Early decisions on coronavirus testing helped shape a pandemic
When the new coronavirus erupted in China more than three months ago, each country faced a monumental task: manufacturing or acquiring enough tests to track the virus as it spread across its territory and around the globe.
Decisions made at those early, pivotal moments determined the course of the pandemic. China, after early denial-fueled stumbles, improved its response to the virus by deploying a flurry of rapid-fire tests. South Korea, hit hard in early days, mounted a comeback steered by knowledge gained from an avalanche of roadside swabs. In recent weeks, Italy has led the globe in testing, producing results that show the highest caseload and death toll in the world.
And Germany cleared regulatory hurdles to allow biotech firms to make tests available on a scale that the country's government could not.
But the United States and Japan stumbled, experts say, by initially shutting out the private sector while proceeding sluggishly with public sector efforts, leaving too few tests to track the extent of the virus' spread. Now, some experts say, the window for testing as a measure to curb transmission could be closing in many places where the virus is widespread.
"Because we didn't have testing early on, it fatally flawed our covid response," said Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law at Georgetown University.
The World Health Organization has said that the gold standard for fighting an outbreak starts with testing.
"Test, test, test," WHO head Tedros Adhanom Ghebreyesus has implored: Test broadly, pick up cases, isolate patients, trace their close contacts and put those people into 14 days of quarantine.
"You cannot fight a fire blindfolded," he said Monday.
Many countries do not publicly report covid-19 testing data, and the World Health Organization does not track testing by country. According to an Oxford University-based outfit that aggregates available governmental data, South Korea, Italy, the United Arab Emirates, Russia, Germany and one province in China are among those that have done the most testing.
The United States had tested about 50,000 as of Friday, according to the CDC.
U.S. lawmakers have pledged to massively amplify testing in the coming days, but epidemiologists say the virus has blazed through American soil, following a troubling community-transmission trajectory similar to Italy's.
"The very honest truth is we have missed the opportunity to really prevent the worst outcomes," said Gostin, who is studying the pandemic in Washington. "And now we are at the very last tool in our tool shed, which is: Everybody hunker down at home."
Some are asking whether the time for widespread testing has passed in places where the virus is spreading rapidly. On Friday, the head of Finland's health security agency questioned the WHO's advice to test as many people as possible.
"We can't fully remove the disease from the world anymore," Mika Salminen of the Finnish Institute of Health and Welfare said in an interview with Helsingin Sanomat newspaper. "If someone claims that, they don't understand pandemics."
Two months ago, as cases climbed in Wuhan, the WHO published instructions from German scientists with the recipe for any nation to create tests.
The global health body didn't talk to the Centers for Disease Control and Prevention about supplying kits to the United States, WHO spokesperson Tarik Jasarevic said. The United States, like other wealthy countries, normally develops its own diagnostic tests, then private companies approved by the Food and Drug Administration produce the kits.
But manufacturing problems with the CDC's initial diagnostic test led to a six-week delay. In a statement announcing coronavirus response legislation, President Trump on Wednesday pledged to ensure that "coronavirus testing is accessible to every American."
While malfunctions bungled the CDC's testing rollout, the WHO supplied hundreds of kits to countries around the globe. European nations largely got a head start on testing, opting to source materials from the WHO and a mix of companies.
Unlike South Korea and China, however, they hadn't battled other viral outbreaks in recent years. The Asian countries already had close relationships with emergency-ready businesses.
South Korea, which logged its first case around the time the United States did, helped curb its steep transmission by testing 10,000 people per day, experts say.
"They were much more amped up and ready because of SARS and MERS," said Ashish Jha, director of the Harvard Global Health Institute. "They were more aware and attuned to these issues."
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