The F.D.A.’s changes succeeded in clearing away many of the regulatory obstacles to new testing. And yet they did little to solve what now appears to be the major bottleneck in deploying widespread testing across the United States. No longer do we need to worry about a single authorized test protocol, or a limited number of laboratories that are allowed to carry out that test. The current trouble is a critical shortage of the physical components needed to carry out tests of any variety. Among these components are so-called viral transport media, which are used to stabilize a specimen as it travels from patient to lab; extraction kits, which isolate viral RNA from specimens once they reach the lab; and the reagents that do the actual work of determining whether the coronavirus that causes COVID19 is present in the sample. Perhaps the most prosaic shortage, but also the most crucial, is a lack of test swabs, which look like glorified Q-tips. Specially designed to preserve viral specimens, they’re what a doctor sticks up your nose or down your throat to collect the necessary biological material.
The swab shortage is happening for the same reason that all the other test components are limited—namely, a global pandemic has created a global demand for them—but it is subject to a further complication. Copan, one of the major manufacturers of the sort of swabs needed for COVID-19 tests, has its headquarters and manufacturing facilities in Lombardy, Italy, which has been hit particularly hard by the disease. A spokesperson for the company says that the national lockdown in Italy has not affected production at its factories, but last week the U.S. Air National Guard had to use one of its C-17 cargo planes to bring an order of eight hundred thousand swabs back to the U.S. According to Defense One, the plane flew on Monday from the Aviano Air Base, in Italy, not far from the headquarters of Copan, to Memphis, where a FedEx distribution center is situated; the Times later reported that the airlift had been arranged by Peter Navarro, a Presidential trade adviser, and that the Administration hoped similar efforts would bring 1.5 million swabs into the country every week. On Saturday, a company spokesperson told me that Copan did not make “special deals” with governments but was “shipping to the U.S.A. the maximum amount that we are capable of, on a best effort basis” through its usual distributors.