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Excerpts from your - Special Report: How Korea trounced U.S. in race to test people for coronavirus

Chad Terhune, Dan Levine, Hyunjoo Jin, Jane Lanhee Lee

March 19, 2020 / 5:13 AM / 2 days ago

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The United States, whose first case was detected the same day as South Korea’s, is not even close to meeting demand for testing. About 60,000 tests have been run by public and private labs in a country of 330 million, federal officials said Tuesday.

[INSERT: Meanwhile at ROUGHLY the same time Australia with a population of 24.6 million have run about 80,000 tests.
While Canada at 37.6 million have run about 50,000 tests ..
https://www.politico.com/news/2020/03/19/canada-has-tested-more-than-50-000-people-for-covid-19-is-that-enough-137028 .]

As a result, U.S. officials don’t fully grasp how many Americans have been infected and where they are concentrated - crucial to containment efforts. While more than 7,000 U.S. cases had been identified as of Wednesday, as many as 96 million people could be infected in coming months, and 480,000 could die, according to a projection prepared for the American Hospital Association by Dr. James Lawler, an infectious disease expert at the University of Nebraska Medical Center.

“You cannot fight what you cannot see,” said Roger Klein, a former laboratory medical director at the Cleveland Clinic and previously an adviser to the U.S. Department of Health and Human Services on clinical laboratory issues.

How the United States fell so far behind South Korea, according to infectious disease experts, clinicians and state and local officials, is a tale of many contrasts in the two nations’ public health systems: a streamlined bureaucracy versus a congested one, bold versus cautious leadership, and a sense of urgency versus a reliance on protocol.

The delayed and chaotic testing in the United States will cost lives, potentially including those of doctors and nurses, many medical experts predict. Already more than 100 people have died overall, and fears of rampant spread have led to extraordinary restrictions on social interaction, upending the U.S. economy, schools, hospitals and everyday life.

“It makes me feel like I’m living in a farce,” said Dr. Ritu Thamman, a cardiologist and clinical assistant professor at the University of Pittsburgh School of Medicine. Even hospital staff who may have been exposed can’t get a test, she said. “We are a rich country but we don’t have these kinds of things?”

The administration of President Donald Trump was tripped up by government rules and conventions, former officials and public health experts say. Instead of drafting the private sector early on to develop tests, as South Korea did, U.S. health officials relied, as is customary, on test kits prepared by the U.S. Centers for Disease Control and Prevention, some of which proved faulty. Then, sticking to its time-consuming vetting procedures, the U.S. Food and Drug Administration didn’t approve tests other than the CDC’s until Feb. 29, more than five weeks after discussions with outside labs had begun.

Meanwhile, in the absence of enough kits, the CDC insisted for weeks on narrow criteria for testing, recommending it only when a person had recently been to China or other hot spots or had contact with someone known to be infected. As a result, the federal government failed to screen an untold number of Americans and missed opportunities to contain the spread, clinicians and public health experts say.

South Korea took a risk, releasing briskly vetted tests, then circling back later to spot check their effectiveness. By contrast, the United States’ FDA said it wanted to ensure, upfront, that the tests were accurate before they went out to millions of Americans.

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In the aftermath of the 2015 outbreak of MERS, short for the Middle East Respiratory Syndrome, critics slammed then-President Park Geun-hye and her administration for a slow response and a lack of transparency. Public confidence waned in Park, who was impeached in 2017 following an unrelated corruption scandal.

https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW