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Widespread testing a barrier for reopening country as White House seeks plan

White House aides scramble to ramp up testing in the U.S., but there's no clear plan yet.
Image: Hospital Offers Coronavirus Antibody Tests, But Health Authorities Urge Caution
A health worker extracts blood from a patient to perform an antibody test for COVID-19.Omar Marques / Getty Images

WASHINGTON — The White House is exploring ways of drastically increasing coronavirus testing in the U.S., as President Donald Trump’s aides scramble to put measures in place that might make it feasible for him to meet his goal of reopening the economy in parts of the country by May 1, according to four people familiar with the efforts.

Multiple ideas are under consideration for increasing diagnostic testing and testing for coronavirus antibodies as well as how to target those tests to geographic areas and specific industries to open as much of the economy as possible, these people said.

One proposal that’s been considered would involve the federal government partnering with major technology companies in an effort aimed at increasing testing capacity to at least 3 million tests a day, according to three people familiar with the plan. Some administration officials, however, cautioned that amount was unrealistic and said different types of testing would be strategically deployed.

A senior administration official said the White House is “close” to making an announcement on a plan.

Another idea that’s been discussed would use the Defense Production Act to rapidly scale up testing, according to one person familiar with the discussions, though officials played down the idea given that Trump has been resistant to more consistently deploying that presidential power since he would rather use the law as leverage to get companies to take such steps.

The push to ramp up testing reflects an acknowledgment by some of the president’s advisers that, despite his insistence that testing is working well, there are problems with access and that significantly increasing the number of tests per day will be critical if the economy is going to reopen. Trump said he will announce guidelines on Thursday for reopening the economy.

“We have the best tests of any country in the world,” Trump said on Wednesday without evidence, adding that he’ll defer to governors on testing matters because “states are much better equipped to do it” and he didn’t want the federal government “running a parking lot in Arkansas.”

While the U.S. has tested more citizens than any other country, it also has the most COVID-19 cases and deaths globally and is significantly behind in per capita testing, as compared to South Korea or Germany. Currently about 140,000 people a day are being tested in the U.S.

Hospitals tell NBC News that they have been in contact with Deborah Birx, the White House coronavirus response coordinator, and others in the federal government to help increase testing capacity, but that conversations to date have been general and they are not aware of any concrete plan.

A spokesperson for the American Hospital Association told NBC news that “hospitals and health systems continue to lack critical testing supplies, including swabs, transport media and reagents, which is the most frequent reason contributing to testing machines not being able to be used to their full capacity.”

On Wednesday business leaders urged Trump during a conference call to significantly increase coronavirus testing before opening up the economy, saying that doing so is key to ensuring it is safe, according to two people familiar with the call.

A White House official said there are plans to do just that as part of the economic opening.

“Testing is an important mechanism that needs to be in place,” the official said. “This administration has taken aggressive measures to make sure testing is available across the country, and that’s only going to continue and increase.”

So much is uncertain on how a significant surge in testing would work, and when such an effort would be realized on the ground. Some people familiar with the White House discussions said it would take weeks at a minimum, raising questions about whether enough testing would be in place in time for Trump's May 1 goal for reopening. Parts of the country may be required to show a significant reduction in the number of coronavirus cases over the course of a month to six weeks before being cleared to lift restrictions that have shuttered the economy.

One senior administration official said increased testing would have to work in tandem with other measures, including contact tracing. The official said that diagnostic testing would surge in emerging high-risk areas and among critical workforces. It's less clear how testing for coronavirus antibodies would be deployed, or how the government would coordinate with state and local governments and businesses to determine where the most need is, given that systems like contact tracing are not yet fully in place.

Trump could announce some details on Thursday. But decisions on when and where to reopen will be determined by state and local governments. On Thursday Gov. Andrew Cuomo of New York announced that he was extending stay-at-home orders until May 15, for instance.

The White House’s rocky rollout this week of the president’s promised new advisory group to lead the country's economic resurgence has not boosted confidence in the administration’s ability to achieve Trump’s goal.

But the president is adamant that regions of the nation could open by the end of the month, and perhaps even earlier. He has repeatedly argued that “there’s also death in keeping” the U.S. closed.

“Our country has to get open, and it will get open, and it'll get open safely and hopefully quickly -- some areas quicker than other areas,” Trump has said. “But there is tremendous testing and the governors will use whatever testing is necessary. And if they're not satisfied with their testing, they shouldn't open.”

Private labs in the U.S., which handle the vast majority of coronavirus testing, are now capable of testing more people because demand has decreased so much since its peak, according to the American Clinical Laboratory Association.

And while test manufacturers like Abbott and Roche are listed as part of the economic revival groups announced by the White House this week, major testing companies like LabCorp and Quest Diagnostics were not.

Still, there continues to be a clambering for more testing in states.

On Wednesday, Cuomo said states like New York were still not in position to conduct large scale testing and needed the federal government’s help. “We can’t do it yet,” Cuomo said. “We cannot do it without federal support.”

Trump has resisted pressure from governors, such as Cuomo, to invoke the Defense Production Act to scale up coronavirus testing. And he said this week that he believes the states, not the federal government, are responsible for testing capacity.

“If they need things, we'll help them get those things, but we want them to do their testing,” Trump said Tuesday. “We can't be thinking about a Walmart parking lot that's 2,000 miles away where we're doing testing, but a governor of a state can, and a mayor can.”

For weeks, governors like Cuomo and Democratic senators have pleaded with the White House to fully employ the powers of the federal government to ramp up testing abilities. But Trump has only used the Korean War-era Defense Production Act a handful of times to increase ventilator production.

When the pandemic started spreading to every state in the U.S. in mid-March, but before enacting nationwide social distancing guidelines, the president was pressed on whether he would accept any of the blame for early testing issues. His own director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, referred to the lag in getting the private sector involved as “a failing.”

“I don’t take responsibility at all,” Trump said.