Coronavirus Test Questions

As the U.S. government promised to drastically accelerate the pace of testing for novel coronavirus, UMD’s top expert on viral disease transmission said the response should focus on slowing the spread of the epidemic to avoid overwhelming public health systems.

In an interview with Maryland Today, Dr. Donald Milton, a professor of environmental health, weighed on revelations that the kit devised by the Centers for Disease Control and Prevention was flawed, the potential risks of a sluggish response by the government, and the need to support public health readiness, even when dangerous disease outbreaks don't appear to be looming.

What’s behind the shortage of tests in the United States so far?
The CDC’s test is three separate tests that are rolled into one to provide multiple confirmations to be sure you’ve got what you think you have. And one of the three doesn't work. Meanwhile, even here in the U.S., there are some commercial kits that are on the market now, and that's how the case of the high school student in Snohomish County, Washington, who had not traveled, was detected last week. 

If the World Health Organization and other countries and companies have developed test, why did the CDC create one too?
The CDC has a tremendous amount of experience with developing test kits that become the standards—their flu typing kits, for example. So I was not at all surprised that they thought they ought to generate their own kit. 

So as a result, the United States is behind?
Look at South Korea, where they're testing 10,000 people a day and they are running drive-through clinics. You can drive up and get your throat swab and you'll get a text message with the results. You will also get a text message—whether you want it or not—if there's a case in your area.

What are the risks of not responding aggressively enough in terms of testing?
It's hard to slow down the epidemic if you don't know what's going on. If you've only tested five people in the whole state of Maryland, which is where we're at right now, you have no idea whether it's here and how much is here and whether we ought to be doing anything to slow it down yet.

Is this about an error creating a test, or a broader malaise about public health?
I think it's a bigger problem of disinvesting in public health infrastructure. After the Great Recession, state and local governments laid off over 50,000 public health workers that have not been hired back, which is a big part of the problem. And then the Trump administration eliminated the Pandemic Preparedness Office of the National Security Council and cut CDC's global pandemic preparedness budget. You have to invest in this during the inter-pandemic peacetime. When get into the crisis, if people aren't there, you can’t effectively prepare.

The president suggested that workers could be called back into service to help with a pandemic. Could that help?
It just doesn't work like that. You can't just call up Navy SEALs totally from reserves and send them on a mission if they’re not organized, practicing a lot and in the physical shape to do it. And it's the same thing with disease preparedness.