US coronavirus testing kicks into high gear as state governors cite continued problems

Bhavan Jaipragas

The Trump administration’s top official in charge of coronavirus testing said on Thursday the US had “effectively transitioned” to large-scale testing with more than 10 million diagnostic kits now in stock and drive-through testing available in a dozen states, setting authorities up to expand rapidly in the coming days.

The remarks, by US “testing tsar” Brett Giroir in a teleconference with state governors, suggest progress after last week’s scramble by the administration to fix shortages and defects in its testing regime – and that American authorities may soon have the broad surveillance capacity used by South Korea, Singapore and Hong Kong to contain the outbreak.

“We're very effectively transitioning to large-scale testing by leveraging all the components in the American health care system, including CDC and the state public health labs, health care and hospitals, and large commercial labs,” Giroir said, adding that some 103,000 tests had been conducted as of Thursday.

About 45,000 of them were done in government labs, including in US Centres for Disease Control and Prevention (CDC) facilities, and 63,000 carried out by private labs. The figures are markedly higher than Tuesday’s total of 58,878.

US “testing tsar” Brett Giroir, assistant secretary for health, at a teleconference with state governors on Thursday. Photo: EPA-EFE

The US supply of test kits is also on the rise, thanks to the involvement of private labs and the lifting of bureaucratic red tape, said Giroir, an assistant secretary in the Department of Health and Human Services.

The Trump administration has faced sharp criticism over limited testing capacity, which was first encumbered by a faulty government-designed test kit and rules preventing the private sector from playing a substantial role.

The Food and Drug Administration (FDA) lifted a key regulatory hurdle on February 29, paving the way for the current surge.

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While officials earlier suggested the country would have five million tests by next week, Giroir said 10.4 million diagnostic kits were available nationwide, as of last weekend. By March 28, that figure is expected to rise to 27.6 million, he said.

Mobile testing, the much vaunted approach used by South Korea – where individuals can quickly provide a throat or nasal swab without leaving their cars, is now up and running in 47 sites across 12 US states, Giroir said. “More than a dozen” states will begin mobile testing on Friday, he said.

Giroir, who was appointed as the administration’s de facto “testing tsar” last week, was speaking at a teleconference at the Federal Emergency Management Agency (FEMA) in Washington, attended by President Donald Trump, Vice-President Mike Pence and members of the White House Covid-19 task force.

Governors who spoke during the nearly hour-long teleconference acknowledged the increase in available tests, but said capacity was still lagging.

J.B. Pritzker, the Democratic governor of Illinois, said he was facing problems procuring reagents and swabs needed for the tests, and suggested they may be “monopolised” by the federal government for its mobile testing programme.

Giroir rebuffed that claim, saying the supplies were readily available on the commercial market and the administration was ready to help states source them.

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Some governors have complained that, along with the previous hiccups with testing, one of the shortcomings of the federal government’s response to the crisis has been an inadequate response to requests for help with procurement.

Asked about the issue in a press conference earlier on Thursday, Trump questioned why states needed the administration’s help to buy these supplies when they had been doing so on their own all this time. “We are not a shipping clerk,” he said.

Also in focus on Thursday was confusion over Trump’s comments that an antimalarial pill in use for decades had been given “immediate” approval by the FDA for use as a therapeutic for Covid-19. In his daily press conference alongside members of the task force, Trump touted the drug – chloroquine and its derivate hydroxychloroquine – as a “game changer”.

“They’ve gone through the approval process, it’s been approved. They took it down from many, many months to immediate, so we’re going to be able to make that drug available by prescription,” Trump said.

But speaking after Trump, the FDA commissioner Stephen Hahn contradicted the president. He said that, while the drug was being legitimately used “off label” by some physicians to treat Covid-19 patients on a compassionate basis, a clinical trial was still required before the FDA approved the drug’s use as a coronavirus therapeutic.

Off label usage refers to the practice of physicians prescribing approved drugs for unapproved purposes or to unapproved groups, based on their judgment that it may have a therapeutic effect. The practice is legal.

Trump again repeated the claim in the afternoon teleconference with the governors, praising Hahn for approving it “very quickly”.

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In a statement later in the day, the FDA released a statement clarifying that it was continuing to work with other agencies and academic institutions to study the effect of the antimalarial drug on Covid-19 patients.

It said that, while there were “no FDA-approved therapeutics or drugs to treat, cure or prevent Covid-19, there were several FDA-approved treatments that may help ease the symptoms from a supportive care perspective”.

Chloroquine is produced by several pharmaceutical companies including Sanofi SA, which brands the drug Plaquenil.

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The Financial Times reported on Thursday that the New Jersey-based Rising Pharmaceuticals – the only US manufacturer of the drug – raised its price by nearly 100 per cent in January. The drug price rose 97.86 per cent to US$7.66 per 250mg pill and US$19.88 per 500mg pill.

The company told the Financial Times the price rise was “coincidental”, and restored the previous price once it noticed the spike in demand.

Countries, including Thailand and India, are reportedly using chloroquine on Covid-19 patients.

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