page_title: COVID-19 pandemic in the United States
section_title: Testing
hierarchical_section_title: COVID-19 pandemic in the United States / Responses / Medical response / Testing
caption_attribution_description: English: Members of the West Virginia National Guard’s Task Force Chemical, Biological, Radiological and Nuclear (CBRN) Response Enterprise (CRE) (TF-CRE) assist staff, medical personnel, and first responders of an Eastbrook Center nursing home with COVID-19 testing April 6, 2020, in Charleston, West Virginia, after a resident tested positive for the pandemic virus. Members donned proper personal protective equipment (PPE) to complete testing on more than 120 residents and 25 staff as part of ongoing operations across West Virginia in support of a whole of government response effort. (U.S. Army National Guard photo by Edwin L. Wriston)
context_page_description: The COVID-19 pandemic in the United States is part of the worldwide pandemic of coronavirus disease 2019. As of August 2020, there were over 180,000 COVID-19-related deaths in the U.S. The first confirmed local transmission was recorded in January 2020, while the first known deaths were reported in February. By the end of March, cases had been confirmed in all fifty U.S. states, the District of Columbia, and all inhabited U.S. territories except American Samoa.
  Within a week after China announced that it found a cluster of infections from the virus in Wuhan, the CDC offered to send them a team of experts to help contain the spread, but they refused the offer. The US outbreak was officially declared a public health emergency on January 31, and restrictions were placed on flights arriving from China. The initial U.S. response to the pandemic was otherwise slow, in terms of preparing the healthcare system, stopping other travel, and testing for the virus. Meanwhile, President Donald Trump downplayed the threat posed by the virus and claimed the outbreak was under control.
  On March 13, President Trump declared a national emergency.
context_section_description: Beyond identifying whether a person is currently infected, SARS-CoV-2 testing helps health professionals ascertain how bad the epidemic is and where it is worst. However, the accuracy of national statistics on the number of cases and deaths from the outbreak depend on knowing how many people are being tested every day, and how the available tests are being allocated.
  While the WHO opted to use an approach developed by Germany to test for SARS-CoV-2, the United States developed its own testing approach. The German testing method was made public on January 13, and the American testing method was made public on January 28. The WHO did not offer any test kits to the U.S. because the U.S. normally had the supplies to produce their own tests.
  The United States had a slow start in widespread SARS-CoV-2 testing. From the start of the outbreak until early March 2020, the CDC gave restrictive guidelines on who should be eligible for COVID-19 testing. The initial criteria were (a) people who had recently traveled to certain countries, or (b) people with respiratory illness serious enough to require hospitalization, or (c) people who have been in contact with a person confirmed to have coronavirus.
  In February, the U.S. CDC produced 160,000 SARS-CoV-2 tests, but soon it was discovered that many were defective and gave inaccurate readings. On February 19, the first U.S. patient with COVID-19 of unknown origin (a possible indication of community transmission) was hospitalized. The patient's test was delayed for four days because he had not qualified for a test under the initial federal testing criteria. By February 27, fewer than 4,000 tests had been conducted in the U.S. Although academic laboratories and hospitals had developed their own tests, they were not allowed to use them until February 29, when the FDA issued approvals for them and private companies.
  From February 25, a group of researchers from the Seattle Flu Study defied federal and state officials to conduct their own tests, using samples already collected from flu study subjects who had not given permission for SARS-CoV-2 testing. They quickly found a teenager infected with SARS-CoV-2 of unknown origin, newly indicating that an outbreak had already been occurring in Washington for the past six weeks. State regulators stopped these researchers' testing on March 2, although the testing later resumed through the creation of the Seattle Coronavirus Assessment Network.
  On March 5, the CDC relaxed the criteria to allow doctors discretion to decide who would be eligible for tests. Also on March 5, Vice President Mike Pence, the leader of the coronavirus response team, acknowledged that "we don't have enough tests" to meet the predicted future demand; this announcement came only three days after FDA commissioner Stephen Hahn committed to producing nearly a million tests by that week. Senator Chris Murphy of Connecticut and Representative Stephen Lynch of Massachusetts both noted that as of March 8 their states had not yet received the new test kits. By March 11, the U.S had tested fewer than 10,000 people. Doctor Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, acknowledged on March 12 it was "a failing" of the U.S. system that the demand for SARS-CoV-2 tests was not being met; Fauci later clarified that he believed the private sector should have been brought in sooner to address the shortfall.
  By mid-March, the U.S. had tested 125 people per million of their population, which was lower than several other countries. The first COVID-19 cases in the U.S. and South Korea were identified at around the same time. Critics say the U.S. government has botched the approval and distribution of test kits, losing crucial time during the early weeks of the outbreak, with the result that the true number of cases in the United States was impossible to estimate with any reasonable accuracy.
  By March 12, all fifty states were able to perform tests, with a doctor's approval, either from the CDC or local commercial lab. This was followed by the government announcin
caption: April 5: Testing team in Charleston, West Virginia responds to a confirmed case in a nursing home.
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