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What's The Government's Plan For Rollout Of 150 Million Rapid Coronavirus Tests?

TONYA MOSLEY, HOST:

Testing is a key pillar of the nation's coronavirus response, but throughout the pandemic, states have reported testing shortages and weekslong delays for results. This week, President Trump announced a new phase in the nation's testing strategy - the widespread rollout of rapid antigen tests, which can give results in as little as 15 minutes. The president said 150 million of those tests will be distributed in the coming months.

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PRESIDENT DONALD TRUMP: This will be more than double the number of tests already performed. And here's our plan - 50 million tests will go to protect the most vulnerable communities, which we've always promised to do.

MOSLEY: Admiral Brett Giroir is head of testing for the White House Coronavirus Task Force and joins me now. Welcome to ALL THINGS CONSIDERED.

BRETT GIROIR: Thanks for having me on this afternoon.

MOSLEY: Yes. So you actually demonstrated one of these tests earlier this week at the Rose Garden, and you called it a very sophisticated little piece of cardboard. In a few words, how's it work?

GIROIR: So it works by - unlike some of the traditional tests that amplify the genetic material, this actually looks for the proteins that are actually on the virus. So what it does is you just take a simple sample from the outer part of your nose - not the real deep one. You put it inside this card that you have just added a little bit of fluid - and what it is, it's an antibody that detects the antigen.

And it's sort of like people might have home pregnancy tests at some point in time. If you get one pink line, it's negative. If you get two pink lines, it's positive. It works in 15 minutes. So it really is an advance because we'll have as many as 48 million per month of these, and they're only $5 per test. So, again, a great advancement to our testing ecosystem, going to help a lot of people.

MOSLEY: OK, so this rapid antigen test is easier and faster than the genetic tests we've been using throughout the pandemic, but it's also less reliable and can actually produce more false negatives and false positives. Isn't that a concern?

GIROIR: So every test has false negatives and false positives. When you look at this specific test, its authorization is for those in the first seven days of symptoms, and its agreement with the best laboratory PCR test is 97% for sensitivity, 98% for specificity. So it really is quite good and a cheap, highly produced card. But with every test, particularly if you're testing in areas of low prevalence where there's not much disease, you're actually going to have more false positives than true positives. That's why it's very important to understand what the tests mean, when it needs to be repeated, when it doesn't need to be repeated.

But if you're looking at people who are symptomatic, this is a really, really good - really good test. And it can also be good for screening. Five dollars - we hope it's used that way. And we are using it that way for nursing home workers because we want to protect our elderly home health and also in some vulnerable areas, like historically Black colleges and universities and our tribes.

MOSLEY: OK, so are you prioritizing their delivery to states with a surge in cases like Wisconsin, for instance?

GIROIR: So of the 150 million, 50 million will be going to those vulnerable communities prioritized by the community outbreak. So if you're a nursing home in a green county where you only have to test your workers once a month, you're not getting any of these Binaxes. We've already provided a lot of other things. So 50 million are really going to go by that kind of community-spread priority.

The other 100 million, we made the policy decision to distribute them equally by proportion of the population to the states. We did that because we think most states will use these to keep their schools open, and whether you have a lot or a little spread, making sure that you can test students who are symptomatic, giving teachers the assurance that they can be tested is important. And remember - a state that's good one day could be bad in a couple of weeks, and we don't want that to happen. So we made that, proportionally, 100 million to all the states.

MOSLEY: OK. So looking at the testing landscape at large, though, when we spoke to you in July, you said the administration wanted to have 100 million tests per month done in this country by September. As October begins, we're still only doing about a quarter of that. Why the gap? And what is the administration doing to ramp that number up?

GIROIR: So thanks for asking that. So our goal was to have 100 million test capability per month.

MOSLEY: Capability.

GIROIR: It didn't mean we're going to do all of that because there's lots of reasons why people choose to get tested, they don't get tested. And it turns out, this month, without pooling, we have about 90 million available. Now, we're probably only going to use about 30 million of those. And I do want to emphasize to people that we do need more testing, particularly where there's community outbreak. And we've tried to surge federal sites, but we need all the states and communities to support that.

If you're having a lot of cases right now, it's likely going to be from the younger people under 35 years old. They're likely to be asymptomatic. And we need to increase the testing. We - unlike several months ago...

MOSLEY: Yeah.

GIROIR: ...When we had to build this entire system, we have the tests available now; we just need to make sure it gets to the right people at the right time.

MOSLEY: Admiral, we've seen several instances of political interference with federal agencies, like the FDA and the CDC. I'd like to ask you about one of those, the recent flip-flop of the CDC's guidance on who should be tested. To remind people, the CDC's original guidelines said if you're exposed to someone with the virus, you should get tested, and then in August, they updated that to say you don't necessarily need to get tested. Then a few weeks later, they reversed that again and said you should get tested if you've been exposed, regardless of whether or not you have symptoms.

As the head of the nation's testing strategy, with the minute I have with you, why has guidance to the public been so muddled?

GIROIR: So there's been a couple of reasons why it's changed. No. 1, it's - the science has changed. But this particular incidence, the CDC never meant to imply that people who were asymptomatic yet highly exposed wouldn't get tested. What they really wanted to do is tell people you should get tested in the context of a public health advice or a physician recommendation. For example, if I got exposed today and I went to my home for 14 days and didn't come out, I really don't need a test. But if I get a test on Day 2 and it's negative, what does that mean?

So it was revised because it was misinterpreted that no one who was asymptomatic should be tested. That's the opposite of what we wanted. So the CDC did revise it in the complete - you know, to make it more emphatic that we do want that to happen. So we're going to try to give you the best advice. If it's misinterpreted, misconstrued or we miscommunicate, we're going to change it because the most important thing is to get it right for the American people.

MOSLEY: Admiral Brett Giroir is assistant secretary for health at the U.S. Department of Health and Human Services and heads up the nation's testing response. Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.