As of yesterday, his group estimated US labs could process results for more than 20,000 patients a day, based on a combination of publicly reported information and historical government estimates, private and academic labs. It reflects the total number of patient results that could be processed in a day, not the current number being run.
Whatever the actual number, the US effort is trailing other nations. South Korea, a country one-sixth the size of the US in population, is reportedly testing 15,000 people a day. CDC Director Dr Robert Redfield noted that officials there are using automated, high-volume testing systems capable of processing thousands of samples at a time. In contrast, the equipment used by most US labs requires technicians to manually process each sample in small batches, sometimes 100 or fewer a day.
The testing process in the US requires mixing various chemicals to set up chain reactions that extract genetic information from patients’ swabs. Each lab must fine-tune the process on its own equipment, something experts have likened to perfecting a new recipe.
Unlike countries with centralised, government-based healthcare systems, the US response is fragmented between public labs and private efforts by hospitals, universities and diagnostic companies. –AP