Testing Redux

As I had noted several months ago when this pandemic started, testing is a sine qua non. Also it is relatively simple. Get a sample, extract the RNA, use the target sequence to isolate the virion RNA, reverse transcript to cDNA, use PCR to multiply, then sequence to see if Corona is present. It is simple. Many academic and private labs could do this over night. But alas not so.

Why? The NY Times will have you believe it is because we do not have a National Health System. I remind the reader to think of the USPS, AMTRAK, and the CDC. You really want these folks to do anything?

The Times states:

Puzzled by the low volume, the executive, Dean Tassone, Eurofin’s vice president for payer services, said he wrote to a host of state and federal officials, including representatives of the White House coronavirus task force. He said he found it “bizarre” that so many governors have talked about a lack of available testing.“The capacity is there, it’s simply not being utilized,” he said. “There’s this economic dysfunction that’s occurring.” Weeks after the company had reached out to New York officials, Gov. Andrew Cuomo’s office contacted Eurofins last Friday to assist with testing, the company said. Its labs will now provide testing for nursing homes in five of the state’s counties. LabCorp and Quest, as well as other large players like BioReference Laboratories and Sonic Healthcare, have competed for years to win the loyalty of doctors and hospitals, and to make ordering a test as frictionless as possible. Large health systems, which often run their own labs, have also gotten into the game, requiring doctors in the practices they have bought to use in-house labs.

Interesting but the problem is really twofold. First Government regulations often mandate a certain path and the inflexibility therein is massive. However, second, the real problem is the administrators at hospitals and amalgamated medical practices who have entered into exclusive long term agreements with Labs which are overloaded whereas excess capacity was instantly created outside these labs. The Administrators are generally inflexible, and sad to say incompetent in times such as this.

The problem is not the test qua test. It is a structural problem resulting from the hacking away at a very responsive and efficient distributed health care system into a highly regulated and inflexible one. The solution is not to make it a Government owned and managed entity. Unless the goal is to kill off everyone except some select few. Then again.......