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Why the U.S. is still ‘severely constrained’ in ability to test for COVID-19

Despite recent signs of advancement, many health experts say the U.S. capacity to test for the novel coronavirus remains too limited and progress too slow. President Trump has previously claimed anyone could be tested -- but that isn't what we’re hearing from people who have tried. Jennifer Nuzzo, senior scholar at the Johns Hopkins Center for Health Security, joins Judy Woodruff to discuss.

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  • Judy Woodruff:

    Despite recent progress, many experts say testing for COVID-19 remains far too slow and too low in the U.S. There have been more than one million tests done in the U.S. so far.

    And, today, President Trump reportedly told governors that he had not heard about any problems with testing — quote — "for weeks."

    But many people with symptoms and concerns are saying something different.

    Here's a sample of what viewers like you told us about their experiences.

  • Kristina Katayama:

    My name is Kristina Katayama. And I live in Seattle, Washington.

  • Aaron Warner:

    My name is Aaron Warner. I live in South Burlington, Vermont.

  • Alyson Hinkie:

    My name is Alyson Hinkie. I'm from Magnolia, Texas.

  • Sunny Lee:

    I had a shortness of breath, coughing. My fever got up to about 101.5.

  • Aaron Warner:

    I started to get a lot of pressure on my chest. Kind of reminded me as if I was at the gym carrying like a heavy ball across the gym, except it was all the time.

  • Kristina Katayama:

    I had hard-core fatigue, like deep, deep fatigue, deep into my bones, all the way out to my hair follicles.

  • Alyson Hinkie:

    I left a message with the doctor's nurse. And they called me back, asked me a few questions. And they said I didn't qualify for testing because I was under the age of 65 and my fever wasn't high enough.

  • Darrylhi Locklear:

    They took a long what almost looks like a Q-tip. They told me to look up, and they put the swab down into my nose. It was actually really painful. It burned quite a bit.

  • Sunny Lee:

    I wasn't able to actually get tested until three weeks after symptom onset. So, once I did actually get the test, it took five days to get the results. And, you know, clearly, I showed negative.

  • Marcus Rendon:

    I went get tested at the military hospital in San Antonio. They had it coned off in a parking lot. And they were conducting — they were using the nasal swabs.

    But, before that, when I was actually sick and we were actually really concerned, I guess because it was so early on initially, we didn't get any traction with anybody.

  • Kristina Katayama:

    I have, you know, a confirmed positive COVID test from my colleague who I worked with. I was told that I couldn't do testing because I didn't have the right insurance.

    And then I was able to get ahold of one of the clinics. I was told the same thing again, which is, sorry, you don't have the right insurance. Go home.

    So, needless to say, I didn't get testing. I put in a lot of effort to get testing. And my mom is now sick.

  • Chris Byrne:

    I couldn't get tested. The person on the phone, who was quite nice, was saying: "I'm not saying you don't have this. It's just that we don't have enough tests. We have a service area of 87,000 people, and we can do 50 tests a day."

  • Aaron Warner:

    And there was a lot of panic out there, just — and a lot of just lack of information of what this is like. And not being able to be tested really put a lot of scare into me.

  • Kristina Katayama:

    I did not think it was going to be so difficult to get testing. You could have no symptoms at all and still be carrying and still be transmitting to other people who are very vulnerable and will get sick and may die.

    So, when you know, that information has an impact. And when you don't know, that lack of information has an impact.

  • Marcus Rendon:

    I don't think I would be tested now if it hadn't been for the military facility being set up, because, being a veteran, being retired, I can just show my I.D. and get on it.

  • Alysom Hinkie:

    The way that it has been communicated here, both on the local news and from the doctor's offices, is basically that, if you are my age and symptomatic, as long as you can breathe, that you are being selfish for getting a test, because you're basically taking a test away from someone that really needs it.

  • Sunny Lee:

    We have family in Korea.

    We were hearing from them how aggressive Korea had been. The country itself fully financially sponsored the testing, the drive-through testing facilities, just being super, insanely aggressive.

    When I think about myself and those seven days before I became symptomatic, I was on four plane rides. And I think I counted like 500-plus people that I was exposed to.

  • Judy Woodruff:

    And there was some important news on this front.

    Abbott Laboratories just got federal approval in the last few days for a rapid-response test that can deliver results quickly, in between five and 13 minutes. Eventually, it hopes to ramp up so that medical clinics can do 50,000 of those tests a day.

    But we're not there yet.

    Let's look at this issue now with Dr. Jennifer Nuzzo. She's a senior scholar at the Johns Hopkins Center for Health Security. She is an epidemiologist. She joins me now from Baltimore, Maryland.

    Jennifer Nuzzo, we're getting a conflicting picture.

    President Trump just moments ago told the country a million tests have been done, 100,000 a day, other optimistic words from his administration, but then you hear from ordinary Americans like these who describe the difficulties they had getting tests, getting results.

    Where's the truth?

  • Jennifer Nuzzo:

    Yes, I mean, it's still severely constrained.

    And it's been quite a hobbling of our response to this pandemic that we are unable to differentiate who has this virus and who doesn't.

  • Judy Woodruff:

    Why is it so important right now that there be a lot of tests?

  • Jennifer Nuzzo:

    Well, right now, what we need to do is to figure out how to test smartly.

    We need to come up with a strategy for testing, given the fact that our testing is still so very constrained. Right now, the bottlenecks aren't so much the initial things that we have heard about before, difficulty getting tests out of the labs.

    There are new tests that are coming online, but there are still bottlenecks upstream. So, one important bottleneck is just doctors and nurses are really busy and possibly too busy to administer tests to people who aren't sick enough to require hospitalization.

    They also don't have personal protective equipment in enough quantities to wear, so that they can safely perform the tests. And now there are also shortages of the chemicals and the tools they use to collect the specimens for testing that they would need in order to perform the tests.

    So, right now, the kind of overarching telehealth message is that we don't have the resources to test widely. That is the reality that we have right now.

    But if we are ever to get ahead of this, we are going to have to test more widely. And, in particular, there are certain categories of people who may not be severely ill, but which very much need to be tested.

    Key is doctors and nurses, who are potentially exposed to patients in the course of their work.

  • Judy Woodruff:

    Right.

  • Jennifer Nuzzo:

    And we need to know if they're infected or not.

  • Judy Woodruff:

    So, I was going — you said strategy, meaning there needs to be priority, health care workers, number one.

    Who after that? I mean, people who start to feel bad, or what? And also the fact that it's just hard sometimes to find a place — to get to the place where you need the test. I mean..

  • Jennifer Nuzzo:

    Yes, absolutely. So — right, absolutely.

    There's other categories of people that I think are important. In particular, I'm very worried about long-term care facilities, because an outbreak in one of these facilities could easily overwhelm a local health system.

    There are sometimes thousands of very vulnerable elderly residents living in these facilities, and an outbreak in one can just tip the balance of what is demanded of a health system.

    So, possibly more frequent testing in those facilities would be important. And then, also, people who live at home with medically frail people, they should absolutely be able to be tested if they're symptomatic, so they know how best to protect their relatives.

  • Judy Woodruff:

    Well, President Trump just again, just moments ago, was touting the number of tests. He showed this new rapid test that we just described from Abbott Labs.

    But how long is it going to take for that test and any other test that's going to make a difference to be rolled out, to actually be available in communities around the country, where it's usable?

  • Jennifer Nuzzo:

    Right.

    So it's very encouraging that a number of companies are stepping up to develop more rapid tests. We absolutely need that. And the fact that the Abbott test can be done outside of a traditional laboratory and closer to where patients are, and to be able to provide results in a relatively short time period, minutes, as opposed to now we're hearing, some people, it goes 10 or more days before they get their test results.

    So that's clearly not workable. And having new tools, like the Abbott test, I think is important.

    That said, we still have some upstream bottlenecks that we need to address, like the fact that doctors or nurses or whoever is going to perform the tests need personal protective equipment to be able to do that safely. We still need to be able to have the swabs to take a specimen for these tests.

    So we need to work on all of these issues, and not just focus on one particular test or one particular device. We need an overarching strategy.

    And then a larger problem is that states are taking very different approaches in terms of who they test and how many tests they're doing. And we have no visibility into that, which makes it very hard from a national perspective to understand how much COVID-19 is in the country and whether the situation is getting better or worse.

  • Judy Woodruff:

    A different approach state by state.

    And, just very quickly, this is a big subject, but a lot of people want to know why the United States isn't in a better position. I know it's a complicated question, but some fingers pointed at the federal government.

  • Jennifer Nuzzo:

    Well, I think there were some unanticipated glitches that weren't foreseen.

    That said, soon as some technical problems arose, I really think that there was a lack of urgency to expand the testing. And I, frankly, don't understand why that was.

    But I — you can't argue that we lost a lot of ground and time that we could have used to control cases, to the point where we have now exceeded China.

  • Judy Woodruff:

    It's all a lot to try to understand.

    Jennifer Nuzzo, we thank you very much for joining us.

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