Coronavirus COVID-19 testing levels in the United States are the lowest per capita. Here's why

Updated

The United States, a nation with a population of 327 million, has tested roughly 11,000 people for coronavirus.

South Korea, population 51 million, tests nearly 20,000 people per day.

Oh, and the two countries announced their first known cases of COVID-19 just hours apart.

Granted, it's hard to get an accurate measure of US testing levels because there's no centralised reporting process (more on that below).

But no matter how you slice it, the US has done the fewest tests per capita of any country affected by COVID-19.

Why are Americans — a people who pride themselves on being among the world's most scientifically advanced — failing to measure up?

Let's take a look:

1. Right now, they couldn't get a test even if they wanted one

The first confirmed case of COVID-19 came on January 21, three weeks after the news about the virus's hold on Wuhan spread globally.

On Feb 5, US authorities distributed kits to test 1,600 patients, but they delivered slow results and doctors said those results were faulty.

Meanwhile, private testing was steeped in red tape.

The doctor who reported America's first known case told the New York Times she had to break legal protocol to speak out.

Federal officials responded by telling her to stop testing.

Authorities have since relaxed restrictions, established an emergency hotline to help doctors and invested millions in private companies developing quick-turnaround tests.

President Donald Trump's national emergency declaration gives the Federal Emergency Management Agency new decision-making authority.

It also establishes a testing system that looks somewhat like South Korea's, with big-name corporations operating drive-thru clinics.

"An additional half a million tests will be available next week," Trump said.

"We will bring an additional 1.4 million tests next week and five million next month. I doubt we'll need anywhere near that many."

The President also walked back his previous claims that everybody can and should be tested, saying that "we don't want people taking a test if we feel they shouldn't be doing it".

When asked whether he takes responsibility for his actions, he said not at all.

Health workers and patients say the emergency efforts could not have waited any longer.

They've reported a chasm between the government's promises and the public's reality.

Testing capacity varies across the country and many states — including those with the biggest outbreaks — have been limiting tests to those at highest risk.

Healthcare professionals are vocally concerned about being forced to make ethically dicey decisions about who deserves a test.

Their cries may have been heard sooner had the American public joined in.

2. They may fear it will cost them thousands

News of a $US 3,000 bill for testing went viral last week.

It was a believable sum given the generally high cost of healthcare in the US.

But a fact-check found that the bill was falsely portrayed; the CDC and most private labs are not charging for testing.

The cost of treatment involved if that test comes back positive is still unknown.

The average emergency room visit in the US costs $2,246 AUD— and that's without the standard COVID-19 precautions like isolated rooms and specialised care.

Taking the time to get tested is another financial obstacle.

Nearly one-third of all Americans do not receive paid sick leave, and the current tests can take days to yield answers.

A bill passed by the House of Representatives would ensure free testing, increase financial assistance for treatment and guarantee 14 days of paid sick leave for all workers.

The bill's fate in the US Senate is unclear, likely to come down to whether President Trump signals his support.

In the meantime, Trump's national emergency declaration provides some targeted relief like waiving interest rates on student loans.

Even if there are wider assurances of financial assistance, there's still the unstated task of asking Americans to shake off their ingrained attitudes around health costs and trust that this time, it's different.

3. Many Americans don't trust their health system

The lack of testing means it's impossible to know the full extent of the disease's spread in the US.

Researchers who have used statistical techniques to estimate the size of the outbreak say that thousands of Americans have had COVID-19, unknowingly, for weeks.

At the time of writing, the leading US authority reported there were 1,629 confirmed cases and 41 deaths from the virus.

For the world's third-biggest country, that translates to a relatively small number of people who personally know someone diagnosed with COVID-19, not to mention killed by it.

Paradoxically, the low count may be among the biggest threats.

The US is a country marked by rugged individualism, evident in everything from personal friendships to the Republican slogan 'America first'.

It's hard for Americans to feel a sense of urgency about a threat — let alone act upon it — until the threat becomes menacingly visible in their own lives.

And that's especially true of medical threats.

Studies conducted during previous outbreaks suggest less than one-third of Americans trust public health officials, and Americans go to the doctor less than those in other developed countries.

As the virus spread in the early days, so too did headlines like 'I don't know how to make you care about other people' and 'Family of coronavirus patient break quarantine to attend school dance'.

Reports of xenophobia and racism confirmed that at least some of the country felt their race made them less vulnerable to the virus.

The president's failure to model "social distancing" or get tested didn't exactly inspire civic duty either.

Today, the tide may well be shifting.

The national baseball and hockey leagues recently suspended their seasons, while baseball postponed its opening day.

New York's Broadway district closed its doors to the public. Disneyland followed suit.

Even Tom Hanks' confirmed case could spark a sense of danger in the hearts of some Americans.

His diagnosis evoked memories of the announcement by American actor Rock Hudson in 1985 that he had AIDS.

For many, that was the moment when the American public began to take the HIV/AIDS epidemic seriously.

But with disease symptoms taking two weeks to appear and a country nearing its 60th day of known cases, it may be too little too late.

Topics: infectious-diseases-other, diseases-and-disorders, respiratory-diseases, health, world-politics, community-and-society, united-states

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