US still ‘doing poorly’ on coronavirus testing, Harvard epidemiologist says

The World
A health care professional wearing a protective face mask walks into a hospital following the outbreak of coronavirus disease (COVID-19), in the Manhattan borough of New York City, New York, US, on March 18, 2020.

US President Donald Trump moved on Wednesday to accelerate production of desperately needed medical equipment to battle the coronavirus pandemic. There are now more than 7,300 US cases of the illness and at least 118 deaths as the country scrambles to boost testing after Trump downplayed the virus’ severity for weeks. 

Meanwhile, questions are swirling about what will happen next after public life is shutting down around the country. 

At a personal level: When will life get back to normal? At a group level: Can our collective actions stop the global march of the virus?

The World’s host Marco Werman posed those questions to Dr. Michael Mina, an infectious disease specialist at Harvard’s T.H. Chan School of Public Health. Mina also oversees lab testing for viruses at Brigham and Women’s Hospital in Boston.

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Marco Werman: What did you think of a new study showing that the coronavirus can live for hours or days on certain surfaces?

Dr. Michael Mina: This study wasn’t super surprising. We actually know that coronaviruses can last on surfaces potentially for hours and maybe even days, which is what that study showed. But I think it’s important to recognize that even though they can technically last for days on a surface, whether or not they really remain sufficiently viable to really cause an infection, if they’ve been sitting there for a few days, it’s still under question. And I think we have to take some of those types of pieces of data with a bit of caution. 

Should we worry about getting coronavirus from touching the surface that was contaminated yesterday? 

I think that we should we should all be aware. And I think having that in our minds is certainly important. And that’s essentially why we’re — the public health community — is really pushing the message of, “Wash your hands, wash your hands, wash your hands,” because of these particular issues. 

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So wash, wash, wash. And social distancing, as well — they’re bywords of this pandemic. Remind us once again, Michael, why it’s so important for many of us to remain at home and keep our distance from other people. 

Yeah. So social distancing is absolutely the way that we will control and reduce the transmission of this virus in the population. Every time you go out and you’re around a group of people, it takes just one person to potentially spread it to quite a few other people in that group. And this is how small outbreaks can start in. Each one of those can go on to seed other outbreaks. And this is particularly relevant right now because testing still is not at where we need it to be in the population. 

Right. Let’s get to testing at this point. How available are tests in the US, and how does that compare to other parts of the world? 

So unfortunately, tests remain quite limited in the United States. We are seeing the expected increases in testing. We will see more and more testing come on board in the next weeks. But unfortunately, that means we’re still in this place where who can be tested and how frequently they can be tested is still extremely, extremely limited. 

And in terms of where the United States is relative to the world, we are still doing poorly as a country. The numbers of tests that we’re running per individual in this country is very small. I think that it does show that we have a lot of work to do over the coming years to really prepare for what’s inevitably going to be another epidemic at some time in the future. 

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Well, on that point, I mean, there is a bar graph making the rounds, showing the levels of testing in various countries. South Korea is shown to be very aggressive in testing, Italy somewhere in the middle zone, and the US, frankly, right at the bottom. Based on what you know from Italy and South Korea, are you able to extrapolate out what the lack of testing in the US will mean for the caseload 10 days from now here? 

It’s very difficult to extrapolate out how exactly the dynamics of testing are going to play out, because what we’re seeing happen in this country, even in the absence of testing, is pretty major changes in society. And this is governors and mayors and federal government getting on the TV and in the media and saying we need to quarantine and we need to self-isolate and social distance. I think the message has gotten across from the epidemiologists and the physicians that the coronavirus is here and present in all around us. And whether we have testing or not, we can all make an assumption that it’s outside somewhere, and so let’s social distance.

And my hope is that these pretty drastic measures that we’re starting to see across the United States are going to have an impact regardless of whether or not we have testing. 

So what would it take to ramp up testing to kind of start approaching what Italy and South Korea have been doing? 

So my estimation is that to get the US to a point of testing that is similar, for example, to South Korea would require the US to be performing about 100,000 tests or more per day. To get to that number right now, it’s going to be very difficult because we actually need to be performing these tests in very specialized clinical certified laboratories. And the tests themselves that are available right now are generally not the right types of tests that normally fit into these laboratories in terms of the technical expertise in those labs. 

Last week we saw that Roche Diagnostics came on board with that with sort of what we call a sample-to-answer test that they got FDA approval for. And that is what is going to really allow us to get up to speed with testing in the United States.

This interview has been lightly edited and condensed for clarity.

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