A health-care worker conducted a Covid-19 test in East Los Angeles, Calif., in July.
Photo: Jessica Pons for The Wall Street Journal
When the history of the coronavirus crisis is written, the absence of a national testing strategy to better slow the virus’s spread while speeding the reopening of the economy and schools may go down as the biggest government failure.
In some respects, testing in America looks like a success story. Almost six months into the coronavirus crisis, the U.S. does more coronavirus tests than any other country. The Centers for Disease Control and Prevention reports that some 65 million tests have been done to date.
Yet the U.S. has a mishmash of testing efforts that vary widely from state to state. Results often are so slow to arrive that millions of those tests have been rendered nearly useless. Those who are tested could be unwitting carriers of the disease while they wait for results, which helps explain the summertime virus resurgence.
Crucially, a new generation of somewhat less accurate but cheaper and more rapid screening tests is becoming available, yet the CDC has yet to provide full guidance on how best to use them, public-health activists say. Reopening schools safely would be far easier if rapid tests were widely available, along with a plan on how best to use them.
Billions more dollars would be needed to rectify these problems, yet Congress is gridlocked and has failed to pass a new coronavirus stimulus bill with such funds. The executive orders President Trump has signed in recent days to fill the gap don’t address testing, and he has said testing is a problem for the states.
“We can still get this right,” says Rajiv Shah, president of the Rockefeller Foundation, which first proposed a national testing program in April. “But it requires a paradigm shift.” As a nation, the U.S. now is doing 4.5 million tests a week; the Rockefeller Foundation plan calls for ramping that up to 30 million. Given that it likely will be four months or more before a vaccine is available, the incentive to improve testing remains high.
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Yet here is a real-life story that illustrates where we are: A man was scheduled to go on a week’s family vacation at the beginning of the month, and, in an attempt to be sure it was safe to gather, all family members took coronavirus tests in advance. Because the vacation was planned for Massachusetts, which requires a test within 72 hours before visitors arrive in the state, the test was scheduled three days before the start of the vacation.
Those three days passed with no test result provided. Then the full week of vacation came and went, still with no result. Twelve days after the test was taken, and after family members had dispersed back to their homes, there still was no result. If the man actually was carrying the virus, he had no way of knowing. Not only would other family members have been at risk, they all could have carried the virus back to their own communities. This potential for unwitting spread is one reason the U.S. has seen a summertime spike in cases.
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Beyond that, the disparities in testing availability are on vivid display every day. National Basketball Association players and White House officials can get daily tests and instant results, but average Americans can’t. The coronavirus is hitting particularly hard in minority communities, yet testing is harder to find for people there, particularly because they may not be able to afford the consultation with a doctor often required before a test is approved.
The Trump administration stresses the need for an economic recovery from the coronavirus plunge, yet the lack of a more effective testing strategy is hampering the effort. Indeed, the value of rapid testing in accelerating economic activity is becoming more clear as more is learned about the disease.
The real goal of testing is “to identify people and take them out of the chain of transmission when they are positive,” says Mr. Shah. One of the most crucial lessons learned about the coronavirus recently is that almost half of the spread of the disease is done by people who aren’t yet showing any symptoms—so-called asymptomatic spread—and that most asymptomatic spread occurs in the first few days after the virus has been contracted. That finding underscores the urgency of identifying through regular tests those who are carrying the virus but not showing symptoms, and rapidly taking them out of circulation.
Widespread use of antigen tests, which detect proteins associated with the virus in less than an hour without the need for laboratory work, would be a big help. With that in mind, seven states, with aid from the Rockefeller Foundation, last week formed a compact to jointly purchase millions of these rapid-result tests. That’s a step forward—but not the same as a national strategy to do the same.
Write to Gerald F. Seib at jerry.seib@wsj.com
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