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U.S. Races To Increase Domestic Production Of Swabs For Coronavirus Testing

RACHEL MARTIN, HOST:

We've been hearing that a shortage of supplies has limited our coronavirus testing capacity even though widespread testing is key to reopening the U.S. economy. So this week, the White House announced a plan to get more supplies to states to expand that testing. Sacha Pfeiffer, of NPR's investigations team, has been looking into the breakdown.

Sacha, welcome.

SACHA PFEIFFER, BYLINE: Thanks for having me.

MARTIN: So these testing kits involve things as simple as a swab. But as you explained on All Things Considered yesterday, swabs for coronavirus testing are somewhat specialized. Right?

PFEIFFER: That's right. They're considered medical devices. They have to be long and flexible enough to go all the way through your nose to the back of your throat. And since cotton can interfere with test results, they're instead made with a synthetic material, like polyester.

MARTIN: So this is not what you run to the drugstore to get. This is something totally different than that.

PFEIFFER: Right, exactly. And it turns out that there had only been two major manufacturers of these swabs. One is a company in Maine called Puritan Medical Products. The other is a company in Italy called Copan Diagnostics. When COVID-19 hit and demand for swabs skyrocketed, these companies got overwhelmed. Here's Puritan spokesman Timothy Templet.

TIMOTHY TEMPLET: I don't think the United States was prepared. That includes us, Puritan. And it includes our customers. And it includes the government. And now it's just really nerve-wracking to think that we may be in this for another couple of years.

MARTIN: So when he says the government wasn't prepared, Sacha, what should have happened? What could the government have done? What could it be doing now to address the shortage of swabs?

PFEIFFER: It could have been stockpiling them, but it was not. Swabs are not part of the strategic national stockpile, which is basically a federal warehouse of medical supplies. The government does have the Defense Production Act. That's the tool the Trump administration used in late March to require General Motors to produce more ventilators. But the administration did not act as quickly to use that tool for swab shortages, and that's even though some people were advising that. The governor of Washington, Jay Inslee, told NPR on April 16 that weeks before, he had urged President Trump to invoke the Defense Production Act for that very purpose.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

JAY INSLEE: To convert some of their production to swabs and contact vials and machines that can do analysis. And he did not agree with that assessment. And we lost weeks, frankly.

MARTIN: Let's talk through the timeline of this shortage. Governor Inslee spoke with President Trump more than a month ago. Was the federal government warned about a shortage of swabs before that?

PFEIFFER: We know that on February 12, a group of health experts told a U.S. Senate committee that the country had a testing supply problem. That was at a hearing on pandemic preparedness. More than a month later, on March 16, former FDA Commissioner Scott Gottlieb put out a tweet that said swabs could be a weak link in broadening testing. The next day, Rhode Island Governor Gina Raimondo told CNN that, quote, "the problem is swabs." And in mid-March, there were other public distress calls about supply shortages.

MARTIN: So there were warnings back in February and March. Did the government respond to those at all?

PFEIFFER: In mid-March, the government did start flying shipments of swabs from Italy to the U.S., but that still didn't meet demand. In mid-April, complaints were still happening about shortages. On April 19, President Trump said he would use the Defense Production Act to ramp up swab production. Then, on April 29, the government said Puritan in Maine had been awarded a $75 million contract to produce more swabs. And just this week, as we said, the White House promised to provide supplies to help states meet testing goals.

MARTIN: So will all of this be enough to meet the current demand?

PFEIFFER: It's hard to say because it's difficult to get consensus on how much testing should be happening and how many swabs are needed. I say that because the president of the American Society for Microbiology, Dr. Robin Patel, told me that her group asked to speak with Dr. Deborah Birx's team on the White House Coronavirus Task Force in mid-April. Patel's group wanted to find out what was being done to address testing supply shortages. Turns out, the White House was trying to figure out the same thing. Here's how Patel said that unfolded.

ROBIN PATEL: Something happened that was very surprising. First of all, Ambassador Birx has very good insight into the challenges that are happening. But what they did is they turned around and they asked the American Society for Microbiology to help with this situation. That's not why we were there. We were there asking for information.

PFEIFFER: So Patel's group gave the task force its feedback. She told me the pandemic is complicated and we all need to work together to solve it.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

PATEL: We are pleased to be able to help, but we were not there to volunteer to help. That was what was surprising was the ask back to us.

PFEIFFER: And Rachel, her experience makes clear that nearly three months into the pandemic, the Trump administration was still struggling to understand the shortage of swabs and other test supplies and how to fix it.

MARTIN: OK. So let's focus on the now. What options do we have at this point?

PFEIFFER: Well, the FDA has approved more types of swabs. An Ohio company is converting a plant to make swabs. The FDA has also approved a saliva test that doesn't require a swab. And there's this week's White House promise of more test supplies, although the government said it wants to focus on high-risk communities like nursing homes. So it's unclear how widespread testing will ever be in the U.S.

MARTIN: Sacha Pfeiffer of NPR's investigations team. Thank you, Sacha.

PFEIFFER: You're welcome. Transcript provided by NPR, Copyright NPR.

Sacha Pfeiffer is a correspondent for NPR's Investigations team and an occasional guest host for some of NPR's national shows.