From the WebMD Archives

April 21, 2020 - The U.S. has the testing capacity to move into the first phase of rolling back stay-at-home orders for COVID-19, the White House Coronavirus Task Force said Monday, reemphasizing the same announcement made Friday.

“By our best efforts, we have the testing capacity today to go to phase 1,” Vice President Mike Pence said during the daily press briefing.

To use the full capacity, however, state and local governments must tap into the facilities near them. Earlier in the day on Monday, Pence held a conference call with governors to talk about the laboratories and testing facilities in their states.

“It’s important to know where they are so hospitals and labs can support each other,” said Deborah Birx, MD, the task force coordinator.

Also during the briefing, President Donald Trump held up a thick print-out that listed 5,000 testing facilities across the country.

To enter Phase 1 of the three-phrase White House federal guidelines for reopening, states must have 14 days of reduced COVID-19 cases and the hospital capacity to treat all COVID-19 patients without crisis care. Phase 1 requires that vulnerable people continue to shelter-in-place, restricts gatherings to 10 people and minimizes non-essential travel.

In Phase 1, states should be able to test those with COVID-19 symptoms and vulnerable groups such as nursing home residents and underserved groups in urban areas, Admiral Brett Giroir, assistant secretary for health at the Department of Health and Human Services, said during the briefing.

“We need to test everyone who is symptomatic, and we want to over-test them,” he said.

During the briefing, Giroir and Brad Smith, director of the Center for Medicare and Medicaid Innovation, discussed the supplies needed for COVID-19 tests, including the swabs, collection tubes, transport media and extraction media needed to collect and process tests. Several companies have converted their operations to produce more swabs and tubes, they said, and now states must connect with local laboratories to process more tests.

“We had end-to-end issues” with supplies, Giroir said. “The tests are in the marketplace, but the machines are not being utilized to their fullest.”

Although the testing capacity may be available, states may face obstacles in using non-clinical laboratories, such as university or federal laboratories, to process tests.

“Part of the reason is long-standing regulation that separates research from clinical care,” Harvey Fineberg, the chair of the National Academies of Sciences, Engineering, and Medicine's Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats, said Monday on NPR’s Morning Edition.

“But also, part of the problem is that hospitals do not have the standard operating procedures, the transport systems, the billing and connections to their information on medical records that would allow them easily to use nontraditional sources of testing,” he said. “The second part is that testing is not distributed, you know, even enough to be available yet everywhere. That is a serious concern for many communities.”

On the Monday conference call with governors, Pence said an email was sent to state officials with details about the testing capacity in each state. Gov. Larry Hogan (R-Maryland) said the unused lab machinery listed for his state was in federal and military labs that the state can’t access, according to The Baltimore Sun. During the briefing that evening, Pence said the facilities would be made available for testing.

“We will make all of those laboratories available across the country to every state as the need for testing capacity continues to scale,” Pence said.

Several public health experts have estimated that COVID-19 testing should be doubled or tripled to reopen the economy, according to NBC News.

“We need to deliver 5 million tests per day by early June to deliver a safe social reopening,” according to a report by Harvard University’s Edmond J. Safra Center for Ethics, which was published Monday.

“This number will need to increase over time (ideally by late July) to 20 million a day to fully remobilize the economy,” the report states.