Stephen MacMillan, the CEO of the diagnostic manufacturer Hologic, says of the roughly 10 million tests that were conducted in May, “there had never in the history of diagnostics been a test to develop faster or used in this volume.”

“I know for the outside world,” he adds, “they look at it and say, ‘Why can’t you do this?’ But when you truly understand the magnitude, the industry or the world has never seen volume of one diagnostic test conducted in this quantity — never close.”

The problem with testing nationally is becoming less a shortfall of availability of the tests and more a shortfall of people showing up to get tested. An insider in the diagnostics industry says that laboratories are reporting that they are “sample starved” — i.e., they aren’t getting enough specimens. He notes, “We have all seen stories about sample-collection sites in some regions not seeing that many patients.”

An HHS official says that in May there was the capacity to do twice as many tests as were actually performed, calling it a function of “allocation and efficiency, but more just demand.” Says Giroir, “We really see areas in the country now that there’s more tests available than people who want to get tested or the need for testing.”

How this came to be is a crucial part of the story of the response to COVID-19, although one that has been neglected.