Donald Trump had no idea there was still a testing problem in the U.S. "I haven't heard about testing in weeks," Trump said during a Monday phone call with governors, obtained by CBS News.
Trump was responding to a plea for help from Democratic Gov. Steve Bullock of Montana, who said that his state was delayed in testing partly because it didn't have enough tests and couldn't compete with the federal government to get them. "I could give four or five examples over the last week where we have supply orders, and they've subsequently been cancelled, and they're canceled in part because what our suppliers are saying is that federal resources are requesting it and trumping that," Bullock explained.
That shortage was hampering containment in relatively populated areas in the state like Bozeman, Bullock added. "So we're trying to shift the supplies to really isolate that and do contact tracing, but we don't even have enough supplies to do the testing," he said.
After saying twice that he hadn't heard about any testing issues in "weeks," Trump responded, "We've tested more now than any nation in the world. We've got these great tests and we'll come out with another one tomorrow that's, you know, almost instantaneous testing. But I haven't heard anything about testing being a problem."
True, the U.S. has now tested more people in total than other countries that have tested aggressively like South Korea and Italy. But the statistic that matters far more is how many people are getting tested per capita, because testing 10 people in a town with the population of 100 (10% of the population) is far superior to testing 10 people in a city of 100,000 people (.01% of the population). The U.S. now has more coronavirus cases than any other country in the world; it also continues to lag in terms of testing per capita.
Admiral Brett Giroir, the assistant secretary for health at the Department of Health and Human Services, said Sunday that the U.S. had performed 894,000 tests as of Saturday. With a U.S population of around 327 million, that means about 1 in 366 people are getting tested, according to NPR. "For comparison, Italy has a population of about 60 million and has done approximately 454,000 tests, meaning 1 in 133 people are being tested there—about three times more, per capita, than in the U.S.," writes NPR's Jane Greenhalgh.
That bad news figures even worse for many rural states at the moment. The New York Times compiled data from early March showing that New York was performing some 627 tests per 100,000 people (*well above the U.S. average at the time of 177 tests/100,000 people) while Washington State was conducting 450 tests per 100,000. The testing numbers for Montana were actually too inconsistent to be conclusive, but neighboring Idaho, for instance, was performing just 122 tests per 100,000 people (below the U.S. average); North Dakota fared slightly better with 274 tests per 100,000 people. (*Note: The reason for the discrepancy between the NPR and NYT data in U.S. testing per capita stems from different sourcing material and the fact that NPR’s numbers were more up to date.)
During the phone call with Trump, governors of other rural states also expressed concern about a dearth of resources. "We understand the challenges in New York. I have family in New York," Wyoming GOP Gov. Mark Gordon told Trump. But, he added, "I think a little bit of supply going our way could get us better prepared going forward."
The call also included a fair amount of butt-kissing, because no one wants to anger Trump right now for fear of being choked off from federal resources the way Michigan was. But the main takeaway here is that rural areas continue to be hamstrung by a lack of the most fundamental resource in fighting any epidemic: testing. Unfortunately, that suggests they may suffer the same fate as some larger urban areas did on the front end of this crisis—falling too far behind the curve on testing to actually contain the spread of the disease. Once more, most of those rural states don't have the financial and industrial heft of a New York or a California to try to fill in the gaps left by the federal government.
Every state needs help from the federal government right now in terms of obtaining resources, but they all also desperately need a streamlined, coordinated effort to direct the resources where they are needed most and when. No states are getting enough of either.
By the way, here’s how Trump responded when he was asked Monday about the U.S. lag in per capita testing (spoiler alert: he lashed out and stormed off):
(P.S. If any commenters find problems with my questionable math calculations above, please flag by using my name, Kerry. I once showed mild promise in math. That was 30 years ago.)