WASHINGTON — With schools, universities and businesses pinning their hopes for reopening on rapid coronavirus testing, the Trump administration’s testing czar told Congress on Friday that getting test results within two to three days “is not a possible benchmark we can achieve today.”
But even that sober assessment from Adm. Brett P. Giroir, the assistant secretary for health, most likely did not fully reflect the mounting frustration among patients and health professionals just as the school year struggles to get started.
During a lengthy House hearing with top government health officials, Dr. Giroir told lawmakers that the nation was averaging about 820,000 tests daily, up from 550,000 earlier this month. But the raw numbers belie the testing crunch that officials around the country are facing amid soaring caseloads, particularly in the South and West.
“Turnaround times are definitely improving,” Dr. Giroir insisted, adding that it was “very atypical” to wait more than 12 days for results.
But many researchers are still grappling with severe shortages of the testing supplies needed to collect samples from patients and process them in laboratories. That leaves state and local officials without information they need to make critical health decisions, and it creates lags in contact tracing — a necessary tool for controlling the pandemic’s spread.
“We’re doing so many tests, sometimes it takes seven to 10 days to get the results back,” Gov. Ron DeSantis of Florida noted on Friday evening in a briefing there with President Trump.
Coronavirus testing is essential to opening the economy and getting people back to work and school, but it is almost useless if long lag times keep people unnecessarily quarantined for days or allow them to spread the virus while they await their results.
Dr. Giroir insisted that over all, 59 percent of tests report results within three days, and 76 percent within five.
“I’m sure there’s an outlier at 12 to 16 days because that happens,” he added, “but that’s very atypical.”
Dr. Giroir’s comments, during a hearing of the House Select Subcommittee on the Coronavirus Crisis, were met with puzzlement by public health experts, who say testing shortages persist. In some places, tests cannot be processed at all because of a lack of reagents — the chemicals needed to detect whether the virus is present — or lab capacity.
And anxious patients around the country paint a far bleaker picture. Shawn Jain, who was tested along with several family members on July 7 in Nashville, waited 16 days for his results after they were processed by Quest Diagnostics. Some of his family members still have not heard back.
“I honestly thought they had lost the test,” said Mr. Jain, who tested negative for the virus. He added, “It made me feel like, well if in the future I do worry I have it, I can’t even rely on something as basic as testing.”
On Friday, the National Institutes of Health announced awards totaling $248.7 million for seven companies to ramp up test production and deliver millions more weekly tests as early as September. The N.I.H. director, Dr. Francis Collins, described the announcement as the “first of more awards to come.” Three of the tests are simple enough to deliver results in 30 minutes or less.
At the hearing, Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said again that a safe and effective coronavirus vaccine would most likely be ready by the end of this year or early next, and cast doubt on efforts by Russia and China.
“I do hope that the Chinese and the Russians are actually testing the vaccine before they’re administering the vaccine to anyone,” Dr. Fauci said.
Until a vaccine is available, testing remains critical, but new diagnostic tools will not come soon enough for the fall semester at universities and colleges around the country. Many have decided to transition to online classes in part because administrators cannot be assured that enough testing will be available to keep students, faculty and staff safe.
“Covid-19 testing capacity and delays in reporting results remain a challenge,” Sylvia M. Burwell, a health secretary in the Obama administration who is now the president of American University, wrote this week, in announcing that there would be “no residential experience” for students this fall.
“The ability to test and support contact tracing is critical to reducing community spread of Covid-19,” she added, “and the ambiguity in this area presents a significant hurdle for all.”
Other colleges were in the same position.
“The increased spread of the virus nationwide, the impact that this resurgence has had on the availability of testing supplies needed to satisfy our testing protocols, and the strong national trend of rising rates of infection in younger populations lead us to conclude that our community is best served by maintaining social distancing in miles rather than feet,” Alison R. Byerly, the president of Lafayette College in Pennsylvania, wrote last week.
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Frequently Asked Questions
Updated July 27, 2020
Should I refinance my mortgage?
- It could be a good idea, because mortgage rates have never been lower. Refinancing requests have pushed mortgage applications to some of the highest levels since 2008, so be prepared to get in line. But defaults are also up, so if you’re thinking about buying a home, be aware that some lenders have tightened their standards.
What is school going to look like in September?
- It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
What are the symptoms of coronavirus?
Does asymptomatic transmission of Covid-19 happen?
- So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Democrats seized on reports of testing delays to demand a national testing strategy.
“We once again call upon the president to get serious about this — no, testing is not overrated,” Speaker Nancy Pelosi told reporters as the hearing was underway.
Testing delays hurt efforts to contain the spread of the virus. Diagnostic tests reflect only a person’s health status on the day a sample is collected. While those who visit testing sites are typically told to quarantine at home while they await their results, that advice becomes harder to take the longer people are forced to wait — especially for those who work essential jobs that cannot be done remotely.
“It is an issue if you can’t get it within a 24-to-48-hour period,” Dr. Fauci said.
And diagnostic tests alone are not enough. Experts say that in order to stop the pandemic, the country will have to expand testing in the broader community — not just to identify sick people, but to assess the prevalence of disease in the general population and to catch asymptomatic people who might be unknowingly carrying the virus.
About half of all coronavirus tests, Dr. Giroir said, are conducted in so-called point-of-care settings — like doctor’s offices or urgent care clinics, without the need to route samples through laboratories — or hospitals. Point-of-care tests, intended to be fast and simple enough to obviate the need for specialized equipment or highly trained personnel, can yield results in 15 minutes, he said, while hospital tests take around a day.
The remainder of coronavirus tests are conducted by large-scale commercial laboratory companies, like LabCorp and Quest Diagnostics, which are strained near their limits.
This month, Daniel Larremore, a mathematician and infectious disease modeler at the University of Colorado, Boulder, collected data about testing delays via an informal survey on Twitter, showing that residents in multiple states were experiencing prolonged test result turnaround times.
What is more, turnaround times do not reflect “how long it takes for people to get a test in the first place, and how convenient it is to get the testing done,” Dr. Larremore said. He also pointed out that many places were still prioritizing patients with symptoms for testing.
But mounting evidence suggests that about 40 percent of coronavirus infections could present without symptoms entirely. Tests are also still failing to reach many of those who need it the most, including communities marginalized by race and ethnicity, who have been disproportionately affected by the coronavirus.
Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the administration needed a “national dashboard for testing” where data was collected and made publicly available.
“We need to know how many people are tested, by which test, how long does it take to get a result back and where there is testing capacity available, but they can’t be done because there is an absence of reagent or other critical components,” he said.
While the country’s capacity for testing has certainly increased, Dr. Larremore said, “That doesn’t mean that we are where we need to be — just that we’re continuing to accelerate.”
Sheryl Gay Stolberg reported from Washington, and Katherine J. Wu from Boston.