Falling demand for COVID tests may leave U.S. exposed

WASHINGTON — Just five weeks ago, Los Angeles County was conducting more than 350,000 weekly coronavirus tests, including at a massive drive-thru site at Dodger Stadium, as health workers raced to contain the worst COVID-19 hotspot in the U.S.

Now, county officials say testing has nearly collapsed. More than 180 governmentsupported sites are operating at only a third of their capacity.

“It’s shocking how quickly we’ve gone from moving at 100 miles an hour to about 25,” said Dr. Clemens Hong, who leads the county’s testing operation.

After a year of struggling to boost testing, communities across the country are seeing plummeting demand, shuttering testing sites or even trying to return supplies.

The drop in screening comes at a significant moment in the outbreak: Experts are cautiously optimistic that COVID-19 is receding after killing more than 500,000 people in the U.S. but concerned that emerging variants could prolong the epidemic.

“Everyone is hopeful for rapid, widespread vaccinations, but I don’t think we’re at a point where we can drop our guard just yet,” said Hong. “We just don’t have enough people who are immune to rule out another surge.”

U.S. testing hit a peak on Jan. 15, when the country was averaging more than 2 million tests per day. Since then, the average number of daily tests has fallen more than 28 percent. The drop mirrors declines across all major virus measures since January, including new cases, hospitalizations and deaths.

Officials say those encouraging trends, together with harsh winter weather, the end of the holiday travel season, pandemic fatigue and a growing focus on vaccinations are sapping interest in testing.

“When you combine all those together you see this decrease,” said Dr. Richard Pescatore of the health department in Delaware, where daily testing has fallen more than 40 percent since the January peak. “People just aren’t going to go out to testing sites.”

But testing remains important for tracking and containing the outbreak.

L.A. County is opening more testing options near public transportation, schools and offices to make it more convenient. And officials in Santa Clara County are urging residents to “continue getting tested regularly,” highlighting new mobile testing buses and popup sites.

President Joe Biden has promised to revamp the nation’s testing system by investing billions more in supplies and government coordination. But with demand falling fast, the country may soon have a glut of unused supplies. The U.S. will be able to conduct nearly 1 billion monthly tests by June, according to projections from researchers at Arizona State University. That’s more than 25 times the country’s current rate of about 40 million tests reported per month.

With more than 150 million new vaccine doses due for delivery by late March, testing is likely to fall further as local governments shift staff and resources to giving shots.

“You have to pick your battles here,” said Dr. Jeffrey Engel of the Council of State and Territorial Epidemiologists. “Everyone would agree that if you have one public health nurse, you’re going to use that person for vaccination, not testing.”

Some experts say the country must double down on testing to avoid flare-ups from coronavirus variants that have taken hold in the U.K., South Africa and other places.

“We need to use testing to continue the downward trend,” said Dr. Jonathan Quick of the Rockefeller Foundation, which has been advising Biden officials. “We need to have it there to catch surges from the variants.”

Still, U.S. test manufacturers continue ramping up production, with another 110 million rapid and home-based tests expected to hit the market next month.

Government officials long assumed this growing arsenal of cheap, 15-minute tests would be used to regularly screen millions of students and teachers as in-person classes resume. But recent guidelines from the Centers for Disease Control and Prevention don’t emphasize testing, describing it as an “additional layer” of protection, behind basic measures like masking and social distancing.

The question of medically assisted aid in dying is understandably emotional. We don’t tend to like talk about death, even as it’s the one certainty that binds us all. But the conversation has changed in recent years as more people are willing to have difficult discussions with their families and doctors in an effort to ease minds when their time eventually comes.

Nine states today allow some form of medical aid in dying, or, as proponents like to call it, death with dignity. But it has never advanced out of committee in the times it has been introduced in Connecticut.

It’s important to note how many safeguards are involved in the proposed legislation. The plan would allow doctors to prescribe a lethal dose of medication to terminally ill patients, limited to people who have six months or less to live. Potential candidates would need to submit two written requests for the drug, and doctors must inform them of any risks and alternatives.

It’s not something that would be done lightly or without planning.

Still, the opposition is fierce, and not just for religious reasons. Many simply can’t get comfortable with helping take someone’s life, regardless of the circumstances a person might be facing. No one is unaware of the agonizing decisions involved in endof-life care, but offering aid in dying is simply not something the state should involve itself in, according to many people. Nothing about this is easy. But as the issue continues to gain attention in other states, it’s important for Connecticut to seriously consider the proposal. Ultimately, it’s about giving people more say in how they live their lives, including right up until their final moments.

Considering everyone could find themselves in this situation, either for themselves or their loved ones, it makes sense to give people as much control as possible over how they take leave of this world.

The safeguards are important, and could be strengthened. Disability rights advocates have objected in the past, and their concerns over misdiagnoses and other problems must be taken seriously. Worries about possible coercion are equally serious, and must be considered as legislators move forward.

Ultimately, though, this is about personal autonomy. To people who have faced gut-wrenching moments with loved ones in severe pain and no hope of recovery, the lack of options can be heartbreaking. To give people an option for an alternative, that lets them assert at least some control in a situation where everything else has failed, is one small comfort we can offer.

It’s not unprecedented, as the actions of other states have shown. It’s not a slippery slope, and would not set up “death panels” or necessitate medical rationing. The scare stories used to oppose such proposals in the past have mostly slipped away, but are still worth refuting.

Most opponents are principled, and their stances must be acknowledged and reckoned with. But if there’s a way to make an unbearable situation easier for people in the worst days of their lives, it’s a step we should take. The Legislature should move ahead on the proposed aid-in-dying bill.

Ultimately, it’s about giving people more say in how they live their lives, including right up until their final moments.