U.S. virus testing a ‘failing,’ leaving cases uncounted
NEW YORK — Seven weeks have passed since the first U.S. 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,” said Dr. Anthony Fauci, the top infectious disease expert at the National Institutes of Health. “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.
U.S. health officials, for example, promised nearly a month ago to tap into a national network of labs that monitor for flu. That system 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 U.S. health providers could quickly be overwhelmed by undetected cases.
As of Thursday afternoon, the Centers for Disease Control and Prevention reported about 1,260 U.S. illnesses — a number that trailed independent researchers, who are adding reports from individual states more quickly.
But some experts believe any number based on test results of individual patients is a dramatic undercount. Researchers at Cedars-Sinai Medical Center in Los Angeles this week estimated that the true count of infections was close to 9,000 — about two weeks ago.
“I expect there are more infected individuals now,” said one of the researchers, Dr. Jonathan Braun. “This means that the level of disease in the U.S. is much greater than has been reported by actual testing.”
The problem, these experts say: The U.S. simply isn’t testing enough people.
There are no official numbers from the federal government on the country’s overall testing capacity.
South Korea, a country onesixth the size of the U.S. in population, is reportedly testing 15,000 people per 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 U.S. state and local labs requires technicians to manually process each sample in small batches, sometimes 100 or fewer per day.
The testing process in the U.S. 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 centralized, government-based health care systems, the U.S. response is fragmented between public labs and private efforts by hospitals, universities and diagnostic companies.
U.S. officials have boasted of shipping well over 1 million tests to labs across the country. But it’s unclear how many have actually been used on patients, because tests have gone to some private labs and hospitals that don’t report into the CDC, Health and Human Services Secretary Alex Azar told reporters earlier this week.
Azar said the government is working to set up a system to combine government testing figures with those of outside laboratories.
On Feb. 14, the CDC’s Dr. Nancy Messonnier said the agency planned in the coming weeks to use labs in five cities to provide a good look at whether coronavirus might be appearing. The idea: When patients test negative for flu, their specimens would go through coronavirus testing to see if the new bug caused their symptoms.
But on Thursday, nearly a month after the announcement, the CDC revealed that some labs had begun the testing. But the list of test sites had changed, and the agency did not explain why.
In its initial announcement, the CDC said the work would begin in Chicago, Los Angeles, New York City, San Francisco and Seattle. On Thursday, it said it instead had begun in Chicago and four sites in California — Los Angeles, San Diego, San Francisco and Santa Clara.