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Member Of Now-Disbanded National Security Council Pandemic Response Team Speaks


Widespread testing and contact tracing has allowed China to begin to relax its social distancing measures, and testing is credited with helping South Korea flatten its curve.


But in this country, that testing has lagged far behind. President Trump has blamed his predecessors repeatedly for the slow ramp-up of testing in the U.S.


PRESIDENT DONALD TRUMP: We inherited a very obsolete system. This was a system that was out-of-date, obsolete.

CHANG: Now, the number of tests being conducted is increasing in the U.S., but these tests are still difficult to get unless you are ill or you are a health care worker. Luciana Borio was the director for medical and biodefense preparedness at the National Security Council under President Trump. She previously served as acting chief scientist at the FDA. And she joins us now to talk more about coronavirus testing in the U.S.


LUCIANA BORIO: Good afternoon.

CHANG: I want to begin with what we just heard the president saying about testing, that the U.S. inherited a broken system. Is that fair? Is he correct about that?

BORIO: Well, you know, traditionally, our nation has relied on the CDC to get the initial testing out to public health labs. So they're the first to launch, and they have done so with tremendous success over prior epidemics. But we have to remember that they're not a manufacturing facility; they are a research and reference lab.

CHANG: Right.

BORIO: And in this instance, they encountered some serious technical challenges which really exposed a significant vulnerability in our national capability to roll out tests quickly.

CHANG: Now, I was struck that all the way back in January, you wrote an op-ed that we said - that said that we needed to be aggressively increasing our testing capabilities in the U.S. And now the administration is still emphasizing that you shouldn't seek a test if you're not showing symptoms. What are we losing by not being able to test a larger section of the population?

BORIO: That's right. So until we have this broad capacity, which requires the private sector to be fully on board, it will be difficult - impossible, actually - to ascertain how big a problem we have in different locations across the U.S. And importantly, it would be difficult, impossible to conduct the public health measures that we know are so critical to be able to mitigate and contain the outbreak, and by that I mean the contact tracing - so identifying individuals who are infected and then identifying who their contacts are...

CHANG: Right.

BORIO: ...So then they can be in isolation or quarantine. Right now we have almost the whole country sheltering in place, which really is a very blunt instrument. And if we had testing and also technologies to be able to conduct the contact tracing in a much more efficient manner, we would be able to then try to resume life as we previously knew it in a way that is much more strategic than we are implementing these measures today.

CHANG: Now, we are hearing from the administration that they hope to try to relax social distancing recommendations in a targeted way. Here's something that Dr. Deborah Birx said this week. She's helping coordinate the federal response.


DEBORAH BIRX: The American people can understand where the virus is because we'll have the testing data and where it isn't and make sure that they're taking appropriate precautions as they move in and out of spaces.

CHANG: So there's a lot of talk about making tests more available for people who are actually showing symptoms, but that's a lot different from doing, say, like, random screening of the population to find out where the virus is, where is this pandemic going. Do you have a sense of how far we are from having just a screening test in place to help us understand where to loosen social distancing restrictions?

BORIO: That's right. So I think what's important to realize is that we need the surveillance tests, but we also need the diagnostic tests for sick patients because they are also going to be critical in informing the social distancing measures. So the surveillance would give us a general feel for how broad the infection is going on in a given population, where it's going. But to be able to conduct the public health measures that allow us to prevent widespread disease in a community, we require the diagnostic tests of sick patients and, again, the isolation that comes with that and the contact tracing.

And what Singapore and other countries have been doing is that they're deploying the diagnostic testing but also technology to be able to do contact tracing in the - with 21st century technology, using, for example, apps and cellphone data. Now, we need to do so in the U.S. in a way that comports to our values, our privacy values. We need to safeguard the data. We need to make sure that it's going to - only going to be used for public health purposes. We need to find a system where public - the public can be engaged and volunteer for such a system. But we don't have much time to lose if we really want to loosen - life the restrictions that are in place today.

CHANG: That is Luciana Borio. She was the director for medical and biodefense preparedness at the National Security Council in the Trump administration.

Thank you very much for joining us today.

BORIO: My pleasure. Transcript provided by NPR, Copyright NPR.

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