A series of missteps at the nation's top public health agency caused a critical shortage of reliable laboratory tests for the coronavirus, hobbling the federal response as the pandemic spread across the country like wildfire, an Associated Press review found.
President Donald Trump assured Americans early this month that the COVID-19 test developed by the Centers for Disease Control and Prevention is "perfect" and that "anyone who wants a test can get a test."
But more than two months after the first US case of the new disease was confirmed, many people still cannot get tested.
In the critical month of February, as the virus began taking root in the U.S. population, CDC data shows government labs processed 352 COVID-19 tests an average of only a dozen per day.
"You cannot fight a fire blindfolded," Tedros Adhanom Ghebreyesus, head of the World Health Organization, said at a recent briefing. "We cannot stop this pandemic if we don't know who is infected."
The Department of Health and Human Services, which includes the CDC, has begun an internal review to assess its own mistakes.
But outside observers and federal health officials have pointed to four primary issues that together hampered the national response the early decision not to use the test adopted by the World Health Organization, flaws with the more complex test developed by the CDC, government guidelines restricting who could be tested and delays in engaging the private sector to ramp up testing capacity.
Combined with messaging from the White House minimizing the disease, that fueled a lackluster response that missed chances to slow the spread of the virus, they said.
"There were many, many opportunities not to end up where we are," Dr Ashish K Jha, the director of the Global Health Institute at Harvard, told the AP.
"Basically, they took this as business as usual. ... And that's because the messaging from the White House was 'this is not a big deal, this is no worse than the flu.' So that message basically created no sense of urgency within the FDA or the CDC to fix it."
Even as private labs have been cleared by government regulators to process tens of thousands of additional tests in the last two weeks, experts warn that the nation is still falling well short of enough testing capacity to keep ahead of the highly contagious virus. And it can often take a week just to get results back.
Trump last week rated his administration's response to the crisis as a perfect 10.
However, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the CDC's system wasn't designed to test for and track a widespread outbreak, which he characterised as "a failing."
In interviews with the AP, two federal health officials with direct knowledge of the situation said CDC experts don't know why many of the agency's test kits failed to reliably detect the virus.
The officials spoke on condition of anonymity because they were not authorized to speak publicly about what went wrong.
J Stephen Morrison, a health policy expert at the Center for Strategic and International Studies in Washington, called the testing issues a "debacle," contributing to what he described as a confused and delayed federal response to the crisis.
As a result, he said, the CDC has now been marginalized within the White House a worrisome development.
"CDC has generally been regarded as the best in the game," Morrison said.
"I don't think they anticipated the technical difficulty, or the speed with which the virus has been moving. The virus was racing out ahead of them."
On New Year's Eve, Chinese scientists informed the World Health Organization about a cluster of 27 pneumonia cases of unknown cause in the industrial megalopolis of Wuhan that they linked to the city's wholesale fish market.
Less than two weeks later, the Chinese had sequenced the virus' genetic makeup and shared it with the world.
Within days, German scientists had developed a test that could identify a unique part of the virus' DNA.
The WHO quickly adopted the German test, publishing technical guidelines on January 17 and working with private companies to produce testing kits.
As they have done with some past outbreaks, officials at the CDC headquarters in Atlanta decided to develop their own test, focusing on three gene targets distinct from what the WHO used.
Over the decades, the headquarters lab had built a track record of being among the first to develop tests for new diseases and quickly making them available for disease tracking.
The CDC published the technical details for its COVID-19 test on January 28, 10 days after the WHO. By then, the virus had already been in the US for at least two weeks.
The 35-year-old man who would become the first American to test positive had arrived in Seattle on Jan. 15, following a trip to Wuhan. After swabs from his nose and throat were flown to the CDC lab, federal officials announced the results January 21.
In an interview on CNBC the following day, the president was asked about the risk to the nation.
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