[The Atlantic Magazine of Boston] reports on one of the most urgent questions in the United States right now: How many people have actually been tested for the coronavirus?

Widespread testing.

On Monday, Stephen Hahn, the commissioner of the Food and Drug Administration, estimated that “by the end of this week, close to a million tests will be able to be performed” in the United States. On Wednesday, Vice President Mike Pence promised that “roughly 1.5 million tests” would be available this week. But the number of tests performed across the country has fallen far short of those projections, despite extraordinarily high demand, The Atlantic has found. “The CDC got this right with H1N1 and Zika, and produced huge quantities of test kits that went around the country,” Thomas Frieden, the director of the CDC from 2009 to 2017, told us. “I don’t know what went wrong this time.” Through interviews with dozens of public-health officials and a survey of local data from across the country, The Atlantic could only verify that 1,895 people have been tested for the coronavirus in the United States, about 10 percent of whom have tested positive. And while the American capacity to test for the coronavirus has ramped up significantly over the past few days, local officials can still test only several thousand people a day, not the tens or hundreds of thousands indicated by the White House’s promises.

Public health officials perceived slow-moving response.

 State-based results do not give United States citizens a clear picture of the overall testing efforts and cannot confirm that testing has been ramped up as quickly as in past pandemic situations.  Even as state websites attempt to provide comprehensive information to citizens, the numbers are skewed for lack of U.S. comprehensive reporting, for example, states including New Jersey, Texas and Louisiana have not shared the number of coronavirus tests they have conducted making their positive result figures inconclusive.

In simple terms, it is not clear to citizens what the actual capacity for testing is in the United States, and it seems to be slow-moving, compared to other developed countries reacting to the outbreak of COVID-19.  After the Centers for Disease Control and Prevention (CDC) confirmed that the virus was in community transmission mode in the United States, certain actions should have taken place to assure a complete picture of the number of U.S. tests administered compared to positive results in each state.  Nancy Messonnier, the chief CDC official for respiratory diseases, said at the time. “States are reporting results quickly, and in the event of a discrepancy between CDC and state case counts, the state case counts should always be considered more up to date.”

  1. Tests must be available. Very few physical tests were available until recently because of a CDC mishap.  Even though the White House has pushed for a considerable increase in test kits, up to 1 Million in the next week, lab personnel still need to be trained on the complex procedure of administration.
  2. The CDC sets parameters for state and local public health staff that should be tested were expanded after infections occurred not related to traveling or association with travelers.
  3. Demand for testing will increase as people become sick. California and Washington State will probably have enormous increases for testing since the number of cases reveal the spread of the disease.

Transparency.

Public health officials need to set up metrics based on past CDC comprehensive reporting that include the latest figures of tests available, tests performed and percentages of positive results, to keep the United States public optimally informed as to the spread of the disease, while they navigate through any impacts to daily life.  The easiest thing to do is to try to remain healthy by self-quarantine through limiting exposure, eating well, resting well, keeping hands clean and away from the face and contacting healthcare professionals immediately if you feel like you cannot recover from sickness, or breathing has become problematic.

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