Harvard University epidemiology professor Marc Lipsitch warned that there is a significantly larger number of people with the coronavirus or COVID-19 than the public thinks that there is.
In a Washington Post editorial, he sounded the alarm that there must be more testing so that Americans can act with more responsibility and care.
He explained that reporters are all asking the same questions about test kits and isolation, which prompted him to issue a blanket editorial to explain the way things should be moving in an ideal world where the virus is taken more seriously than it currently is.
“In one respect, the answer is the same for all of them: We must vastly expand our testing capacity,” he wrote. “No country has controlled transmission effectively without massive testing capacity. The United States currently has a sliver of the capacity we need, which is a tiny fraction of that available in other countries. South Korea has performed over 320,000 tests — almost one for every 150 people. That is 30 times the testing per capita that we have done in the United States. Exceptional teams are racing to solve testing bottlenecks at local and state levels — Massachusetts is just one example — filling the vacuum left by the complete absence of federal leadership.”
He said that regulations and technical problems have caused delays but now that we’re past them, there should be mass testing. There isn’t. Now there’s an equipment problem.
“We don’t have enough protective equipment for testers, nor swabs for sampling or reagents to extract genetic material from the virus,” he explained. “We don’t have enough physical test kits, or enough human power to run large-scale testing. The result is that we have no idea how many people are infected with the coronavirus or how fast the virus is spreading.”
When it comes to controlling the country or even a community, he said that isolation continues to be key in stopping transmission and keep from overwhelming our healthcare system.
“Containment can work when there are few enough cases that the public health system is able to deal with them and their contacts, so that the workload is manageable, and when a large fraction of cases are tested and identified, so that preventing them from infecting anyone else dramatically reduces the total amount of transmission,” he explained.
Of course, things in the U.S. are different from places like Italy and Spain, who have managed to shutdown the entire country.
“The feckless federal response created such delays in testing that most cases here are not being confirmed, even now. We don’t know even approximately how many people are infected, but it’s certainly more than the current count of more than 35,000 confirmed cases. Even though many places are reporting relatively small numbers of confirmed cases, this is not comforting. In many parts of the country, we are seeing rising numbers of flu-like illnesses that when tested, are not flu, and may well actually be covid-19 if only we could test them.”
It’s for this reason that so many epidemiologists believe that the majority of the coronavirus cases are going undiscovered. He said that he doesn’t even believe the U.S. will ever really find all of the cases that exist because it simply can’t get mass testing to happen.
“If we can scale up testing and reduce case numbers through effective social distancing, we should consider testing very widely and resuming isolation and tracing, which work best in synergy with social distancing,” he encouraged. “For now, testing priority should go to hospitalized patients and health-care workers (to protect them from infecting one another) and to surveillance to estimate the prevalence of mild infection in the community.”
Until the U.S. reaches this point, he said that the government will be forced to answer why tests are only available for the sickest of patients.