The debate over testing capacity
Tuesday, Apr 21, 2020 - Posted by Rich Miller
* President Trump yesterday…
Earlier today, Vice President Pence spoke with governors from all 50 states about our unified effort to defeat the virus. He had a great call. It was a great call, very positive in I’d say every way. Prior to the call, we provided each governor with a list of the names, addresses and phone numbers of the labs where they can find additional testing capacity within their states. Many, many labs. We’re providing you with the list. We’ll show it to you now if you need it. We’ll give you the details, but hundreds and hundreds of labs are ready, willing, and able. Some of the governors, like as an example, the governor from Maryland didn’t really understand the list. He didn’t understand too much about what was going on. So now I think he’ll be able to do that. It’s pretty simple, but they have tremendous capacity and we hope to be able to help him out. We’ll work with them and work with all of the governors.
Similar to the situation with ventilators, states need to assess their complete inventory of available capacity. Some states have far more capacity than they actually understand, and it is a complex subject, but some of the governors didn’t understand it. The governor, as an example Pritzker from Illinois, did not understand his capacity, not simply ask the federal government to provide unlimited support. I mean you have to take the support where you have it, but we are there to stand with the governors and to help the governors, and that’s what we’re doing and they have a tremendous capacity that we’ve already built up and you’ll be seeing that. We’re going to be introducing a couple of the folks in a little while to talk about it.
* I asked the governor’s office about this and was referred to Pritzker’s remarks yesterday at his own media briefing…
The main focus of that call was about testing. The White House is reiterating … the Coronavirus Task Force is reiterating that states have testing capacity. And I’ve said this before, but you know testing capacity is a function of how many machines do you have and if you ran them 24/7, what output could you get.
The problem is there’s a big difference between testing capacity and getting testing result and what’s the big difference in all those things in between that you need, like swabs, and viral transport medium and RNA extractor reagent. And then you’ve got to run those machines with lab techs, and if you’re going to run them 24/7, that’s three shifts.
So, what they really have said is ‘Hey, you’ve got plenty of machines out there, go to it.” And what all … the other governors who spoke, Republican and Democrats, really said the same thing which is, we all need swabs, we all need VTM. We all need RNA extractor and reagent.
And so, it was an interesting call because I think you can see what, how they’re thinking about what their responsibility is. But the fact of the matter is that when they say ‘There’s lots of testing available,’ it’s a far cry from testing capacity to actually getting testing results.
…Adding… Bloomberg last week…
A lack of reagents, swabs, personal protective gear and specialized equipment has severely hampered testing capacity, according to an April 13 letter to Birx from AAMC Chief Executive Officer David Skorton. The association represents the academic medicine community that owns many of the 175 Abbott machines across the country.
“The inability to secure adequate quantities of any of these components will result in lower testing capacity,” Skorton said. “The absence of certain components could result in testing machines sitting unused.”
In some cases, labs trying to purchase parts, reagents and test cartridges to determine if patients have Covid-19 have been unable to do so, as they have been told that the federal government or other laboratories have a higher priority, the letter said.
- PublicServant - Tuesday, Apr 21, 20 @ 10:25 am:
Capacity of test processors does not equal ability to administer tests due to lack of materials.
- Ducky LaMoore - Tuesday, Apr 21, 20 @ 10:25 am:
What this basically comes down to is, it doesn’t matter if you have 10 millions tests if you can only process 10 thousand a day.
- Lucky Pierre - Tuesday, Apr 21, 20 @ 10:29 am:
The Governor’s staff doesn’t listen the daily Coronavirus briefings from the White House experts, most of whom are career people on the job for decades.
Unbelievable Trump derangement syndrome.
- Langhorne - Tuesday, Apr 21, 20 @ 10:31 am:
We have heard this tune often. Way too often.
Classic trump insults and disinformation.
People trust their governors more than the pres.
- CCM - Tuesday, Apr 21, 20 @ 10:33 am:
I think that Illinois is in as a vulnerable spot as any in the country. Meaning, we were in horrible fiscal shape. The reason that the order has not been extended yet, is the reality is we have not seen the amount of deaths as say New York. The Gov has much to consider. We have to get folks back to work.
- 47th Ward - Tuesday, Apr 21, 20 @ 10:34 am:
===Unbelievable Trump derangement syndrome.===
The daily WH briefings have very little info that the Pritzker admin can’t get elsewhere. The briefings are clearly about self-aggrandizement for the President. JB could buy his own copy of the WSJ that Trump trumpeted the other day.
To the post, somebody is lying here. I don’t understand the testing science enough to know which side is lying, Trump/Pence or the Governors. Fortunately, I’ve heard enough of this President to know he and the truth remain unacquainted.
- Jeremy K - Tuesday, Apr 21, 20 @ 10:35 am:
City Council to Fire Chief: You have all the engines and pumper trucks you will ever need. Go fight the fire!
Fire Chief to City Council: If you don’t give me water and hoses, it doesn’t matter that how many trucks we have - we can’t do a thing.
- Downstate Illinois - Tuesday, Apr 21, 20 @ 10:36 am:
But is Illinois operating its testing 24/7, or are they taking the weekends off. Do we have three shifts operating or two? Are we utilizing all the labs at our state universities? I know SIU is making some of what they need is anybody else making the rest. I never hear any answers to these questions. I just hear whining.
- Ok - Tuesday, Apr 21, 20 @ 10:36 am:
If you doubt the lack of testing capacity, try to get tested if you have symptoms, but are not being admitted to a hospital.
The only people able to get tested still are those in respiratory distress and getting admitted, those that have high fevers, first responders, medical personnel, and those who are at-risk with underlying conditions.
That is sufficient for when you are “stay at home,” and trying to target help to those who are most vulnerable.
However, that is not sufficient if you open the economy back up and have a bunch of untested people walking around spreading it more.
- Oswego Willy - Tuesday, Apr 21, 20 @ 10:37 am:
===White House experts===
Governors get their own briefings.
If any governors’ offices are wasting time listening, that’s not good news.
Trumpkins feel POTUS deserves 24/7 attention… governors are working, they’re busy, and frankly, propaganda isn’t factual information given by this POTUS.
Dr. Fauci… it’s is info that matters.
- Donnie Elgin - Tuesday, Apr 21, 20 @ 10:39 am:
“The briefings are clearly about self-aggrandizement for the President”
JB’s daily briefing are just a variation on that theme as well.
- Lester Holt’s Mustache - Tuesday, Apr 21, 20 @ 10:39 am:
==What this basically comes down to is,==
What is basically comes down to is the white house playing a game of semantics in which they know they won’t be called out for by supportive conservative media orgs like fox. They’re going to pass blame on to the governors with statements like “Well it’s their fault they aren’t opening back up/had a spike in cases/etc., they had plenty of testing capacity” while refusing to acknowledge that states don’t have all the pieces to perform actual tests. Why they aren’t using DPA to get this stuff out to everyone is beyond me
- Pundent - Tuesday, Apr 21, 20 @ 10:41 am:
=Unbelievable Trump derangement syndrome.=
If we define this as being lied to repeatedly but still being willing to accept what the President says as accurate and not self-serving, I would agree.
- neutral - Tuesday, Apr 21, 20 @ 10:42 am:
Trump — “We’ll give you the details, but hundreds and hundreds of labs are ready, willing, and able.
but they have tremendous capacity and we hope to be able to help him out.”
“…states need to assess their complete inventory of available capacity. Some states have far more capacity than they actually understand…”
The Pritzker and his admin response don’t answer the questions. His response makes it sounds like IDPH employees are doing the testing and needing supplies.
What labs (public and private) are “ready, willing, able” in Illinois, and what is their capacity*?
*number of sites, supplies, labor. classic max/min problem.
- Anon221 - Tuesday, Apr 21, 20 @ 10:47 am:
States may have “capacity”, but if the tests themselves are suspect, what good does that do for accuracy? We know from media reports that there are bad test kits out there. And we can’t be hanging our hats on “liberation” with just one test per person to determine contagion or not. Testing is going to have to be ongoing for months if not years to determine if someone could still possibly spread the virus. If we don’t have accuracy with rigorously tested test kits, then the “curve” is bound to rebound.
- 47th Ward - Tuesday, Apr 21, 20 @ 10:48 am:
===JB’s daily briefing are just a variation on that theme as well.===
You argue like a child. When has Prizker lashed out at female reporters for asking questions he doesn’t like? When has Pritzker held up flattering news articles praising his performance?
If you believe they are truly the same, we have nothing left to discuss.
- TinyDancer(FKASue) - Tuesday, Apr 21, 20 @ 10:49 am:
=Unbelievable Trump derangement syndrome.=
So, what are you saying? The governors have actually had the capacity to run adequate testing since February but, although people are dying, they are too lazy or stupid to do it? Or that they are strategically sacrificing people’s lives?
- We'll See - Tuesday, Apr 21, 20 @ 10:49 am:
===Unbelievable Trump derangement syndrome.===
Seems to me that syndrome works both ways now days…. some folks could actually benefit from understanding facts - not the POTUS’ fiction.
- illinifan - Tuesday, Apr 21, 20 @ 10:50 am:
The governor has also said capacity is determined by the number of techs available to do the test. In addition to limits on supplies to run the tests, there are not enough trained techs available so that limits output. Not sure how much training is needed to do the job, but it appears to be more skill is needed than a 1 hour training session.
- Pundent - Tuesday, Apr 21, 20 @ 10:50 am:
This does not seem to be going particularly well for the President. His comments suggest that the Governors are not informed. Yet polling suggests that the American people trust their state government more than they trust the federal government right now. And when we hear our own Governor talking about sending cargo planes to China because we can’t get adequate PPE from the feds there’s little wonder why. Unfortunately the President is incapable of showing leadership, accepting responsibility and expressing empathy for how this situation has unfolded. We desperately need that right now.
- Pot calling kettle - Tuesday, Apr 21, 20 @ 10:50 am:
==The Governor’s staff doesn’t listen the daily Coronavirus briefings from the White House experts, most of whom are career people on the job for decades.==
==To the post, somebody is lying here.==
No one is lying, but a few blog commenters are not paying attention.
Step 1 to correct your attention/understanding deficit: read Ducky boiled it down very clearly: “What this basically comes down to is, it doesn’t matter if you have 10 millions tests if you can only process 10 thousand a day.” When the Trump Whitehouse says “capacity” (akin to 10 million tests) they are ignoring the reality that no one can actually achieve that number with current supplies and personnel.
Also, the “White House experts” are only a few of the people and they are often muzzled during the briefings.
- Oswego Willy - Tuesday, Apr 21, 20 @ 10:51 am:
=== ===JB’s daily briefing are just a variation on that theme as well.===
Then you must be the most naive soul out there.
If you think they’re the same and still support one over the other that isn’t at all thoughtful to… anything.
:)
- Oswego Willy - Tuesday, Apr 21, 20 @ 10:59 am:
- Ducky LaMoore - indeed cuts it to the quick.
The three T’s, and - DLM -‘s tip in, that’s the ball game.
The rest seems to be Trumpkins confused that;
1) The White House briefs governors specifically
2) The White House plan is the plan this POTUS seems to be railing against most because Guv’s are trying to follow it.
I know it makes little sense, but it’s on brand for this White House.
- Steven Naslund - Tuesday, Apr 21, 20 @ 11:02 am:
The State needs to identify the bottleneck. Is it technicians, supplies or testing systems. I am sure the technician issue could be solved by training up some people. How hard is it? Supplies are more difficult. Seems the systems are available. Lets get some specifics instead of going back and forth. The White House publicly said Illinois has the capacity and the States did not provide any facts to refute that.
- Lt Guv - Tuesday, Apr 21, 20 @ 11:12 am:
I know LP didn’t mean it this way, but I finally agree - Trump does have derangement syndrome.
- Lincoln Lad - Tuesday, Apr 21, 20 @ 11:17 am:
It couldn’t be clearer -
Trump needs a foil, someone to blame, and for now has settled on the governors.
Trump’s blame game does nothing to save lives - it is an effort to get re-elected.
His supporters continue to support him, though he is costing lives and is willing to sacrifice more in an effort to improve his re-election chances.
Re-election above American lives.
End of story… people willing to look past that aren’t going to be swayed by an argument. There is nothing more powerful than re-election above thousands of lost lives.
- Sangamo Girl - Tuesday, Apr 21, 20 @ 11:20 am:
The people working in these labs are not hourly-wage technicians with a few hours of training. Which is one of the reasons there aren’t enough of them. Laboratory science is a rigorous and highly technical field requiring a B.S. at a minimum. “Many Scientists/Technologists specialize in one particular area, such as in hematology, clinical chemistry, immunology, molecular pathology, cytogenetics, microbiology, or transfusion medicine. Scientists/Technologists have a bachelor’s degree in clinical/medical laboratory science or the life sciences that included three or four years of academic course work and one year of clinical experience. Most labs require that they be certified to demonstrate their competence to conduct their job functions.”
- Commisar Gritty - Tuesday, Apr 21, 20 @ 11:25 am:
This is the metaphorical equivalent of Trump delivering his “Mission Accomplished” speech from the deck of the U.S.S. Abraham Lincoln, except it is rapidly sinking behind him.
- Illinifan - Tuesday, Apr 21, 20 @ 11:40 am:
Great job description Sangamo Girl. The challenge is the Feds and states are talking about 2 different things and no one is listening.
- Pot calling kettle - Tuesday, Apr 21, 20 @ 11:50 am:
== Laboratory science is a rigorous and highly technical field requiring a B.S. at a minimum.==
What good is having a fleet of airplanes (capacity) if you do not have enough pilots? And, you cannot just give someone a pin with wings and call them a pilot. Also, the planes need fuel, maintenance, etc.
- Dotnonymous - Tuesday, Apr 21, 20 @ 12:09 pm:
Narcissism may be the most curious and perplexing personality disorder affecting America.
Narcissists have all the answers…but do not care if they are right…because they are never wrong.
- the Patriot - Tuesday, Apr 21, 20 @ 12:24 pm:
As of yesterday less than 270 tests done in Southern 7 counties. Not even enough data for analysis. At some point the Governor has to shift testing resources down state because we don’t know where it is yet because we are not testing. If he is convinced it it not in those areas so there is no need to test, then he needs to let the local authorities decide when to open things back up.
He can’t keep saying you don’t matter enough to test, but we can decided to keep you closed because people in Chicago have a problem.
Really tired of Governors saying they dictate when the state opens not the President and that it is wrong to hold resources for certain states over others, then they turn around and do the same thing to rural counties on a daily basis.
- Oswego Willy - Tuesday, Apr 21, 20 @ 12:31 pm:
=== Really tired of Governors saying they dictate when the state opens not the President===
Yeah, the president says governors dictate when the state opens not the President
Keep up.
- XDNR - Tuesday, Apr 21, 20 @ 12:35 pm:
Apparently the Divider in Chief doesn’t understand that a number of materials and lack thereof, which is at issue, are required to prepare the samples for analysis. His record on coordinating a national response to this pandemic is dismal.
- the Patriot - Tuesday, Apr 21, 20 @ 12:42 pm:
OW==
Yea, after a month when it became clear they were going to take responsibility for a lot of deaths.
The point is they wrestled it away from Trump, now apply the same principles they were crying about.
Pritzker has no clue what the real numbers are in 75% of the counties because he has decided not to allocate testing resources there.
The reality is that his briefings are pretty clear he would rather lie and release murders than deal with Rural Illinois.
- Oswego Willy - Tuesday, Apr 21, 20 @ 12:45 pm:
=== The point is they wrestled it away from Trump, now apply the same principles they were crying about.===
For the love of Pete, how truly ignorant are you?
The President never, ever-ever had that power. Ever. Never ever.
Stop watching Fox News
The federal response, the White House response is… each state should follow these guidelines, but they control themselves.
Yikes, man.
- zatoichi - Tuesday, Apr 21, 20 @ 1:10 pm:
Since Trump claims Pritzker and Hogan do not understand what ‘capacity’ means or where labs exist, both sides keep talking past each other with no real time response. I wish there was a televised meeting with reporters with Trump/Pence/Fauci at one table and Cuomo/Hogan/Pritzker at the other, same room, same stage, same time. No ‘Enough’ statements to cut off reporters. Stay focused on testing, COVID-19, Fed/state purchasing/cooperation, funding related to pandemic issues, and the reopen criteria. No drifting off topic or anything that happened before Jan 1, 2020. Let the public ask questions. Huge ratings potential. And maybe some straight answers.
- dbk - Tuesday, Apr 21, 20 @ 1:42 pm:
When the President says “the states have testing capacity,” what he is actually saying is “the states have theoretical testing capacity” - in other words, they’ve got the machinery needed to run the tests. Unfortunately, you need more than the machinery to do the tests.
There’s a critical shortage of (1) swabs, (2) Viral Transport Medium (VTM) - which SIU has just succeeded in producing, and here’s hoping they’ll be able to scale up production fast - and (3) reagents.
Re: (1) The President finally implemented the Defense Production Act (yesterday) and is compelling a company in Maine to start producing 20 million swabs per month (theoretically, of course).
Re: (3) Reagents: Until now, most reagents were being produced in - you guessed it - China, which understandably stopped exporting when it was hit by Covid-19; this had a knock-on effect for Europe, which was hit next, and then for the U.S.
The production of (3) is complex and production is dominated by a small number of chemical labs which until now have had limited production. Scaling up is not as easy as it sounds in theory.
I listened to Cuomo’s presser today; he explained it pretty clearly, and by the way he departed immediately after for Washington to meet with the President to “talk testing.”
Re: technicians, it seems hard to believe Illinois (or any state) has the number of qualified lab techs needed to run the machines 24/7.
But before we get to that stage, we need to solve severe shortages - nationwide, not just in Illinois - of (1), (2), and (3).
- Pundent - Tuesday, Apr 21, 20 @ 1:57 pm:
=Since Trump claims Pritzker and Hogan do not understand what ‘capacity’ means or where labs exist, both sides keep talking past each other with no real time response.=
Sure that’s one possible solution. But that assumes that both are “correct” and simply don’t understand one another. I have a sneaking suspicion that somebody is lying here. And it would quite a yarn to suggest that it was a coordinated effort among governors from both political parties.
Here’s an analogy that some might understand. Think of the test as rifle. Now think of swabs, VTM, and reagents as ammo. The state can have 10,000 guns but it’s meaningless if they’re only able to find 100 bullets.
- Cool Papa Bell - Tuesday, Apr 21, 20 @ 2:05 pm:
That operation in Maine has already been running lights out for weeks. The guy can only get his hands on the raw materials needed to create the swabs. NPR had a great conversation with him a few weeks back.
Trump doesn’t need that company do it. He needed to tell someone else - a month ago - to do it. The problem here again is lack of federal action to back stop states and any forethought as to needed supplies ect.
And really Patriot?
=Pritzker has no clue what the real numbers are in 75% of the counties because he has decided not to allocate testing resources there.
The reality is that his briefings are pretty clear he would rather lie and release murders than deal with Rural Illinois.=
So the IDPH Strike team in a Decatur nursing home didn’t happen? State resources for testing and PPE in Randolph County didn’t happen. Just stop from being that guy.
- Demoralized - Tuesday, Apr 21, 20 @ 2:24 pm:
==The point is they wrestled it away from Trump==
They didn’t have to wrestle anything away. It was never Trump’s to begin with.
- MyTwoCents - Tuesday, Apr 21, 20 @ 4:03 pm:
Jeremy K had a good analogy, and to add on to it, there’s a real life example from WWII. Late in the war the German military was short on most supplies, particularly fuel. So they had massive amounts of equipment (tanks, planes, etc.), aka “testing capacity” but no fuel to run said equipment (”testing ability”) hence the equipment was about as useful as a pile of metal.