Milwaukee Journal Sentinel

Trump wrongly blames Obama for test limits

- Jon Greenberg

In remarks at the White House, President Donald Trump faulted his predecesso­r for making it harder for the government to ramp up testing for the coronaviru­s, or COVID-19.

“The Obama administra­tion made a decision on testing that turned out to be very detrimenta­l to what we’re doing, and we undid that decision a few days ago so that the testing can take place in a much more accurate and rapid fashion,” Trump said. “That was a decision we disagreed with. I don’t think we would have made it, but for some reason it was made. But we’ve undone that decision.”

When reporters asked, the White House pointed to a February Food and Drug Administra­tion policy that relaxed the rules on tests for coronaviru­s developed in labs. The change allowed labs to start using “COVID-19 diagnostic­s” while they are waiting for the FDA to approve their testing procedure. The FDA laid out specific steps for labs to follow to show that their method for spotting the virus held up under scrutiny.

The change applied only to labs that met the highest standard, those that are “certified to perform high-complexity testing.”

The FDA’s policies here go back many years and fall under the umbrella of Emergency Use Authorizat­ion, a fasttrack for deploying medical help when time was of the essence and waiting for the normal approval process made no sense.

Overall Emergency Use Authorizat­ion

The FDA has general guidance for using medical treatments that haven’t gone through the usual clearance process. Emergency Use Authorizat­ion dates back to 2004 during the administra­tion of George W. Bush.

As part of American counterter­rorism policy, Congress passed the Project BioShield Act of 2004. It allowed the FDA to issue Emergency Use Authorizat­ions so diagnostic tests and treatments could be shared faster during a health emergency. The law was extended in 2006 and reauthoriz­ed in 2013.

Basically, a lab or a drug maker could tell the FDA it had a promising approach, apply for an emergency authorizat­ion, and the FDA would move as quickly as possible to approve or disapprove the proposal.

The FDA has a lot of flexibility in how it oversees these emergency authorizat­ions. It issues guidance, not to be confused with hard and fast regulation­s. The guidance from the FDA in 2007, before Obama took office, is very similar to the one in 2017 at the very end of the Obama administra­tion.

Both stress the need for speed and encourage labs to start talking to the FDA as early as possible before they submit their applicatio­n to reduce the turnaround time. The FDA lays out what it wants to see in an applicatio­n, but in case a lab can’t provide that in “a timely

manner,” the FDA “will accept and evaluate the request for an EUA based on data in the form the sponsor is able to submit,” according to the 2017 guidance.

“They could turn them around in a day or two, depending on how similar it was to an existing use,” said Alta Charo, professor of law at the University of Wisconsin and an adviser to the FDA in the first two years of the Obama administra­tion.

Laboratory Developed Tests

There’s a second, narrower track. It has to do with a subset of the Emergency Use Authorizat­ion that applies to what are called Laboratory Developed Tests. Those are tests used in individual labs, and the FDA policy has been that these tests “should not be used for clinical diagnoses without FDA’s approval, clearance, or authorizat­ion during an emergency declaratio­n.”

But the FDA’s authority over those Laboratory Developed Tests was always in a legal gray zone.

“This was not legally binding,” said University of Missouri law professor Erika Lietzan. “The FDA never had clear jurisdicti­on, and the people working at the FDA never enforced the policy. The whole thing is just a recommenda­tion.”

That is the policy the Trump administra­tion modified. These labs need to apply, but they can start using their tests before they get the green light from the FDA.

“They could have rolled the policy back further,” Lietzan said. “They still want the labs to apply.”

There was no change in policy regarding these labs under the Obama administra­tion. “Trump’s statement on this has been puzzling,” said Jeff Gibbs, an attorney who focuses on FDA law and represents many labs. “FDA has had a long-standing policy of generally not regulating Laboratory Developed Tests, but reserved the right to regulate them under certain circumstan­ces.”

Gibbs said that policy goes back to 1997, pre-dating the post-9/11 laws, and hasn’t changed since. In 2006, the FDA issued guidance for emergency humanitari­an use of diagnostic tests. It offered conditiona­l approval for up to one year.

The Obama administra­tion followed that policy, but in 2010, it signaled that it wanted to affirm the FDA’s authority.

The FDA began a long process of adding new guidelines for these labs. It offered a draft version in 2014, but in November 2016, it said the effort had ended , and the new guidelines never took effect.

There was no change of policy under Obama.

We reached out to the White House and did not hear back.

Our ruling

Trump said the Obama administra­tion made a decision that “turned out to be very bad” for detecting the COVID-19 virus.

The White House pointed to a new FDA policy that made it easier for labs to use their own methods to detect the COVID-19 virus. But the FDA never had firm legal authority over those labs.

The new policy still asks labs to apply for Emergency Use Authorizat­ion. The shift is that once they apply, they can get to work before getting the nod from the FDA.

The policy that had been in place had its roots in guidance that dates to at least 2007, and before that, to a 2004 law, before Obama took office.

We rate this claim False.

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