There continues to be widespread confusion about #COVID19 testing. One problem is that there are so many different roadblocks that have slowed things down--even when earlier ones are cleared, new ones have popped up. Testing has scaled up, but it's not enough yet. 1/x
Early on, CDC decided to develop its own test, rather than use other countries', which ate up time. That test had technical problems, which delayed things more. CDC also had extremely narrow criteria for testing & didn't let other public/private labs develop their own tests. 2/x
The CDC slowly expanded testing to state/local public health labs. They eventually let some do the testing themselves. But 1) there still weren't enough test kits or labs doing testing. 2) CDC criteria was finally loosened, but it was--and is--still very restrictive. 3/x
The state/local public health labs have *extremely* limited capacity and aren't designed for high volume testing. That why criteria was--& is--so strict. Private labs pushed to get on board in mid-January, but the FDA only sped up the onerous authorization process on Feb 29. 4/x
Commercial labs can do it at large scale. Clinical/hospital labs are on site with very quick turnaround. You don't need state approval for tests, which saves more time & criteria will be less strict. But you can't just turn on a switch & have all this at scale overnight. 5/x
New problems: Labs need equipment, staff, and FDA authorization, which take time to acquire. Basic lab testing supplies are now running low (swabs, gloves, reagents), &. the government didn't plan for supply chain problems in advance. 6/x
*All of this* is why testing continues to be so limited--and why hospitals and doctors everywhere are still using very restrictive criteria in deciding who to test, based on the CDC's narrow guidelines. Simply having #COVID19 symptoms isn't enough. 7/x
Our solutions aren't keeping pace with the problems. The Trump admin keeps saying there are millions of test kits. But that isn't the key problem now. It's having enough labs with the technology, staff, equipment, staff, supplies & authorization to do large-scale testing. 8/x
There are signs that the Trump admin is finally recognizing this, as reported this morning: But again, you can't scale up overnight. It will take time—and we're racing against time to slow this down. 9/x
