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Slow testing may be skewing numbers of U.S. COVID-19 survivors, deaths

Workers in protective suits check the ID of possible patients when they arrive by car at New York State's first drive-through coronavirus mobile testing center at Glen Island Park in New Rochelle, N.Y., on Friday. Photo by John Angelillo/UPI
Workers in protective suits check the ID of possible patients when they arrive by car at New York State's first drive-through coronavirus mobile testing center at Glen Island Park in New Rochelle, N.Y., on Friday. Photo by John Angelillo/UPI | License Photo

March 13 (UPI) -- Estimates of the number of COVID-19 cases, recoveries and deaths in the United States may be affected by the lack of testing capacity, public health experts say.

The U.S. Centers for Disease Control and Prevention, the National Institutes of Health and the Trump administration have been criticized over the "failure" -- as Dr. Anthony Fauci of NIH put it to Congress -- to perform diagnostics on sufficient numbers of the population who may be at risk for infection.

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As part of its plan to expand COVID-19 testing capabilities, the Trump administration on Friday announced the creation of a new screening website for the virus that will guide people through a series of "yes" or "no" questions and, based on their responses, direct them to where they can get the type of healthcare they need in their local area.

This would not only help identify those in need of testing, but also would prevent people from being tested unnecessarily. The president said 500,000 new coronavirus testing kits would be made available early next week, with "millions" more to follow.

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The U.S. Food and Drug Administration recently awarded fast-track approval on a third testing platform, and delivery of that is expected to begin next week.

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"We still have a long way to go," Fauci, director of the National Institute of Allergies and Infectious Diseases, told the press. "There will be many more cases. But we'll take care of that. What's going on here today is going to help it end sooner than it would have."

However, the delays up until this point mean that some who may be ill aren't getting immediate treatment. It also indicates officials may not have a real sense of the outbreak's scope.

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"We need to act faster to contain and limit the infection in the U.S.," Andrew Pekosz, a professor of microbiology and immunology in the Center for Global Health at Johns Hopkins University, told UPI Thursday night.

"China's response to the infection bought the world some time to prepare, and we need to learn that early action has a chance to minimize disease impact. If the virus gets too far ahead of us, we will not be able to catch it," Pekosz said.

Catching up will require a significant increase in testing, officials have said. According to congressional testimony from Fauci and others on Thursday, just 22,000 people in the United States had been tested.

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In comparison, South Korea has tested some 230,000 people. That has enabled the country to get a better handle on the COVID-19 outbreak, World Health Organization officials said earlier this week.

Through Friday, South Korea has had 7,979 confirmed cases, with 72 deaths -- a fatality rate of less than 1 percent. The United States has reported 41 deaths from 1,881 confirmed COVID-19 cases, for a fatality rate of more than 2 percent.

That figure is in line with an analysis published last month in JAMA that included 72,000 patients in Wuhan, China, the epicenter of the pandemic.

Those numbers suggest the overwhelming majority of those infected survive. Still, it's hard to get a true sense of the impact without knowing exactly how many people actually have been infected.

"The death rate and severe disease rate will drop some more as we get a better idea of the total number of mild cases that are occurring," Pekosz said. "However, you have to balance this against the fact that there is no pre-existing immunity in the population, no vaccine and no antivirals. That means we could see an extremely large outbreak in the population because we are all susceptible."

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Without knowing how many people in the United States have or had the virus, Pekosz said, officials have no way to adequately plan how to allocate resources in the short term.

"A high number of cases would counter a low fatality rate and still result in more severe disease cases than the hospital infrastructure can handle," he said.

This is further complicated by what's known about disease progression. A study published Wednesday in The Lancet suggests that the progression time from symptom onset to severe disease is seven to nine days.

"It's not a rapid, sudden onset of respiratory failure," Pekosz said. "This is a critical area of research that needs to be given a high priority."

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