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Why widespread coronavirus testing isn't coming anytime soon

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  1. skybrian
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    From the article: [...] [...]

    From the article:

    The current trouble is a critical shortage of the physical components needed to carry out tests of any variety. Among these components are so-called viral transport media, which are used to stabilize a specimen as it travels from patient to lab; extraction kits, which isolate viral RNA from specimens once they reach the lab; and the reagents that do the actual work of determining whether the coronavirus that causes covid19 is present in the sample. Perhaps the most prosaic shortage, but also the most crucial, is a lack of test swabs, which look like glorified Q-tips. Specially designed to preserve viral specimens, they’re what a doctor sticks up your nose or down your throat to collect the necessary biological material.

    The swab shortage is happening for the same reason that all the other test components are limited—namely, a global pandemic has created a global demand for them—but it is subject to a further complication. Copan, one of the major manufacturers of the sort of swabs needed for covid-19 tests, has its headquarters and manufacturing facilities in Lombardy, Italy, which has been hit particularly hard by the disease. A spokesperson for the company says that the national lockdown in Italy has not affected production at its factories, but last week the U.S. Air National Guard had to use one of its C-17 cargo planes to bring an order of eight hundred thousand swabs back to the U.S. According to Defense One, the plane flew on Monday from the Aviano Air Base, in Italy, not far from the headquarters of Copan, to Memphis, where a FedEx distribution center is situated; the Times later reported that the airlift had been arranged by Peter Navarro, a Presidential trade adviser, and that the Administration hoped similar efforts would bring 1.5 million swabs into the country every week. On Saturday, a company spokesperson told me that Copan did not make “special deals” with governments but was “shipping to the U.S.A. the maximum amount that we are capable of, on a best effort basis” through its usual distributors.


    In recent weeks, Whitmar said, political pressure has made the problems even worse. Missouri is still, he guesses, at least several weeks behind New York and California on the epidemiological curve, which means that containing the outbreak through targeted testing of suspect cases remains a possibility. But recently, Whitmar told me, “National and state policymakers decided that we needed to offer testing to more individuals. Then the floodgates opened. When that happens, then the supply chain on the front end—which is the swabs, the viral transport media, the collection tubes—started to evaporate from the suppliers.” He went on: “If you think you’re going to test everybody, you have to look at your supply chain and analyze it closely. Not just make a promise, but look at your ability to provide a test for everybody. If you think you can, you may be surprised.”


    “Had we had access to high-volume, quality testing prior to there being community transmission,” Rakeman, the director of the New York City lab, told me, “a lot of testing would have been helpful, and maybe would have helped containment.” But, given the prevalence of covid-19 in the city, she said, test results for people who are mildly or moderately ill have little therapeutic or epidemiological value. “When we talk about testing capacity, it sort of gives this tacit message that people should be tested, and feeds into that anxiety: ‘I need to get tested. I need to know my status,’ ” Rakeman said. “You don’t need to know your covid status.” Anyone who suspects they have covid-19 should call a doctor, but in New York, unless you belong to a high-priority category, the recommendation will likely be the same regardless of whether you have the test: stay home for two weeks, or until you’re fever-free for seventy-two hours. In any case, Rakeman said, “If you have a cough and a fever and a sore throat, or any of those, you probably have it.”

    A larger problem, Rakeman told me, is that widespread demand for testing is exacerbating the critical shortage of masks and other P.P.E. The supply of available P.P.E. in New York is currently so low that, on Friday, Cuomo put out a public call to manufacturers to address it: “We will pay a premium for these products,” he said. As Rakeman told me, “Hospitals are going to run out of P.P.E. in the next couple of weeks, if not sooner. And any mask that is used now at a doctor’s office or a pop-up tent that’s providing ‘drive-through testing’ is a mask that’s not going to be available for a health-care worker in a couple of weeks.”

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