America’s testing problem
Let’s get one fact clear up front: The U.S. is not the king of coronavirus testing. Not queen, not duke, not prince, either.
For all President Donald Trump’s boasts of how the U.S. leads the world in testing, it is in at best 12th place in the most important measure that counts — tests per capita. The U.S. testing rate is 32,175 per 1 million people. Portugal, the world leader, is at 58,827.
The nation’s lagging testing rate is tragically not the only problem. Tests themselves have been f lawed, and there appears to be widespread misunderstanding of what they can tell us.
But back to the testing rate for a moment. This matters, not for the sake of bragging rights as if we’re in some sort of global testing pageant, but because testing is how public health authorities and policymakers can discern how much of the population is infected, where the virus is spreading and whether it is surging or subsiding.
Lay aside Mr. Trump’s absurd logical fallacy: “If we didn’t do any testing, we would have very few cases.” In fact, the more we test, the better informed we are in deploying strategies to try control the virus’ spread.
Quality tests, however, are also essential, and on that count, too, the U.S. has sometimes fumbled, in part by design. To speed up development and deployment of tests, the Food and Drug Administration has been granting emergency authorizations for tests, both those that detect active infections and those that detect antibodies that would indicate past exposure. The authorizations allow the tests to be quickly put into the field while fuller review of their accuracy is done.
As a result, flawed tests have been used, leading to inaccurate results — both false negatives for people who were wrongly told they weren’t infected, and false positives for people who were told they had antibodies.
There’s misinformation and misunderstanding out there, too, including the dangerous assumption that having antibodies indicates an immunity. That remains unknown.
How did one of the world’s most technologically, scientifically and medically advanced nations end up in such a chaotic situation? Congress got a partial answer to that Thursday from Dr. Rick Bright, who says he was ousted from his role as head of a biodefense agency of the Department of Health and Human Services for calling attention to the lack of a comprehensive pandemic plan.
Late-night comedians are poking fun at the seeming effort to boast, spin, insult or happy-talk the pandemic away. But with some states and localities already reopening without treatment or a vaccine in place, Mr. Trump’s flailing is surely more tragic than humorous.
States are picking up what slack they can, but it must be a national priority to fix the dismal testing situation that is anything but a success story. The FDA needs to tighten authorization standards to better guard against flawed tests, and the federal government must ensure that the supply of tests, and the supply chain, are up to the massive need in a population of 328 million people.
As for keeping Mr. Trump from spreading wild claims and medical theories, well, one challenge at a time.