U.S. coronavirus testing drops even as infections remain high and death rates rise by more than 1,000 per day, a worrying trend that officials attribute largely to Americans being discouraged from having to wait hours for a test and days or weeks for to find out the results.
An Associated Press analysis found that the number of tests per day went 3.6% over the past two weeks to 750,000, with the number falling in 22 states. It includes places like Alabama, Mississippi, Missouri and Iowa where the percentage of positive tests is high and continues to climb, an indicator that the virus is still spreading uncontrollably.
In the midst of the crisis, some health officials are demanding the introduction of another type of test that would yield results in minutes and would be cheap and easy enough for millions of Americans to test themselves ̵
“There is a sense of desperation that we need to do something else,” said Dr. Ashish Jha, Head of Harvard’s Global Health Institute.
Widespread testing is considered necessary to contain the outbreak as the United States approaches a mammoth 5 million confirmed infections and more than 157,000 deaths of over 700,000 worldwide.
Testing demand is expected to increase again this autumn, when schools reopen and the flu season hits, likely exceeding deliveries and leading to new delays and bottlenecks.
Part of the decline in testing in recent weeks was expected after retrospective commercial laboratories urged physicians to concentrate on their high-risk patients. But some health and government officials are seeing increasing public frustration and declining demand.
In Iowa, government officials report less interest in testing, despite plenty of deliveries. The state’s daily test rate peaked in mid-July but has decreased by 40% in the last two weeks.
“We have capacity. Iowans just need to test, “said Gov. Kim Reynolds last week.
Jessica Moore in rural Newberry, South Carolina, said that after a private lab lost her COVID-19 test results in mid-July, she had to be tested again on a state-run pop-up website.
Moore and her husband arrived early on a Saturday morning at the scene, a community center, where they waited for two hours for her test. Moore looked in the rearview mirror as people drove up, saw the long line of cars and then turned left.
“If people have something to do on a Saturday and they want to be tested, they will not wait two hours in the South Carolina heat for a test, especially if they are not symptomatic,” Moore said.
Before traveling from Florida to Delaware last month, Laura DuBose Schumacher signed up to go to a test-up test site in Orlando with her husband. They were given a window in an hour to arrive.
They got there at the beginning of the window, but after 50 minutes it looked like the wait would be another hour. Others who had passed through the line told them that they would not get their results until five days later, on a Monday, at the earliest. They planned to travel the next day, so they gave up.
“Monday had been pointless, so we left the line,” Schumacher said.
The number of confirmed infections in the United States has peaked at 4.7 million, with new cases averaging 60,000 a day, from more than 70,000 in the second half of July.
US testing is primarily based on highly sensitive molecular tests that detect the genetic code of the coronavirus. Although the test is considered the gold standard for accuracy, experts are increasingly saying that the country’s congested lab system cannot keep pace with the outbreak and produce results within two or three days, the time frame that is crucial for isolating patients and containing the virus.
“They’re doing the best job they possibly can, but the current system will not allow them to keep up with demand,” said Mara Aspinall of Arizona State University College of Health Solutions.
Test delays have led researchers at Harvard and elsewhere to propose a new method with so-called antigen tests – rapid technology already used to screen for flu, throat plugs and other common infections. Instead of detecting the virus itself, such tests look for viral proteins or antigens, which are generally considered to be a less accurate measure of infection.
A number of companies are studying COVID-19 antigen tests where you spit on a specially coated strip of paper, and if you are infected it changes color. Experts say that the speed and widespread availability of such tests would more than compensate for their lower precision.
Although no such tests for coronavirus are available in the US market, experts say the technology is simple and the barriers are more regulatory than technical. Harvard researchers say that production can quickly scale into millions.
A proposal from Harvard researchers urges the federal government to distribute $ 1 saliva-based antigen testing to all Americans so they can test themselves regularly, perhaps even daily.
Even with an accuracy as low as 50%, researchers estimate that the paper strip tests would reveal five times more COVID-19 cases than the current laboratory-based method, which federal officials estimate catches of only 1 in 10 infections.
But the approach faces opposition in Washington, where federal regulators have demanded at least 80% accuracy for new COVID-19 tests.
To date, the Food and Drug Administration has allowed only two COVID-19 antigen tests to enter the market. These tests require a nasal stick supervised by healthcare professionals and can only be run on special machines available in hospitals, clinics and clinics.
Due to the risk of false negatives, doctors may also need to confirm a negative result with a genetic test when patients have possible symptoms of COVID-19.
On Tuesday, the governors of Maryland, Virginia, Louisiana and three other states announced an agreement with the Rockefeller Foundation to purchase more than 3 million FDA-cleared antigen tests, underscoring the growing interest in the technology.
Asked about introducing cheaper, paper-based tests, the government warned “testing of the czar,” Adm. Brett Giroir, that their accuracy could drop as low as 20% to 30%.
“I do not think it would do the service to the American public to have something wrong seven out of ten times,” Giroir said last week. “I think it can be catastrophic.”
Associated Press writers Brian Witte of Annapolis, MD, David Pitt of Des Moines, Iowa, and Mike Schneider of Orlando, Florida, contributed to this story. Liu reported from Columbia, SC and Forster from New York.
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