Debate in U.S. intensifies over lack of testing

Trump says it’s going ‘very smooth,’ but others skeptical

WASHINGTON — Concerns about the lagging pace of coronavirus testing have become a political issue, with lawmakers of both parties demanding more tests for Americans as the president has insisted problems that have hindered capacity are being addressed.

The issue dominated separate briefings for members of the House and Senate on Thursday, emerged in the presidential race and became a flash point at a House Oversight and Reform Committee hearing, where the country’s top public health officials tried to explain why more Americans could not get tested for a global pandemic.

“The system is not geared toward what we need right now, what you are asking for,” Dr. Anthony Fauci, an immunologist and the head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said at the hearing. “That is a failing. Let’s admit it.”

At the White House on Thursday, President Donald Trump responded to a question about the lack of test availability by claiming that “over the next few days, they’re going to have 4 million tests out.”

“Frankly, the testing has been going very smooth,” he said. “If you go to the right agency, if you go to the right area, you get the test.”

So far, in the United States, only about 11,000 people have been tested, according to figures shared with members of Congress on Thursday. According to statistics compiled by the American Enterprise Institute, nationwide capacity to process the test kits being distributed has so far ramped up only to about 20,000 people per day — meaning it could be weeks before any tested patient gets results.

Members of Trump’s party sounded alarms Thursday. After a Senate briefing with Fauci and other officials, Sen. James Lankford, R-Okla., acknowledged that Trump’s recent statement that anyone who wants to get tested can get tested is “not consistent right now” with what is actually happening.

“We couldn’t get a good clear answer on when we’re going to get commercial testing out there, labs that can get faster responses and when we’re going to allow every person who wants to be tested to be able to be tested,” he said.

The uproar extended to the presidential campaign, where Democratic candidate Joe Biden called the Trump administration’s inability to quickly scale up testing a “colossal … failure of planning, leadership and execution.”

“Tests should be available to all who need them and the government should stop at nothing to make that happen,” he said.

The concern about testing has been at the center of the response to the crisis on Capitol Hill. An economic relief package introduced by Democrats late Wednesday includes provisions providing for free testing for any patient who seeks one, and the White House has signaled openness to supporting that language, according to two people familiar with the matter who spoke on the condition of anonymity to discuss pending negotiations.

But the concern about the cost of tests, which could stretch over $1,000 for the uninsured, was secondary Thursday to the dismay of the lack of test availability. Lawmakers of both parties reached for the same touchstone — South Korea, which has managed to treat hundreds of thousands of its people, allowing it to avoid the rapid spread seen in China, Italy and other countries.

“South Korea is able to process tests in an hour, and in the U.S. it takes more than two days — that’s not adequate,” said Sen. Ben Sasse, R-Neb., who called on officials to “get to the bottom of why those problems are there.”

Both in the Oversight Committee hearing and the private congressional briefings, Fauci sought to address the disparity with the South Korea model — noting that the Asian nation has embraced a “drive-up” testing model where individuals do not need to seek the approval of doctors or public health officials to take a test.

In the United States, testing has been tightly rationed in the face of a lack of testing capacity and guidance from the Centers for Disease Control and Prevention. The government agency has asked clinicians to prioritize patients exhibiting symptoms of respiratory illness who are in hospitals and nursing homes or belong to high-risk groups, such as the elderly and those with compromised immune systems.

Rep. Anna Eshoo, D-Calif., who led the House meeting as the chairman of a key health subcommittee, said she pressed the officials on why U.S. capacity has lagged that of South Korea. Fauci, she said, acknowledged the disparity and said the American health care system was not presently set up to administer tests without a doctor’s involvement.

Asked whether the administration was taking steps toward a different model, Eshoo said the response was: “‘Well, we’ll examine it. We’ll take a look at it.’ Except time is of the essence in our country.”

Fauci said much the same in public later that day: “The idea of anybody getting [a test] easily, the way people in other countries are doing that, we’re not set up for that. Do I think we should be? Yes. But we’re not.”

The concerns were shared by a top Republican, Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor and Pensions committee.

“South Korea, for example, is doing a better job,” he told reporters. “We not only need a better system for later, we need a better system for now. And we’re going to focus on that as rapidly as we can.”

Rep. Greg Walden of Oregon, the top Republican on the House Energy and Commerce Committee, said moving to a new model was not a simple matter: “You get a pretty complicated set of questions behind that easy one. How do you pay for that? Who pays for that? What system are you in? You know, we have a different medical delivery system here.”

At the hearing with Fauci, Robert Redfield, the CDC’s director, created confusion about whether the costs of tests will be covered for all Americans, including the uninsured. Initially he said yes to lawmakers’ questions, but at the end of the hearing, Redfield took it back, saying the administration “is currently examining all avenues” for the uninsured to afford tests and treatment. In the meantime, he recommended that they go to community health centers.

In the House briefing, much of the discussion surrounded bottlenecks in the availability of testing — particularly the availability of special chemicals known as reagents needed to conduct the tests.

Food and Drug Administration Director Stephen Hahn told lawmakers his agency was aware of the issue and doing everything possible to secure supplies of the needed chemicals, attendees said.

Walden said the supply-chain issues have been well known to pharmaceutical industry experts for years, but are only now coming to broader prominence.

“A lot of us have talked about this. … Now we’re getting this reality,” he said. “So they’re doing everything they can to ramp up the private and public sectors to provide that kind of access to tests that are needed. And there’s more that needs to be done, and they know that.”