Where Are the Tests? COVID-19 Sidelines Clinicians

What your doctor is reading on Medscape.com:

MARCH 18, 2020 — On Friday, I sat on my couch in the middle of what should have been my operating day, watching President Trump’s address in disbelief.

The President stated that any doctor seeking COVID-19 testing can get it. This is not true.

I was dumbstruck by the irony of the President’s reassurance that testing was readily available for providers like me, while I sat at home in a self-quarantine, unable to get COVID-19 testing to clear me to go back to work.

To be absolutely clear, testing for COVID-19 for healthcare providers is still limited. It’s becoming more available every day and may soon become available to providers at my hospital needing clearance. But there is still limited access at most hospitals, and these delays have set us back.

I’m not alone. In Vacaville, California, delayed testing in the first case of community-transmitted COVID-19 in the United States left over 200 healthcare workers in quarantine.

Testing is currently recommended only for those with a known exposure and symptoms highly suggestive of coronavirus, or for symptomatic, high-risk patients.

So far, only around 22,000 people have been tested by the US Centers for Disease Control and Prevention (CDC) and US public health laboratories. South Korea, on the other hand, has tested more than 200,000 people and has the capacity to test 15,000 a day. We are way behind.

One reason for this delay: hubris. The CDC was unwilling to use readily available World Health Organization (WHO) test kits.

German researchers had already developed the first test for COVID-19 by January 17. The WHO began shipping around 250,000 tests to laboratories across the globe in the beginning of February.

Instead of partnering with and capitalizing on the efforts of the global community, the CDC determined that it would make its own test, a process that was plagued with delays.

Another reason for the delay: laboratory error.

The first US test was approved on February 4, but the CDC announced problems with the test a week later. Error is inevitable in the scientific process, for sure. But in circumstances where a pathogen is spreading so rapidly, there is little room for such error. Delays of 2 weeks result in thousands of potential cases going undetected, leading to exponentially increased rates of transmission.