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U.S. Sees Decline In COVID-19 Testing


Where are we in this pandemic? Here in the United States, we actually don't know, and that's partially because, for the first time since this all began, fewer tests are now being done. For example, in Texas and Florida, two hard-hit states, testing has dropped more than 40%, and public health officials are trying to figure out why. To give us some insight, we're joined now by Dr. Ashish Jha. He is the director of the Harvard Global Health Institute. Welcome to the program.

ASHISH JHA: Good morning. Thank you for having me on.

GARCIA-NAVARRO: Can you tell us, from a public health perspective, why this drop in testing is alarming?

JHA: Yeah. So it is really concerning because testing is sort of the first step to figuring out how much disease there is in a community. It isn't the end-all, be-all, but it is pretty fundamental. If you can't test people, you don't really know how much disease there is, how much disease you're missing. And right now I'm getting worried that we're missing a lot of cases in Texas and Florida and other states.

GARCIA-NAVARRO: But could it just mean fewer people are getting sick?

JHA: Well, it could, of course. And we - and it's certainly - that's a possibility. But when I look at the states with relatively few cases, like New York and Massachusetts, they're doing a lot more testing per capita than Texas and Florida are. So this is not about fewer people getting sick. This is really a whole set of other factors that are driving a drop in testing, and that's why I'm worried.

GARCIA-NAVARRO: So explain what you think those are. Why are people not getting tested?

JHA: Well, we've all seen the stories about the very long delays. Test results are taking seven, 10 days to come back in some instances. But a good chunk of them are certainly taking more than three to five days, at which point their utility really goes down. And I can imagine doctors are ordering fewer tests. People are less willing to get a test if they're not going to get a result soon. There are, in some places, long lines to get a test. All of this, I think - the barriers that we've put up to making testing simple and easy are really dissuading a lot of people from getting tested.

GARCIA-NAVARRO: Yeah. A recent survey run by CNBC suggested that at least 40% of tests are coming back too late to be clinically meaningful. It can take many, many days in some places to get a result. How problematic is that?

JHA: Well, it's hugely problematic - right? - because by the time you find out that you're positive, it might be many days since you got the test and many, many days since you first developed symptoms, at which point it's nearly impossible to do contact tracing. You've probably spread the virus to a whole lot of folks, and you didn't know it. So it makes curtailing the pandemic incredibly difficult. That's why we need test results that are quick, that come back, ideally, that day - within hours, if possible.

GARCIA-NAVARRO: You have been having a rather public difference of opinion with the White House coronavirus testing czar. I had to ask.

JHA: Yes.

GARCIA-NAVARRO: You've said that we need to be testing at least 4 to 5 million people a day, and Admiral Brett Giroir says he doesn't believe that frequent testing is necessary. This seems like a fundamental difference of opinion, and there seems to be a pretty big disconnect there between what senior Trump health officials believe and what experts like you think needs to happen.

JHA: Yeah. So there is pretty broad consensus in the public health community that we need many millions of tests a day. And if you just think about it, we need to be testing not just people who have symptoms, who are sick. We need to be testing people in nursing homes, in schools, in hospitals, health care workers. We really do need many millions. Just even at 4 to 5 million, it would only be about 1 to 1 1/2 percent of the population. Many experts like Paul Romer, a Nobel laureate, thinks that we should be testing 30 million people a day. Admiral Giroir and this administration are really the only folks I know who think that we've largely gotten the testing right. I think the rest of us feel like we've got to do a lot more if we're going to bring the virus under control.

GARCIA-NAVARRO: But don't you think that's a problem when you have health experts like yourself and the sort of coronavirus testing czar saying two very different things? I mean, it's confusing to the public, at the very least.

JHA: Absolutely. And my sense is that Admiral Giroir really does believe - even if he hasn't always been consistent in his language, really does believe that we need a lot more testing. The problem is the administration has not been willing to put all of its efforts into making that kind of testing widely available for reasons that continue to baffle. So he's stuck between a rock and a hard place. I'm sure he wants more testing for Americans, but the administration is unfortunately not willing to do what is necessary to make that testing available.

GARCIA-NAVARRO: OK. So let's set the record straight, then. How often should people be getting tested and when?

JHA: Yeah. So it's really about who you are. So certainly, anybody with even the mildest of symptoms needs to get tested because we need to find out if you're infected and if you've been transmitting. But we also need to be testing high-risk places, like nursing homes. It'll help get our kids back to school. So it's not about who - it's not about how often, but it's really about who needs to be tested. And when you add up the numbers, it does get into many millions a day.

GARCIA-NAVARRO: Dr. Ashish Jha is the director of the Harvard Global Health Institute. Thank you very much.

JHA: Thank you. Transcript provided by NPR, Copyright NPR.

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