Trump’s own officials and his Republican allies have recognized that it is not true that an increasing number of tests are the reason why the number of cases has skyrocketed in the past month. A clear proof that the tip is real: The percentage of people tested positive, a key measure of the actual spread of the virus, has also increased.
Trump also keeps saying that the only reason the U.S. has shown more confirmed cases than other countries like Germany is because the U.S. does more tests than it does. That’s not true either. Countries like Germany have had to perform fewer tests over time because they have been more successful in containing their outbreaks ̵
1; primarily by using a strategy that included aggressive early tests.
Trump’s general claim that the US test system is now an “enormous” success is more subjective than the others, but many experts say it is also wrong. After a lethally slow start to the test system, experts believe the US is still not doing enough.
Evidence abounds. Given the high demand, laboratories take longer to achieve results. The delays reduce the benefits of the tests themselves. And there are still bottlenecks in the availability of tests in parts of the country.
“Tests are certainly better than in April or May, but we still have a long way to go,” said Tara Smith, professor of epidemiology at Kent State University, and reported overused test sites in several states. “We’re still a long way from where we need to be to test everyone who wants it, and lack of testing affects our ability to do isolation and contact tracking. We still need to do a lot of improvement.”
Eyes closed, no cases?
Trump was ridiculously dishonest when he repeatedly claimed that the US would “only have” a few cases if it did fewer tests.
It’s like saying that someone with cancer would not have cancer if they had never been tested for the disease – or someone who is standing in front of you is not there when you close your eyes. The United States would show fewer coronavirus cases with fewer tests, as Trump tweeted on Thursday, but still to have the cases that were not recorded.
In fact, the actual number of cases with fewer tests would likely be higher.
This is because testing is not just a passive data tool that the government can use to measure the number of people infected. It is also said to be a tool to fight pandemics – it informs infected people and enables them to take measures to prevent the virus from spreading. (In theory, government testing also allows contact tracking to be carried out to inform people who have spent time near infected people that they are also at risk and should take precautions to avoid further spread.)
“This may not seem intuitive, but if you do enough testing, the number of cases should decrease because you can find people early before they spread them,” wrote Dr. Sanjay Gupta, chief correspondent for CNN, on Twitter in June.
Rising number of cases – and rising positivity rates
The number of confirmed cases rose on Thursday in 33 of the 50 states, according to Johns Hopkins University.
The United States as a whole set a series of one-day records for newly confirmed cases in late June and early July.
Trump’s own officials, like deputy health minister Brett Giroir, have confirmed that the country is experiencing a “real” increase in cases, not just the result of further testing.
The evidence Giroir noted to Congress last week: “Percentage positives are increasing.”
The positivity rate measures the number of people who tested positive for the virus compared to the total number of people who tested.
According to Johns Hopkins, the national positive rate almost doubled last month – the 7-day moving average rose from 4.4% on June 9 to 8.2% on Thursday.
Texas, Arizona, and Florida, where the number of confirmed cases have recently increased, have also seen a dramatic increase in their positivity rates – Texas rose from 6.6% to 15.6% last month, Arizona from 12.7% to 26.8% in the same period and Florida from 4.1% to 19.1%.
Texas Governor Greg Abbott pointed to the positivity rate as a key measure in early May when the state started to reopen, saying that if the state saw a rate above 10% it would serve as a “red flag”. Texas exceeded a 10% rate on June 24; Abbott interrupted the reopening plan the next day.
Another Republican governor, Florida’s Ron DeSantis, admitted in late June that the increase in the state was not due to test increases: “Even if the tests increase or are flat, the number of people who test positive will accelerate faster.”
Florida’s Miami-Dade County, which has seen a sharp increase in some cases, reported a 26% positive rate on Sunday.
“That is the real problem, and if you link this to the increase in hospitalization, you know that the infection rate has increased here in Miami-Dade County,” said county mayor Carlos Gimenez on CNN.
The international comparison
Trump, as he did again on Twitter on Thursday, argued that the U.S. has higher case numbers than other countries just because the U.S. tests more than these countries.
Trump has even claimed that the increased number of U.S. tests is the reason the U.S. shows more cases than Germany, a country that has been widely praised for dealing with the pandemic.
“So Germany will show fewer cases because it tests far fewer people – countries of different sizes and all, but they test far fewer people,” Trump said in late June in the Fox News.
That is also inaccurate. Through aggressive testing at the start of the crisis, Germany – like another country that Trump mentioned in the total number of US tests, South Korea – simply worked better to suppress its outbreak. In the long term, fewer tests per person were therefore required.
Dr. Hans-Georg Krausslich, professor and expert in infectious diseases at Heidelberg University in Germany, said that the number of tests performed generally depends on medical needs, especially the number of people who experience symptoms – and because Germany is low has real infection rate, the country doesn’t even have to use near its full test capacity.
In other words, Krausslich said, Trump argues that more tests “create” more cases – but actually “more symptomatic infections” create more tests.
By Wednesday, Germany with around 83 million inhabitants had 197,341 confirmed cases and 9,036 deaths. The United States, with a population roughly four times larger, had approximately 15 times as many confirmed cases (3,054,699) and approximately 15 times as many deaths (132,300) as of Wednesday.
Miguel Hernán, professor of epidemiology at Harvard TH Chan School of Public Health, said that “greater intensity of the tests cannot explain the difference alone”. He found that, per million people, the number of US tests exceeds Germany by a ratio that is less than the ratio by which the number of US cases exceeds Germany.
“No, I don’t think the test rates explain the differences,” Krausslich said.
Trump’s claims about international comparisons contain a core of truth. It is reasonable to argue that the actual number of coronavirus cases in some large countries like Brazil and India is much higher than the confirmed number of cases in these countries, as experts say they do not test nearly enough.
However, the actual number of cases in the U.S. is most likely much higher than the confirmed number. Robert Redfield, director of the Centers for Disease Control and Prevention, told reporters at the end of June, “Our best estimate at this time is that 10 other infections have actually occurred for each reported case.”