The U.S. should invest $75 billion in order to fix its badly flawed system of diagnostic testing for Covid-19, according to a bipartisan committee of industry experts, investors, scientists, and former federal health officials assembled by the Rockefeller Foundation.
“America faces an impending disaster,” the foundation’s panel warns in a 55-page report released Thursday. “The extraordinary scale of the Covid-19 crisis is evident in the growing deaths and economic losses the pandemic has wrought in every state.” The report adds: “This terrifying tragedy was not and is not inevitable.”
The report, which includes among its authors several former commissioners of the Food and Drug Administration and a who’s who of researchers in pandemic preparedness and diagnostic testing, suggests several steps for improving the U.S. response, including a dramatic ramp-up in different types of tests. The Rockefeller Foundation is also committing $100 million to the global coronavirus response.
Rajiv Shah, the foundation’s president, said he could point to “half a dozen, maybe three dozen” other countries, including South Korea, New Zealand, Australia, Iceland, and Germany, that have done better than the U.S. by using widespread diagnostic testing to identify people who are sick early and better control the spread of the virus.
Testing, Shah said during a media briefing, is “the legitimate way out of the conundrum of either having tens of thousands, now hundreds of thousands, of Americans die of Covid-19 or having a lockdown that forces economic pain.” Paul Romer, a report co-author and the co-recipient of the 2018 Nobel Prize in economics, estimates shutdowns cost the U.S. economy $300 billion to $400 billion a month.
The same committee previously suggested that the U.S. develop the capacity to conduct 3 million diagnostic tests a week this summer and then reach 30 million tests a week by October, when flu season will begin. But the experts said it is now clear that the rate of testing must be ramped up even faster, employing multiple strategies.
One major problem is that even though U.S. laboratories are now conducting 4.5 million Covid-19 tests a week, many patients are waiting seven days or longer to get test results. This makes the tests almost useless.
“This is just unacceptable, because by the time you get test results back, you’ve already infected many, many people,” said Mara Aspinall, a professor at the College of Health Solutions at Arizona State University and a report co-author.
The report offers two basic solutions to this problem. One is to further ramp up the existing technology, known as PCR, that is mostly used in the U.S., and to get turnaround times below 48 hours for those tests. The other is the widespread distribution of a cheaper, less accurate type of test, known as an antigen test, that can be conducted at home, in schools, or in offices. The antigen tests may miss 25% of cases, but by using them to screen people who do not have symptoms, the Rockefeller authors think they could catch many people who don’t have symptoms but are infectious. The report lists several tests that could play this role that are already approved, but notes that more would be needed and that they would need to be purchased in massive numbers by the federal government.
While $75 billion might sound large, Romer, the economist, said that it is very small compared to the potential benefit from such a plan. “There is actually a pretty broad consensus among Republicans and Democrats in Congress to back this level of spending on testing,” Romer said. The problem is that the testing money could get bogged down in the political fight over extending unemployment benefits, something Romer called less important. The “worst outcome,” he said, would be if Congress doesn’t embrace new funding for testing before the August recess.
The U.S. will need at least 5 million PCR tests a week, with results returned much faster than they are currently, said Michael Pellini, a venture capitalist at Section 32 and a report co-author. For the antigen tests, there will need to be upward of 30 million, which means they will need to be inexpensive — less than $10 a test, potentially substantially less.
“There has been no plan and there is no plan, and that is the danger,” said Pellini. “No country is perfect, but the ones that have done well, some exceptionally well, all have plans.”
About the Author Reprints
l’m on day 18 of my quarantine since testing positive for Covid 19. I have not had any symptoms of the corona virus or anything else. I’m feeling great. I’m 78 with no high risk health issues. I’m a resident of Florida. I got retested 9 days ago and still don’t have the test results. This long wait is unacceptable but there’s nothing I can do about. I’d like to know just where I stand now. I’m sticking with the quarantine because I certainly don’t want to pass the virus to others. I’m doing ok with the quarantine. My wife tested negative and she has no corona virus symptoms. It took 7 days to get her results. She got tested about a week before I did at a different location. I’m drinking a lot of water as recommended by my doctor. I’m keeping a good distance from my wife and wearing a mask when I leave my bedroom. I’m not going out into the public. Because I have no symptoms and feeling as good as ever, I’m wondering if I really do have the corona virus. Hopefully, the results of the retest will give me that answer. I’m ok with whatever the results are. I’d just like to know where I stand now. We have a kitchen remodeling project on hold because of my positive covid 19 test. I need to be free of the virus for the contractor to
continue work the project.
Dr. Richard Bartlett, from Midland, Texas has the Silver Bullet for Covid 19, he has been using the inhaled steroid called Budesonide, used for the past 20 years for Asthma patients He uses the Nebulizer that goes directly to the problem. His patients feel better after their first treatment. We won’t need all these big pharmaceutical company’s making money grabs, plus we won’t need a vaccine, saving billions of dollars. The Covid virus mutates too many times and a vaccine is not needed or necessary when we already have a drug that will destroy the virus. BUDESONIDE
We have at least 2 drugs that can fix the Covid 19 , Hydroxychloroquine, and a new one that Dr . Richard Bartlett has discovered, Budesonide, it’s been around for 20 years and he uses the inhaled steroid with a nebulizer. His paper has been turned over to Senator Ted Cruz.Lets see what happens to this.
SCIENCE PLUS FACTS, NOT FEAR
Why dont we see use of pooled PCR testing, namely testing combined samples from many people (say 20)
Instead of testing each individual separately?
This ‘pooling’ should be simple. I think the best grouping is a Fibonacci series 1 1 2 3 5 8 12 20 32 … but binary (1 2 4 8 16 32 …) might be as good. Probably depends on the expected positivity rate. Might be an interesting problem to investigate.
Oops, 1 1 2 3 5 8 13 21 34 …
Here’s an excellent article. Table 1 is what most people will need. https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25929
https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25929 is an excellent article on this. Table 1 is what most people need.
The cited paper assumes that upon finding a ‘positive’ everyone in the pool of 11 is tested. This is far from optimal except for time — using my approach would require splitting a pool for testing if ‘positive.’ For instance, using Fibonacci and a pool size of 13 would require, not 13 additional tests, but 5 but the time required would be 4 times longer. Also, if more than 1 person were positive in the pool, additional testing of subsequent splits would be required. My approach would have to be automated while the paper’s version could be manually controlled.
My concern us not only the 7 day wait time for test results now and possibility of infecting others during the lag time but the fact that you may get a negative result and three days later pick up the virus somewhere. Think about that for a minute or two! Makes testing almost pointless. 🤔
Jay Thomas and Linda McDonald have excellent responses to Pat’s comment. It’s about thinking your way through a problem, not just complaining about it. It’s not financially prudent or smart to have to test people over and over again, and that would be the only way to know whether a person is infected over a period of time. And if certain governors would do their job and stop expecting the federal government to foot the bill for everything, their states would be better off and their citizens would be healthier. For political reasons though, they put people at risk just to try and make the president look bad. Most of us are aware of what is occurring though.
Someone should rub the President’s nose in the savings to the economy (300 – 400 billion USD per month ?!), and have an Executive Order document and a fat black felt pen plus camera personnel at the ready. Maybe this is how the merits of lots of testing will finally sink in ……..
It appears Decision Diagnostic’s GenViro testing would fit what’s needed here. Testing with results reported to be in less than 15 seconds. Plus it’s supposedly home use friendly. Maybe the FDA ought to look at these options for approval and use nation wide.
It may take a week to get tests back, but we already are testing more people “than ever” by far. If states want their results back faster then maybe they can buy their “own equipment”, then you would see where this is coming from politically…same for the $10 Antigen Kits! Next is consider why Governors and Mayors refuse to provide Stay-At-Home orders enforcing it, but allow BLM and ANTIFA protests, are those citizens worried about the 7 day turnaround?
I believe expanding the search 4x vs 2x for a more proactive way to treat using other co-effective FDA medications at the same time. Focusing on a STATE widespread study would benefit for those States that are willing to buy their OWN equipment, shows you which states care about their citizens as well, not their budgets.
“Test, test, test” said Tedros months ago. But the POTUS counters with noxious “logic” that more tests mean more positive results. Then blames other leaders for what he attempts himself (manipulating numbers). Wanted: a SMART leader who CARES, and seeks testing, with fast results so contact tracing is then worth the effort. And EVERYONE needs to do their little bit for huge spread curb: mask, social distance.
This is so important and we are way behind the time when it should have already been done. But let’s hope someone is listening and will fund it. There ought to be permanent convenient testing sites designated all over the country.
But we know not everyone will get tested in a timely way, so the second part of this should be quickly determining prophylaxis measures and early case treatments that keep people out of the hospital. Cheap, readily available. Currently there is only one approved drug to treat this, an expensive IV drug used in hospitals that knocks off a few days of sickness. We need multiple choices and they should be cheap pills.
$75B would buy 250M of the BD testers that produce results in 15min. Let’s just buy one-per-family and put the extra money into the supplies. Test daily at home. I think that would solve the problem.