The Trump administration bungled its initial effort to get a broad-based testing regime in place for the new coronavirus and has been playing catch-up ever since. But now the United States has conducted more than 5 million tests, more than any other country.
That would seem to be a good talking point for President Donald Trump. But it also lacks important context, because what really matters is how many tests are performed per million people. Moreover, Trump keeps exaggerating the statistics or making claims that turned out to be incorrect. “Anyone who wants a test can get a test,” he declared March 6, a statement so false it needed to be corrected the next day by Health and Human Services Secretary Alex Azar.
Here’s a tour through Trump’s recent rhetoric on testing.
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“We are way ahead on testing. We are the best in the world on testing. We’ve tested much more than anybody else, times two — or every country combined. We’ve tested more than every country combined.”
— Trump, remarks at the White House, April 28, 2020
More than every other country combined? Not by a long shot.
As of the end of April 28, the United States has conducted 5.9 million tests, according to one metric. (The crowdsourced Covid Tracking Project reports almost 5.8 million tests but it does not have international comparisons.) The next five countries — Russia, Germany, Italy, Spain and United Arab Emirates — had conducted 10 million tests as of that date. The total for all non-U.S. countries is about 25 million. So Trump is wrong.
What matters is the number of tests per million people. The United States, at about 17,855 per million, was the lowest of those five countries — Russia tested at a rate of 21,511, Germany at 24,748, Italy at 30,547, Spain at 28,799 and the UAE at 106,904.
We should note that international comparisons are difficult because countries use different metrics. The United States reports “test results,” South Korea “cases,” Turkey “tests” and Italy “swabs.” So not all of these numbers may be apples to apples.
Deborah Birx, the coronavirus task force coordinator, has said that the United States focused on hot spots at first, and those results are more favorable for the United States. For instance, New York has had 41,399 tests per million people as of April 27, according to the Covid Tracking Project. But of course, the test results for individual states or cities in Europe are also probably higher.
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“I’ve told you that we inherited a very broken test — a broken system and a broken test, and within a short period of time, we were setting records.”
— remarks, April 28
There were no tests for the novel coronavirus, which emerged in China late in 2019, so tests had to be developed specifically by countries starting in January. Trump appears to be referring to a system in place that relied on the Centers for Disease Control and Prevention to take the lead in developing the tests. But contamination at a CDC lab caused the CDC to distribute flawed tests to state and local health departments. On top of that, having the CDC take the lead, rather than the private sector, was inappropriate for the task of testing potentially hundreds of thousands of people.
Two former Trump administration officials had warned Jan. 28, in a Wall Street Journal article, that the CDC was not up to task and the private sector needed to be engaged. But the Trump administration waited another month before it fast-tracked the development of tests by private companies. From mid-January until Feb. 28, fewer than 4,000 tests from the CDC were used out of more than 160,000 produced, The Washington Post reported.
That delay left the United States dangerously exposed to the spread of the virus. Both South Korea and the United States reported the first case on the same day — Jan. 21. But South Korea rapidly developed a test and conducted massive testing — 10,000 people a day — while the United States did not. So while the United States now has more tests per capita than South Korea — it finally caught up April 16 — it has a far higher death toll. South Korea reports 5 deaths from COVID-19 per million people, compared to 185 for the United States.
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“Well, it will increase it and it’ll increase it by much more than that [5 million tests a day] in the very near future. We’re way ahead of everyone on testing. … Well, we’re going to be there very soon. If you look at the numbers, it could be that we’re getting very close.”
— remarks, April 28
A Harvard University study had said 5 million tests a day by June — and 20 million a day by July — would be necessary for a return to normal life. Given that testing is running at about 300,000 tests a day, achieving 5 million tests a day in the very near future would be quite an achievement. Trump made these remarks in response to a question about the Harvard study from a reporter, but it turned out he did not know what he was talking about.
Unfortunately for Trump, Brett Giroir, the assistant secretary of health, had told Time magazine earlier in the day: “There is absolutely no way on Earth, on this planet or any other planet, that we can do 20 million tests a day, or even 5 million tests a day.”
The next day, Trump said, “I didn’t say it. … I think it was the Harvard report.” He added, “We are going to be there at a certain point. We’ll be there.”
This time, he did not say “very soon.”
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“Individual states were doing in cooperation with the federal government. But originally, it was, ‘Oh, 40,000 people came in.’ What they don’t say — what the news doesn’t say is they happen to be American citizens. How do you keep American citizens — you say they’re coming in from China, they want to come back to their country. There is a tremendous problem in China; they want to come back. Are we supposed to say to an American citizen, ‘You can’t come back into your country?’ And we did do testing, and individual states did testing or were supposed to have.”
— remarks with Florida’s governor, April 28
Trump has bragged about the restrictions he imposed Feb. 2 on some non-U.S. citizens traveling from China, but here he conceded that it was not foolproof because 40,000 people in February and March — a figure disclosed by The New York Times — managed to travel from China.
But the problem was that screening of arriving travelers at airports was spotty and inconsistent, probably catching only one out of every three cases. Trump tries to pin the blame on states, but as noted, there was virtually no testing available in the United States in the month of February because of the federal government’s failures.
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“The only reason the U.S. has reported one million cases of CoronaVirus is that our Testing is sooo much better than any other country in the World. Other countries are way behind us in Testing, and therefore show far fewer cases!”
— tweet, April 29
“The reason [for 1 million cases] is because of testing, because other countries don’t test. So, if you don’t test, you’re not going to find cases.”
— remarks, April 29
Trump is trying to make lemonade out of lemons. Many countries with significant case loads are testing, often at greater rates than the United States. The United States has such a huge case load because it failed to ramp up testing at the speed of other countries, so the virus spread silently before Trump finally took the problem seriously and advocated mitigation and social distancing efforts.
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