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The U.S. Is Not Testing Enough To Know The Progress Of The Virus

Right now in the United States, it’s not possible to say where the virus is, much less where it isn’t.
The U.S. Is Not Testing Enough To Know The Progress Of The Virus
Drive-through test facility in Goyang, north of Seoul, on February 29, 2020. Image from: Getty Images

In the early days of computers, there was a game known as “Hunt the Wumpus.” The game, which was well-suited to computers that had far less memory than a modern calculator and whose display might have been nothing more than a paper print out, was very simple: You are trapped in a maze. Somewhere in the maze with you is a monster known as “the Wumpus.” To win you try to locate the Wumpus, identifying its location by carefully probing around the maze, using where the Wumpus isn’t to determine where it is. Millions of children around the world have had a similar experience with the game “Battleship,” in which they try to suss out the hidden contours of an enemy fleet. Every blue “miss” is, in its way, as valuable as a “hit.”

When it comes to COVID-19, the same game is underway right now, only it’s not plastic pegs or computer coordinates searching out the enemy, it’s nasal swabs and test kits. And it’s not bragging rights at stake, it’s human lives—large numbers of human lives. Which makes it so horrible to watch how this is being handled.

Every day since the beginning of the COVID-19 epidemic, there seems to have been an onslaught of numbers. Cases in China, cases in South Korea, cases in Italy, deaths around the world. For those who have reported on the virus, keeping up with the daily announcements from affected countries has swiftly become impossible. This has meant they must depend on daily situation reports from the World Health Organization along with news sites like BNO News and tabulating pages such as Worldometer to find the most recent numbers when it comes to the progress of the fight against COVID-19 in nations around the world.

There are some countries that provide fantastically detailed and transparent reports; Singapore, for example, has a marvelously detailed dashboard that goes right down to each individual case. It’s possible to see where the cases are located, the loads on various hospitals, the age and sex of victims—just about everything you might want to see. And one click gets you to the Ministry of Health, where information almost as detailed is available about the extensive and ongoing testing program that has helped keep the level of COVID-19 in Singapore at just 401 active cases despite playing host to some of the first cases outside China.

Other countries, such as Iran, provide information, but it’s impossible to tell whether that information is more like disinformation. The 27,000 cases and 2,200 deaths reported there now may be fairly accurate, but the information provided in the first weeks of the epidemic was so clearly false that it’s difficult to tell for sure.

Then there’s the United States. Or rather, there isn’t the United States. There’s a page devoted to Coronavirus Disease 2019 statistics at the CDC, but this page is uniformly behind, rarely updated more than once a day, and—incredibly at this point—still not updated on weekends. It features a particularly intriguing bit of information in giving the date that confirmed patients first reported symptoms. Otherwise it’s so lacking that even if all the embedded links are followed, anyone trying to get a glimpse of what’s happening in the United States has only one real choice—go to the individual states.

That’s what the people at the COVID Tracking Project have done. They’ve sifted the information, state by state, in an attempt to learn exactly what’s happening at a state level.

The data at the state level within the United States varies at least as much as it does at the national level around the world. There are sites like Illinois or Kentucky that offer accurate, regularly updated information, including showing cases by county, the number of tests conducted, and the results of those tests. There are also states like Missouri that offer pretty much nothing, forcing anyone who wants information to go down to the county level, or sift through local media to find any announcements. The COVID Tracking Project gives Missouri a very generous “C” when scoring their site. By any objective measure, it’s an absolute failure, and it’s just one of many.

As The New York Times reported, the roll out of testing in the United States was an “epic failure.” Now Donald Trump is arguing that the U.S. has out-tested South Korea. South Korea used 300,000 tests to “hunt the virus” in that country, tracking it down with a combination of targeted testing, public sampling, and a dogged system of case tracking, source identification, and isolation. As Reuters reported on March 18, South Korea “trounced” the United States when it came to testing.

It did so not just by getting a jump on the United States when it came to rolling out those tests, and not just by testing at a rate that is five times greater when compared to the size of the population. It did so by understanding that the negatives are as valuable as the positives—that you hunt the Wumpus by knowing where it is not.

According to the COVID Tracking Project, the United States has now roughly equaled South Korea when it comes to the total number of tests. Across all the states, there have now been 380,000 tests. South Korea had tested at least 290,000 people a week ago. But it’s not just that the population of South Korea is only 55 million compared to the 327 million in the United States. There’s also this: Of the 290,000 tests deployed in South Korea, over 280,000 are negative. That’s a ratio of over 30 negatives for every positive.

South Korea has not only identified and isolated the confirmed cases, it also knows that there is not a huge number of undetected cases lingering in its population. At the same time, it continues to conduct public screenings, directed tests, and careful follow-ups.

Meanwhile in the United States, the ratio of negatives to positives is just 5:1. On a population basis, the United States has tested less than one fifth of the number that have been tested in South Korea. On the basis of determining the real scale of the infection, it’s done about 1/30th of the necessary work. That kind of number is necessary because the United States took so long to get started and flubbed its test rollout so badly. And because, at this stage, new cases are popping up a rate that makes it clear we’re still discovering pools of unknown infection in the country.

And there are states like Maryland, where—so much as it’s possible to tell—four tests out of five have been positive. On the scale where Missouri gets a C, Maryland gets a still-generous D in terms of the information it provides. And speaking of Missouri, the total number of tests recorded is only 624, of which 255 were positive. That’s not even hunting for the virus, that’s putting a hand over your eyes and hoping it goes away. Still, it might be better than Ohio, where the 704 total tests including a staggering 564 positives.

Right now in the United States, it’s not possible to say where the virus is, much less where it isn’t. And until both things are possible—a task that will now require millions of tests—real action to suppress the virus in a way that doesn’t also require draconian measures isn’t possible.

Until recently, it wasn’t practical to include China on the chart with other nations because it so distorted the scale that it made it difficult to see what was going on elsewhere. Sadly, that’s no longer true. The curves in Europe and the United States make it clear that what’s happening in this third round of COVID-19 is fundamentally different than events in either China or South Korea. And what’s happening in the United States is different than what is happening anywhere else—where “different” also means “worse.”

Published with permission from Daily Kos.

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