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A28    SCIENCE
                   Saturday 21 March 2020
            U.S. virus testing faces new headwind: Lab supply shortages



            By MATTHEW PERRONE                                                                                                  tion has instructed countries
            WASHINGTON  (AP)  —  First,                                                                                         to  "test,  test,  test"  to  track
            some  of  the  coronavi-                                                                                            and  isolate  those  carrying
            rus  tests  didn't  work.  Then                                                                                     the  virus.  But  the  evolving
            there  weren't  enough  to                                                                                          message  from  U.S.  deci-
            go  around.  Now,  just  as                                                                                         sion-makers acknowledges
            the  federal  government                                                                                            that many suspected cases
            tries to ramp up nationwide                                                                                         will likely go untested.
            screening, laboratory work-                                                                                         The  White  House  has  in-
            ers  are  warning  of  a  new                                                                                       creasingly    emphasized
            roadblock:  dire  shortages                                                                                         that testing should prioritize
            of testing supplies.                                                                                                the elderly and health care
            The shortages are the latest                                                                                        workers  who  have  symp-
            stumble in a botched effort                                                                                         toms of the virus. While most
            to track the spread of coro-                                                                                        cases of COVID-19 are mild
            navirus that has left the U.S.                                                                                      and  tens  of  thousands  of
            weeks  behind  many  other                                                                                          people  have  recovered,
            developed countries. Dwin-                                                                                          older  people  and  those
            dling supplies include both                                                                                         with   underlying   health
            chemical components and                                                                                             problems are at higher risk
            basic  swabs  needed  to                                                                                            for  more  serious  problems,
            collect patient samples.                                                                                            such as pneumonia.
            There  are  "acute,  seri-                                                                                          "We  don't  want  everyone
            ous  shortages  across  the                                                                                         to go out and get a test be-
            board" for supplies needed                                                                                          cause there's no reason for
            to  do  the  tests,  said  Eric                                                                                     it," President Donald Trump
            Blank, of the Association of   In this Wednesday, March 11, 2020 file photo, a technician prepares COVID-19 coronavirus pa-  told  reporters  in  a  briefing
            Public Health Laboratories,   tient samples for testing at a laboratory in New York's Long Island.                  Friday.  (Two  weeks  ago,
            which represents state and                                                                         Associated Press   Trump  declared  "anybody
            local health labs.                                                                                                  who wants a test can get a
            Blank said government labs  On  Thursday  California's  of  swabs,  liquids  to  store  tive supplies.              test."  But  his  deputies  later
            in  the  U.S.  are  compet-  governor  told  its  40  million  patient samples and kits to  "Usually  it's  that  the  lab  walked  back  that  state-
            ing  for  supplies  with  larg-  residents  to  stay  home  in-  develop  the  results.  Many  people do not understand  ment.)
            er  commercial  labs  and  definitely and venture out-    labs  are  having  similar  that  there  are  alternative  The  CDC  tells  people  to
            governments  around  the  side only for essential jobs.   problems, said Bill Whitmar.   supplies in the marketplace  seek  testing  if  they  have
            world.  In  conference  calls  But  public  health  experts  "Quite  frankly,  95%  to  98%  that they are perfectly free  certain  symptoms  of  the
            this week with the Centers  stress that policymakers are  of the talk between lab di-  to use," Azar told reporters  flu-like illness caused by the
            for  Disease  Control  and  "flying  blind"  in  deciding  rectors has been about the  in  a  briefing  at  the  White  coronavirus – fever, cough
            Prevention,  some  lab  staff  how  to  manage  the  pan-  shortage of supplies," Whit-  House. He said the federal  and  trouble  breathing  –
            warned  that  they  may  demic.                           mar said.                    government  is  purchas-     and  if  they  have  traveled
            have  to  shut  down  testing  "The  only  way  to  get  At this point only 500 swabs  ing  and  shipping  swabs  to  recently  to  an  outbreak
            within  days  due  to  lack  of  through it without testing is  are available. And the lab  states.                 area or have been in close
            components, Blank said.      to keep the entire country  only  has  supplies  to  last  Whitmar,  the  Missouri  lab  contact with someone who
            Wide scale testing is a criti-  quarantined for the next 18  through  Tuesday,  he  re-  director,  said  many  sup-  is infected. They should first
            cal  part  of  tracking  and  months" said Dr. Ashish Jha,  ported.                    pliers  just  don't  have  the  be  tested  for  the  flu  and
            containing  infectious  dis-  a Harvard University global  The Jefferson City lab does  products in stock.          other routine infections.
            eases  like  COVID-19.  But  health professor. "That obvi-  only a fraction of the coro-  "An  order  is  not  a  swab  in  While  doctors  are  sup-
            the  U.S.  effort  has  been  ously is untenable."        navirus testing performed in  hand," he said.             posed  to  decide  who  ulti-
            plagued by a series of mis-  Jha and his colleagues say  Missouri,  with  commercial  The  coronavirus  test  uses  mately  gets  tested,  many
            steps,  including  accuracy  the  U.S.  should  be  screen-  labs now doing the largest  a  chemical  chain  reac-  state  labs  have  adjusted
            problems  with  tests  the  ing 100,000 to 150,000 peo-   share.  But  Whitmar's  lab  is  tion  to  detect  tiny  traces  their guidelines depending
            CDC sent to other labs and  ple  per  day.  The  current  where tests are run on the  of  the  virus'  genetic  ma-  on testing availability.
            bureaucratic  hurdles  that  rate  is  roughly  20,000  per  people most likely to be in-  terial  and  reproduce  it  The  Trump  administration
            slowed  the  entrance  of  day,  he  estimates,  though  fected in that state.         many  times.  State  and  lo-  is  expected  to  soon  an-
            large, private sector labs.   it  is  accelerating  as  larger  The  shortages  have  be-  cal  health  labs  follow  the  nounce the rollout of near-
            With the virus spreading, of-  commercial    companies  come  a  central  concern  technique  first  developed  ly  50  community-based
            ficials in the U.S. have shift-  ramp up testing.         in increasingly urgent com-  by the CDC, which calls for  testing centers around the
            ed focus from tracking the  The  director  of  Missouri's  munications among gover-    a specific genetic kit made  country,  including  drive-
            virus to extraordinary mea-  state lab said Friday that his  nors and federal officials.  by German diagnostic firm  thru sites.
            sures  to  blunt  its  damage.  facility  is  facing  shortages  "Most  of  my  phone  calls  Qiagen.  Labs  around  the  Some experts worry the in-
                                                                      today  have  been  about  globe  are  reporting  short-   troduction  of  convenient,
                                                                      swabs," Gov. Gina Raimon-    age of those kits.           mass  screening  will  divert
                                                                      do  said  during  a  Tuesday  Qiagen  said  this  week  it  is  supplies  from  people  with
                                                                      news  conference.  "That's  trying  to  boost  production  severe  symptoms  to  those
                                                                      our  big  issue  at  the  mo-  from  normal  levels,  which  who face lower risks.
                                                                      ment."                       are  capable  of  testing  1.5  "It's taking supplies that are
                                                                      The  Trump  administration's  million patients per month,  already in very short supply
                                                                      top health official suggest-  to  amounts  that  would  al-  away from the testing labo-
                                                                      ed  Friday  that  the  "anec-  low for testing more than 10  ratories that are doing nec-
                                                                      dotal"  reports  of  shortages  million patients by the end  essary  testing,"  said  Blank,
                                                                      are  caused  by  confusion  of June.                      of  the  public  health  labs
                                                                      about how to find alterna-   The World Health Organiza-   association.q
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