Speaker 1: Hi, I'm Carol Masser and I'm Jason Kelly. It's time
Speaker 1: for this week's cover story. Well, Carol, we're still at
Speaker 1: the earliest months away from a working, widely available vaccine.
Speaker 1: Until then, rapid COVID night teen tests could help close
Speaker 1: the gap between normalcy and where we are right now. Yeah,
Speaker 1: it's pretty simple, Jason. If Americans want to safely send
Speaker 1: kids to school, go to a restaurant, travel somewhere, or
Speaker 1: even host a holiday party, well, the United States needs
Speaker 1: to test a lot more people and a lot faster. Faster,
Speaker 1: cheaper testing which several companies are working on, may not
Speaker 1: flag every new case of COVID, but that shouldn't mean
Speaker 1: we should settle for the status quo that's right. At
Speaker 1: the minimum, a new approach to testing might allow us
Speaker 1: to enjoy a semblance of our normal lives. Coronavirus testing
Speaker 1: could even become a habit. If not like brushing your teeth,
Speaker 1: then at least like flossing. Check it out. If your
Speaker 1: preferred climate as business friendly, check out Ohio with zero
Speaker 1: presents taxes on corporate income, R and D investments, and
Speaker 1: good sold out of state, Ohio was better for business
Speaker 1: because Ohio was a built for followers. They're building for
Speaker 1: leaders Ohios for leaders dot com. We can still pass
Speaker 1: this test with the seasons changing and a vaccine a
Speaker 1: ways off. The US needs to dramatically improve its infrastructure
Speaker 1: for rapid COVID testing. It's got options by Drake Bennett
Speaker 1: and Michelle fay Cortes. As undergraduates returned to the University
Speaker 1: of Arizona for the fall semester, many of the new
Speaker 1: precautions were hard to miss. Plexiglass dividers were affixed in
Speaker 1: front of lecterns and between lab benches. Giant tents were
Speaker 1: set up so students arriving early for a class could
Speaker 1: wait outdoors, sheltered from the punishing sun. Roving teams of
Speaker 1: student health ambassadors tooled around in golf carts, handing out
Speaker 1: masks and politely chiding their peers for standing less than
Speaker 1: six ft apart. But the first thing students had to
Speaker 1: do was visit one of the university gyms for a
Speaker 1: rapid stars cove to test. The results took an hour
Speaker 1: negative and you could move into your residence hall right away.
Speaker 1: Positive and you were sent to a special isolation dorm
Speaker 1: where you spent the next ten days taking classes online.
Speaker 1: Many of these safety measures emerged from discussions headed by
Speaker 1: Richard Carmona, a former U S Surgeon General who is
Speaker 1: a professor of public health at the university. Carmona's medical
Speaker 1: career stretches back to the Vietnam War, where he served
Speaker 1: as a Special Forces medic after dropping out of high school.
Speaker 1: Over the years, he's developed an expertise in emergency preparedness
Speaker 1: and disaster response. As news of the novel coronavirus began
Speaker 1: making its way out of China last winter, the university's
Speaker 1: president asked Carmona to form a working group and propose
Speaker 1: ways to keep the institution functioning during a pandemic. The
Speaker 1: question was what were the metrics were going to look
Speaker 1: at and how are we going to be able to
Speaker 1: make a reasonable determination that this is somewhat safe. Carmona says,
Speaker 1: we didn't have a playbook for this. Nobody had a playbook.
Speaker 1: In early spring, the team reached out to Ian Pepper,
Speaker 1: an environmental microbiologist on the faculty who had experience with
Speaker 1: wastewater testing. It used to be called sewage surveillance, says Pepper.
Speaker 1: Now the preferred term seems to be wastewater based epidemiology.
Speaker 1: The technique traditionally has been used in population level studies
Speaker 1: of illegal drug use or viral infections. Carmona's team, however,
Speaker 1: wanted to go upstream from the treatment plant to determine
Speaker 1: not just if the coronavirus was on campus, but where
Speaker 1: the sampling would provide an early warning system. People ill
Speaker 1: with COVID nineteen can start shedding the virus in their
Speaker 1: stool as many as seven days before showing symptoms. That
Speaker 1: gives you seven precious days for intervention, Pepper says. Over
Speaker 1: the summer, Carmona poured over university blueprints with the facilities department,
Speaker 1: tracing decades old sewage pipes back to the dorms they drain,
Speaker 1: while Pepper worked on filtering samples and identifying trace amounts
Speaker 1: of the virus. By the time students returned in August,
Speaker 1: the program was in place each morning at eight thirty,
Speaker 1: an hour chosen to give residence a chance to visit
Speaker 1: the bathroom. A faculty engineer working with an underground assistant
Speaker 1: would make the rounds at each stop, prying off a
Speaker 1: manhole cover and lowering an open nalgene water bottle at
Speaker 1: the end of a long aluminum pole into the river
Speaker 1: of waste below. The pair would place the samples in
Speaker 1: a cooler and drive them back to the lab, where
Speaker 1: Pepper's crew would turn around the results by the afternoon.
Speaker 1: On Tuesday, August twenty fifth, a week and a half
Speaker 1: after students started to return, Pepper got his first positive
Speaker 1: from the pipe, leaving a dorm called Lichens Hall. The
Speaker 1: next day, all three hundred and eleven Lichens residents took
Speaker 1: COVID tests. Two students, both without symptoms, came back positive
Speaker 1: and were relocated to the isolation dorm. Thanks to the
Speaker 1: head start, no other residence would contract the virus. Since then,
Speaker 1: the university has stemmed outbreaks in at least eight other
Speaker 1: dorms using the same method. Pepper is scaling up his lab,
Speaker 1: training more teams of samplers, and expanding the effort to
Speaker 1: off campus apartments and Greek houses. He's fielding requests from
Speaker 1: around the world for help setting up similar programs. Carmona,
Speaker 1: for his part, is careful not to get ahead of himself.
Speaker 1: It's a tool that's just evolving, he says, But we
Speaker 1: see value. Ever since the novel coronavirus began circulating in
Speaker 1: the US, the country's response has been crippled by a
Speaker 1: failure to see the spread in anything close to real time.
Speaker 1: Half a year after the first wave of US lockdowns,
Speaker 1: with more than two hundred thousand Americans dead from COVID,
Speaker 1: we're still playing catch up. The Trump Administration's botched rollout
Speaker 1: of its first tests and the supply chain shortages that
Speaker 1: followed helped the disease spread unchecked. Today, processing bottlenecks still
Speaker 1: render many test results worthless by the time people get them.
Speaker 1: This blindness has left public health officials only the crudest
Speaker 1: measures of containment, such as braw add social distancing mandates
Speaker 1: and lockdowns. It's turned the loosening of restrictions on restaurants,
Speaker 1: sports offices, gems, and schools into terrifying leaps of faith,
Speaker 1: and it has surely killed people. The testing we are
Speaker 1: doing today is mostly just keeping score for the virus.
Speaker 1: Since William Hannage, an epidemiology professor at Harvard, even that
Speaker 1: grim framing gives the u S system too much credit.
Speaker 1: The Centers for Disease Control and Preventions sampling of Americans
Speaker 1: with stars COVE two antibodies shows that the true number
Speaker 1: of infections is as many as seven times higher than
Speaker 1: the official count. Over time, though, the problem of testing
Speaker 1: has attracted new focus, new thinking, and new money. Experimental
Speaker 1: viral screening technologies have taken big steps forward, and researchers
Speaker 1: have found ways to retool existing procedures. Some of that
Speaker 1: work isn't likely to pay off in time to change
Speaker 1: the course of the pandemic, but some of it already has,
Speaker 1: and the outbreak's global scale has rd epidemiologists and policymakers
Speaker 1: to seek better answers to fundamental questions about the management
Speaker 1: of a modern plague, not only how to test, but
Speaker 1: whom to test and why. Those debates are particularly vital now.
Speaker 1: The number of new US COVID cases, which peaked this
Speaker 1: summer before dropping significantly, is climbing again. The c d
Speaker 1: c's seven day moving average rose from thirty four thousand,
Speaker 1: three D seventy one on September twelve to forty four thousand,
Speaker 1: three D seven on September Colder weather and classroom reopenings
Speaker 1: threatened an explosion of cases at a time when the
Speaker 1: public has tired of social distancing's heavy costs, and we're
Speaker 1: still at the earliest months away from a working, widely
Speaker 1: available vaccine. Until then testing can help close the gap
Speaker 1: between normalcy and where we are. If Americans want to
Speaker 1: safely send kids to school, eat in a cafe, go
Speaker 1: to a basketball game, or get on a plane, the
Speaker 1: US needs to test a lot more people, a lot faster, faster, cheaper.
Speaker 1: Testing may not flag every new case of COVID, but
Speaker 1: that shouldn't mean settling for the current level of blindness
Speaker 1: with its tortuous drip of preventable deaths. Even world class
Speaker 1: testing won't rid us of the virus, but it can
Speaker 1: allow us to live our lives in the meanwhile. Well
Speaker 1: before this year, the US had ample warning about the
Speaker 1: health care system's vulnerability to a pandemic. An industry long
Speaker 1: kept as lean as possible, lacked the personnel and hospital
Speaker 1: beds needed to respond to a national crisis, let alone
Speaker 1: the protective gear and ventilators. The coronavirus requires. Testing was
Speaker 1: the one thing the US had supposedly handled. The c
Speaker 1: DCS early warning system for epidemics, based on reports from
Speaker 1: medical professionals all over the country, was designed to spot
Speaker 1: new diseases in time to head off bigger problems, and
Speaker 1: the technology to create tests for new viral diseases is
Speaker 1: so straightforward. It can really be done in a few days.
Speaker 1: When the time came, though, the apparatus worked against itself.
Speaker 1: After its Chinese counterparts published stars Cove two's genetic sequence
Speaker 1: on January eleven, the CDC did indeed create its own
Speaker 1: test in a matter of days, but because of regulatory
Speaker 1: requirements and limited access to the relevant viral samples, the
Speaker 1: agency's Atlanta headquarters was the only place it could be done.
Speaker 1: In early February, the CDC produced tests that state labs
Speaker 1: around the country could use, but they were faulty and
Speaker 1: returned in conclusive results. Public and private clinical labs rushed
Speaker 1: to fill the void, only to be stymied by the
Speaker 1: Food and Drug Administration, which demanded extensive data and a
Speaker 1: regulatory submission before authorizing alternatives. By early March, the US
Speaker 1: was struggling to run one thousand tests a day, while
Speaker 1: South Korea, which confirmed its first case the same day
Speaker 1: the US did, was running ten thousand. By the end
Speaker 1: of that month, lab giants, ab Labs, hal Logic Lab, Corps,
Speaker 1: Quest Diagnostics, and Roche had rolled out US tests of
Speaker 1: their own, but at one to a hundred and fifty
Speaker 1: dollars apiece, they were expensive and labs were short on
Speaker 1: technicians trained to run them. Long complex supply chains led
Speaker 1: to further shortages from the swabs needed to gather nasopharyngeal
Speaker 1: samples to the reagents used to process the tests. The
Speaker 1: tests in use at the time were molecular diagnostics known
Speaker 1: as polymerase chain reaction tests, performed by medical professionals and
Speaker 1: processed in specialized labs. PCR tests identify segments of a
Speaker 1: virus's genetic material in secretions swabbed from the back of
Speaker 1: a patient's throat or nose. The process starts with enzymes
Speaker 1: being added to the sample, which is then repeatedly heated
Speaker 1: and cooled to create billions of copies of the viral genome.
Speaker 1: Special probe molecules bind to the copy genetic material, releasing
Speaker 1: fluorescing nanoparticles whose globe signals the virus's presence. Used everything
Speaker 1: from food safety to DNA profiling. PCR tests take several
Speaker 1: hours and are extremely sensitive. If the virus is present
Speaker 1: in a sample, even in infinitesimal amounts, PCR will find
Speaker 1: it to public health officials. In the early days of
Speaker 1: the pandemic, reliability seemed like the most important quality, but
Speaker 1: the hospitals, dodgers offices, and pop up testing facilities where
Speaker 1: PCR tests are given often don't have the equipment to
Speaker 1: process the results on site. The thermo cycler that incubates
Speaker 1: the samples costs at least a hundred thousand dollars, so
Speaker 1: the swabs are usually sent out. That's resulted in massive
Speaker 1: backlogs and severely limited the tests usefulness. There are alternatives. One.
Speaker 1: A lateral flow test is a disposable strip of cellulose
Speaker 1: or woven fiber picture a home pregnancy test. Instead of
Speaker 1: looking for viral DNA or RNA, it identifies proteins called
Speaker 1: antigens that protrude from the virus capsule. It exploits the
Speaker 1: lock and key relationship between those molecules and the antibodies
Speaker 1: the human immune system makes to identify them. Lateral flow
Speaker 1: tests can be done on nasal swabs, but some are
Speaker 1: in development to work with saliva. The sample is deposited
Speaker 1: at one end, doused with liquid, and then spreads through
Speaker 1: the fiber by capillary action, like a spill infusing a sponge.
Speaker 1: As it advances, the solution flows over antibodies embedded in
Speaker 1: the fiber with nanoparticles of gold or dye grafted onto
Speaker 1: them as tags. If the virus is present in the sample,
Speaker 1: the antibodies latch on and are carried along until the
Speaker 1: virus antibody pair encounters a second set of antibodies anchored
Speaker 1: in a line. Those two grab onto the target viruses,
Speaker 1: activating the tags on the antibodies that hitch deride earlier.
Speaker 1: As more virus rich liquid reaches the line, the tags,
Speaker 1: like millions of microscopic pixels, form the telltale stripe of
Speaker 1: a positive result. The whole process can take as little
Speaker 1: as fifteen minutes or Assure Technologies has long sold lateral
Speaker 1: flow tests for habititis C and HIV. In twenties seventeen,
Speaker 1: it created the only FDA approved ebola antigen test. The
Speaker 1: company is based in Bethlehem, Pennsylvania, but sells many of
Speaker 1: its fast, cheap, over the counter diagnostics in sub Saharan
Speaker 1: African nations that lack the medical infrastructure for PCR testing.
Speaker 1: At the beginning of this year, with the U S
Speaker 1: struggling to create reliable tests and its most advanced labs overwhelmed,
Speaker 1: chief executive Officer Stephen Tang saw the parallels we have
Speaker 1: to repatriate our experience from low and middle income countries.
Speaker 1: He says, you have a test that is rapid, that
Speaker 1: you can take by yourself, that doesn't require an instrument
Speaker 1: to read or a medical professional to administer. What we
Speaker 1: have learned from experience is that people will test themselves
Speaker 1: more frequently in the privacy of their own homes. Tang
Speaker 1: plans to build on the company's HIV test platform to
Speaker 1: bring an at home COVID test to market before the
Speaker 1: end of the year. While the HIV test costs forty
Speaker 1: to fifty dollars in a U S pharmacy, the company
Speaker 1: promises its coronavirus test will be cheaper. Other strip test
Speaker 1: makers have also prioritized the pandemic. Eive Bio, a startup
Speaker 1: born in an m I T lab two years ago,
Speaker 1: has temporarily shifted its focus from epidemic fever viruses such
Speaker 1: as dingey and zica with COVID. There have been maybe
Speaker 1: fifty million infections worldwide, says CEO Bobby Brooke Herrera. Dinge
Speaker 1: causes four hundred million every single year. Like Tang, Herrera
Speaker 1: has been trying to apply lessons from countries with threadbare
Speaker 1: public health systems to those like the US he's in
Speaker 1: discussions with US regulators to authorize a coronavirus strip test
Speaker 1: made to be processed in a lab. Once it reaches
Speaker 1: the market, he says a home version will be next established.
Speaker 1: Testing companies are already bringing lateral flow tests to market.
Speaker 1: On August, Abbott Laboratory Is announced that the f d
Speaker 1: A had awarded it an emergency use authorization for bin as,
Speaker 1: now a fifteen minute disposable antigen test priced at five dollars,
Speaker 1: A so called point of care test, it must be
Speaker 1: given by a health professional, but since it requires no
Speaker 1: lab equipment, an unlimited number can be conducted and processed
Speaker 1: at any given time. Abbott is already producing fifty million
Speaker 1: of them a month. A test's accuracy is a matter
Speaker 1: of sensitivity, how often it correctly spots a disease, and specificity,
Speaker 1: how often it correctly rules the disease out. A test
Speaker 1: with low sensitivity will miss a lot of cases. A
Speaker 1: test with low specificity will mistakenly tell people they have
Speaker 1: a disease when they don't. Lateral flow tests are neither
Speaker 1: as sensitive nor as specific as PCR tests. They're more
Speaker 1: likely to miss an infection during the incubation period as
Speaker 1: the invader has just started replicating, or weeks in when
Speaker 1: the body's immune response has managed to eliminate many of
Speaker 1: the virus particles. Lateral flow tests lower sensitivity has hampered
Speaker 1: efforts to bring them to market. There are concerns that
Speaker 1: tests done at home, where people swab their own noses
Speaker 1: instead of having a professional du it or at least supervise,
Speaker 1: could further lessen the sensitivity. Herrera says he doubts E
Speaker 1: twenty five bios at home test will be approved without
Speaker 1: a change in expectations from the FDA, which requires accuracy
Speaker 1: levels difficult for him to achieve outside a lab or.
Speaker 1: Asher says it's confident it concluded the bar. Some companies
Speaker 1: are trying to address this shortcoming technologically. Mammoth Biosciences, working
Speaker 1: with a microbiologist named Charles Chew at the University of
Speaker 1: California at San Francisco, is using the DNA splicing technology
Speaker 1: Crisper to improve the accuracy of strip tests. Crisper's potential
Speaker 1: for precise gene editing rests on its use of sequences
Speaker 1: of guide RNA that zero in on target genes. Chew
Speaker 1: and a meth are turning that search engine property to
Speaker 1: the task of finding the telltale genome of SARS cove two.
Speaker 1: The effort is taking two parallel paths. One that the
Speaker 1: FDA cleared this summer runs on the same equipment as
Speaker 1: PCR tests, but it copies the viral genetic material without
Speaker 1: the time consuming heating cycles. The other, in development with
Speaker 1: Glaxo Smith Klein manages to replicate this approach with the
Speaker 1: attendant sensitivity in a self contained and disposable kit. Not
Speaker 1: unlike a lateral flow test. You're getting the same accuracy
Speaker 1: as in the lab, but it's much easier to use,
Speaker 1: says CEO Trevor Martin. Another school of thought, though, holds
Speaker 1: that worries about the sensitivity of strip tests missed the point.
Speaker 1: The way we've been approaching testing so far in this
Speaker 1: epidemic is to try to shove a public health need
Speaker 1: through a diagnostic pathway, says Michael Mina, the Harvard epidemiologist
Speaker 1: who is the leading proponent of this idea. Mina argues
Speaker 1: that we should essentially test everyone, all the time, everywhere.
Speaker 1: It's a form of what public health experts call surveillance
Speaker 1: rather than diagnostic testing. In this model, speed and ubiquity
Speaker 1: are all that matter, Mina likes to talk about what
Speaker 1: would happen if we had one dollar self administered saliva tests.
Speaker 1: Restaurants and bars would have cups of strips on the
Speaker 1: major dast end by the toothpicks and the mints. Theaters
Speaker 1: would have them at the door. Air travelers would be
Speaker 1: tested at their departure gate before boarding. The International Air
Speaker 1: Transport Association recently announced its determination to put a system
Speaker 1: like this in place. Coronavirus testing would become a habit.
Speaker 1: If not like brushing our teeth, then at least like flossing.
Speaker 1: These tests would be much more reliable than temperature checks,
Speaker 1: which can miss carriers with mild or non existent symptoms.
Speaker 1: At a large enough scale and a high enough frequency,
Speaker 1: the thinking goes, testing is all you need to do.
Speaker 1: Tests at the entrance to offices and schools would visibly
Speaker 1: ensure the safety of those spaces encourage people to return
Speaker 1: to them. People who test positive could immediately isolate themselves,
Speaker 1: breaking the chain of transmission. In this world, a strip
Speaker 1: test's relative insensitivity would be less of an issue. Positives
Speaker 1: could be double checked to make sure they're correct, and
Speaker 1: false negatives would be caught. A day or two later
Speaker 1: by the next test, still early in the disease course.
Speaker 1: Mina goes so far is to characterize lower sensitivity as
Speaker 1: an asset because a PCR test taken in the late
Speaker 1: stages of COVID nineteen will still show positive even if
Speaker 1: the patient is well past the contagious stage and no
Speaker 1: longer needs to be isolated. In that sense, he argues,
Speaker 1: strip tests can better gauge in individual's risks to the
Speaker 1: broader population. I don't want to see these kinds of
Speaker 1: tests being promoted as passports to party or to go
Speaker 1: out to dinner. That misses the big picture. The epidemiologist says,
Speaker 1: these aren't passports. These are actually the intervention lack of
Speaker 1: vaccine to suppress population spread. According to his Budeling, testing
Speaker 1: just half the population every three days would bring COVID
Speaker 1: under control within weeks. To make this a reality, the
Speaker 1: FDA would need to relax its testing standards down from
Speaker 1: PCR level sensitivity, and someone would need to manufacture and
Speaker 1: pay for the untold billions of tests. Mina believes it
Speaker 1: should be Congress. This is a national emergency, he says,
Speaker 1: and a fifty billion dollar or one billion dollar price
Speaker 1: tag to stop the virus is easily worth it, given
Speaker 1: that the US has already spent three trillion dollars in
Speaker 1: COVID related stimulus money and its economy has lost trillions more.
Speaker 1: At least one of the two men running for president
Speaker 1: has unequivocally committed to more testing. The first point in
Speaker 1: Joe Biden's seven point COVID plan is to ensure all
Speaker 1: Americans have access to regular, reliable, and free testing. The
Speaker 1: plan mentions at home and instant tests and proposes a
Speaker 1: testing board modeled on Franklin D. Roosevelt's War Production Board,
Speaker 1: which oversaw the Manu facture of weapons and supplies that
Speaker 1: helped win World War Two. President Trump has publicly called
Speaker 1: for less testing, and his CDC recently said asymptomatic people
Speaker 1: who've had contact with a sick person don't need to
Speaker 1: be tested. Most public health experts strongly disagree, and the
Speaker 1: agency has since reversed that guidance. On the other hand,
Speaker 1: the day after ABBOT unveiled its lateral flow kits, the
Speaker 1: U S Department of Health and Human Services announced a
Speaker 1: deal to buy and deploy one fifty million of them,
Speaker 1: and the agency is already distributing a different type of
Speaker 1: antigen tests to nursing homes across the country. Of course,
Speaker 1: all of this is a fraction of what Mina's plan
Speaker 1: would require. Among his fellow epidemiologists and public health experts,
Speaker 1: Mina's plan does have skeptics. Without reimbursement, the price of
Speaker 1: even very cheap tests might be a challenge for some
Speaker 1: families and organizations. New York City School system has more
Speaker 1: than one million students. The production of billions of new
Speaker 1: tests could create supply chain problems of its own, and
Speaker 1: the millions of false positives and negatives that would be
Speaker 1: produced at that scale could further undermine American's shaky confidence
Speaker 1: in their public health system, a dangerous prospect in a
Speaker 1: country where large numbers already refused to wear masks. There's
Speaker 1: also no mechanism to compel people who test positive at
Speaker 1: home to stay there, especially if they're living paycheck to
Speaker 1: paycheck without paid sick leave. It's our failure to act
Speaker 1: on the test results we have that has been the problem,
Speaker 1: these skeptics, argue. As Henage, Mina's colleague at Harvard, points
Speaker 1: out South Korea succeeded in corralling the virus by relentlessly
Speaker 1: tracking down those put at risk by each discovered case,
Speaker 1: not by reinventing testing. All of these extraordinarily smart people
Speaker 1: are coming up with extraordinarily smart things, Hennage says, and
Speaker 1: we haven't done the basic things right. Whether or not
Speaker 1: MINA can sell the idea of regular tests for all
Speaker 1: the imports of faster, more widespread surveillance testing has become clear.
Speaker 1: Such a model could use strip tests if they can
Speaker 1: be scaled up, or it could rely on methods such
Speaker 1: as pooling combining multiple samples to increase the throughput of labs.
Speaker 1: Hann Edge is particularly excited about the potential of wastewater. A.
Speaker 1: Shish Jaw, a physician and the dean of the Brown
Speaker 1: University School of Public Health, is among the scholars who
Speaker 1: have tried to calculate how many tests the country actually
Speaker 1: needs early in the pandemic. His team came up with
Speaker 1: a range of five hundred thousand to six hundred thousand
Speaker 1: per day. Those estimates, though assumed that positive results would
Speaker 1: be followed by South Korea style contact tracing. So far,
Speaker 1: such programs have largely failed in the US, and Jaw
Speaker 1: is reassessing. I have increasingly come to believe that a
Speaker 1: large army of contact tracers may not work in our country,
Speaker 1: he says, and that will need large scale surveillance testing
Speaker 1: as a strategy for building a high degree of safety
Speaker 1: into a lot of our activity these Jaw's new approach
Speaker 1: focuses less on how many tests the nation needs than
Speaker 1: on where they're needed. Nursing homes and hospitals are places
Speaker 1: where people should be tested all the time, he argues.
Speaker 1: With meat packing plants, prisons and schools close behind, you
Speaker 1: could make the case for any place where you can
Speaker 1: get large numbers of people gathering indoors for extended periods.
Speaker 1: He says. My argument has been that we have to
Speaker 1: make decisions if we don't have tens of millions of
Speaker 1: tests a day, and we don't who do we want
Speaker 1: to leave out. The American healthcare system, with its balkanized
Speaker 1: tangle of private and public providers, consumers, and often reluctant reimbursers,
Speaker 1: is structurally resistant to nationwide interventions. With a few exceptions,
Speaker 1: we don't have a national or even a statewide public
Speaker 1: health infrastructure that scales to administering many many procedures directly
Speaker 1: to patients, says Katerine Hempstead, a healthcare policy adviser at
Speaker 1: the Robert Wood Johnson Foundation. It's possible that an imagined
Speaker 1: pandemic testing board on a war footing could overcome some
Speaker 1: of those limitations. If not, and at least until then,
Speaker 1: it's likely that the US will see the uneven growth
Speaker 1: of the patchwork testing quilt. We already have individual companies, schools,
Speaker 1: even states could put together effective testing programs while other
Speaker 1: efforts fail. In August, a group of governors announced to
Speaker 1: joint effort with the Rockefeller Foundation to purchase millions of
Speaker 1: antigen tests. The patchwork model means gaps, blind spots, and inequity,
Speaker 1: but it will nonetheless embed the idea of disease surveillance
Speaker 1: in our lives long after this pandemic is over. One
Speaker 1: of the problems that's bedeviled the u S response at
Speaker 1: every level is the nation's short attention span. Public and
Speaker 1: private funding goes to swine flu or zeca or ribola,
Speaker 1: then evaporates once the immediate danger has passed. It's short sighted.
Speaker 1: The fact that we only deal with the outbreak of
Speaker 1: the day says you see s F. S. Chew. Had
Speaker 1: we had ongoing funding to do diagnostics for zeka, maybe
Speaker 1: the tests that we're now struggling to develop in real time,
Speaker 1: would have already been developed. Even the terrible costs of
Speaker 1: COVID probably won't curb these human tendencies, but more durable
Speaker 1: changes might help. In Arizona, Carmona has been meeting with
Speaker 1: architects trying to figure out how to design buildings with
Speaker 1: wastewater epidemiology in mind. One of their goals is to
Speaker 1: enable future sewage samplers to trace pathogens not just to
Speaker 1: a building, but to individual floors or even rooms. It
Speaker 1: may be what we're going to need in the future,
Speaker 1: Carmona says, we probably will have other biologic hazards. Maybe
Speaker 1: not a pandemic, but it could be an epidemic or
Speaker 1: just an outbreak where you'd like to know where the
Speaker 1: sick people are. That's the cover story in the magazine
Speaker 1: this week, and you can find the magazine on newsstands.
Speaker 1: It's also online at Bloomberg dot com and of course
Speaker 1: on the Bloomberg terminal. I'm Carol Masser and I'm Jason Kelly.
Speaker 1: Check us out every day on the radio are Bloomberg
Speaker 1: Business Week Radio show starts at two pm Wall Street Time,
Speaker 1: Monday through Friday, or check us out on our podcast feed.
Speaker 1: This is Bloomberg