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We can only address the coronavirus crisis if we test on a much larger scale

The Dallas Morning News • Mar 25, 2020 at 5:15 AM

When it comes to battling the coronavirus, it's getting hard to escape the reality that if we aren't testing on a mass scale, then we may not be seriously addressing the epidemic. Unless we ramp up testing, it will be a long time before we return our society to a place of stability, to a sense of normalcy.

Why, among all of the other things that need to be done in regard to COVID-19, does testing rise above? For a few simple reasons. Unless we have broad testing, we don't know who has the virus. That means, rather than quarantining the sick, we're left with social distancing and self-quarantining for every American. Guess which is more efficient, and less damaging to the U.S. economy.

Without testing, we don't know where the disease is spreading, so we can't go after it in effective ways. Without testing, we can only really guess at how deadly and how dangerous it is. Without broad testing, our entire community will be plagued with anxiety about whether every person they meet has just put them at risk.

Yet, some three months after the disease first emerged in China, months after tests were developed in Germany and, yes, here in the United States, any survey of the situation will reveal there aren't enough tests available.

And it's not just us who believe a ball has been dropped on testing. Last week we held a video call with Rep. Colin Allred, D-Texas (because, well, we're doing mass social distancing rather than mass testing). He expressed frustration with the failure to ramp up testing. "Testing capacity and access to testing is our biggest challenge," he said. "In many ways, it has been a disaster for us at the federal level. We have bungled this from the beginning."

What happened was that the Centers for Disease Control and Prevention tried to create a test instead of using the one already in use around the world, and it turned out that test didn't work. So weeks into the process, the feds turned to private industry and nonprofit researchers. Tests were developed there successfully, but then there were problems with the logistics of ramping up production and acquiring all the required materials. So we're weeks behind, and we can only conclude that developing a test and scaling up production of it was not properly prioritized from the start.

On Wednesday, Texas Gov. Greg Abbott's office announced a dramatic increase in testing capacity, saying the state had received some 15,000 swab kits from the CDC, and that a weekly shipment of the same size would now reach the state.

We appreciate the governor's work here, but we'll be honest — brutally so. There are almost 29 million people who live in Texas. We need to be hearing about swab kits and testing capacity in numbers exponentially larger than 15,000 a week.

What's needed is a rapid expansion of testing beyond county health offices and large hospitals to include community clinics, corner pharmacies, private labs and doctors' offices to give us the best possible snapshot of where the disease is concentrating and where it is spreading. This is something the World Health Organization calls "public health surveillance."

John Hellerstedt, commissioner of the Texas Department of State Health Services, said increased testing for public health surveillance can tell officials where to concentrate their efforts, and can help them figure out how to corral this virus. He's right, and he's right that we don't have to test every person to do that. But we do need to test more people than we are now to get ahead of this thing. We also need to help people alleviate their anxiety by letting them know whether they have the virus. Ramping up our testing capacity is crucial.

Allred told us "There needs to be a wake-up call" on this. We agree. The shortage of available tests is an embarrassment. Until we significantly ramp up testing, we won't be living up to what's required medically. And until we reach a point where anyone who wants a test can be tested, we may not reduce public anxiety. In short, whether we ramp up testing quickly is a central test of leadership in this crisis.

(c)2020 The Dallas Morning News

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