The Problems with COVID-19 Testing

Published on: Apr 21, 2020fb-roundtwitter-roundemail-round
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The Story

For months, the US has been struggling to get ahead of coronavirus testing.

What kind of testing?

Diagnostic testing. It works like this: a swab is inserted up your nose to collect cells. Then a lab analyzes the sample to determine if you have COVID-19.

I feel like there’s been a lot of talk about this.

That’s because public health experts say widespread testing is crucial for understanding who’s infected (including asymptomatic carriers) and how the virus is spreading. Health experts say the country shouldn’t reopen without ramped up testing, warning that lifting restrictions too early could lead to a resurgence of the virus.

Where does testing stand right now?

The US has conducted more than 4 million tests total. In the past week, the US has tested an average of around 150,000 people a day. Some Harvard researchers say that number needs to more than triple in order to safely reopen the country in the next few weeks. In early March, President Trump said “anybody who wants a test can get a test.” It hasn’t been that simple.


There’ve been several issues. First, there were problems with CDC testing. In early February, the CDC started distributing test kits to public health labs across the country. But some kits delivered inconclusive results and it took the CDC weeks to fix the problem.


Yep. During that time, the coronavirus continued to spread undetected in some places. And public health officials were unable to get an accurate read on how many people were infected. Without that info, it's also harder for health officials to track down who might’ve been exposed. The FDA (which oversees lab tests) looked into the CDC’s issues and now says that it violated manufacturing protocol and had sent out contaminated tests.

Wait seriously?

Yes. But the FDA also came under fire itself for being slow to allow private labs to do their own testing. In February, the agency gave the private sector a green light to start testing for the virus. But as manufacturers deal with huge global demand, labs have run into supply chain shortages for materials like swabs and certain chemicals. And one test the White House has been hyping has had accuracy issues. In the meantime, tests are piling up in labs, and it can take days to get results.

What is going on here?

Some health experts say the testing chaos is due to a lack of organization and coordination within the federal government. Trump has said it’s up to states to figure out their own testing. Some governors have been pushing back, saying the federal government needs to help states with issues like a lack of supplies. 

And has it?

Last weekend, Trump said he plans to invoke the Defense Production Act to direct one company to increase its production of test swabs. It’s unclear when he’s going to actually invoke the act, which gives Trump the power to force companies to fill government orders of critical supplies. Meanwhile, as part of talks on the latest aid package from Congress, Senate Dems have asked for $30 billion to ramp up national testing. Their plan focuses on addressing the supply chain shortages and providing funding for everything from building new test facilities to at-home testing. But all of this is only part of the testing issue.

Uh oh. What’s the other?

Antibody tests. Antibodies are proteins our bodies develop after being exposed to a virus. Recently, some health officials and states have started shifting attention to collecting blood samples from people to test for coronavirus antibodies, which may mean they have some immunity to the disease. Some tests involve a finger prick and can deliver results in minutes.

Why are states focused on antibody tests now?

Along with diagnostic testing, antibody tests are considered a key part of the criteria for starting to reopen the country. Health officials are looking to these tests for answers to questions like how deadly the virus is, and who can go back to work. Plus antibody testing could tell us how many people have been unknowingly infected, given the CDC estimates that up to 25% of people could be asymptomatic.

But you said there were issues...?

To speed things along, the FDA relaxed rules for antibody tests, letting more than 90 companies sell tests that the agency hasn’t reviewed. Those tests are also reportedly running into problems, like mistakenly determining that people have antibodies...when they don’t. Because of accuracy concerns, the FDA plans to review the tests. More broadly, even when the tests work, there’s also the issue with how little we know about COVID-19 immunity, and how much protection antibodies may provide.

Are other countries also dealing with these testing issues?

Some of them. The supply chain shortages have been global problem. At least as of last month, some countries were also restricting who gets tested, reportedly due to a lack of available tests. Meanwhile, multiple European countries that bought antibody testing kits from China have reported that the tests were defective or faulty. While other countries try to figure their sh*t out, South Korea is considered the testing pro. After its first confirmed COVID-19 case was reported back in January, South Korea quickly deployed widespread diagnostic testing, as well as measures like contact tracing. The country got the virus under control and flattened its curve.

How though?

By learning from its mistakes. In 2015, South Korea experienced an outbreak of an illness called MERS, which is caused by another type of coronavirus. 38 people died and the gov faced criticism for its slow response to the crisis. Afterward, South Korea revised its laws related to infectious diseases. So this time around, the country had the authority to do things like fast-track approval for testing kits. Plus use big brother tactics like accessing peoples’ credit card transactions and using surveillance camera footage in order to track down who a patient may have come into contact with.

Whoa, invasion of privacy much?

Yes those methods might not go over well everywhere. But...they seem to have worked in South Korea. The country closed schools but didn’t impose a nationwide lockdown. Now, after a couple of months, things are starting to return to normal


Without widespread and accurate testing, America is operating in the dark. And while Trump pushes for states to get their economies going again, governors on both sides of the aisle say that can’t happen until we know how many people are, and have been, infected.

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