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As the pandemic weeks turn into pandemic months, many questions remain about how we know what we know about COVID-19. One of the major limiting factors in testing for the virus is the availability of supplies for test kits¹.

As Michigan slowly moves to re-open its economy—and resume something like “normal” life—what is the state of testing in the state right now?

What’s in a test kit²?

COVID-19 test kits are actually remarkably³ simple. They consist of three things: a nasal swab to take a viral sample; a clean, uncontaminated tube to store the swab in; and oftentimes, a liquid solution to put the swab in as it’s taken to a lab. Importantly, that must be a sterile⁴ solution, without any chemicals that interfere⁵ with the polymerase chain reaction (PCR) testing that’s used to actually process COVID-19 test samples.

Sounds pretty simple, right? But there have been huge supply chain problems, leaving the entities⁶ that conduct tests—mostly hospitals, and state and local governments—constantly scrambling⁷ for the supplies.

The obstacles

Detroit Mayor Mike Duggan has declared himself “obsessed” with COVID-19 testing. He’s been clear about his intention to test as many Detroiters as possible for the disease caused by the coronavirus. And his administration has pretty successful at actually getting testing supplies.

But they’ve also run into some significant, sometimes mind-boggling obstacles, which Duggan illuminated⁸ at a press conference earlier in May.

"We found a supplier in China who delivered us the first 5,000 [tests], and the FDA [U.S. Food and Drug Administration] embargoed⁹ it when it came into the warehouse¹⁰,” Duggan said. “And I talked to Dr. [Stephen] Hahn, the head of the FDA, and they cleared it. They got the 5,000 released.

“So we ordered another 20,000. They got embargoed by the U.S. Department of Agriculture at a Romulus warehouse. But Senator Debbie Stabenow stepped in and with the federal government's help, they released the 20,000 kits. I won't tell you this is easy.”

Duggan said his procurement¹¹ people are constantly “scouring the country” for more testing supplies. But Duggan has also looked for supplies closer to home.

Duggan, the former CEO of the Detroit Medical Center, is well-connected within the health care industry. So when he needed 6,000 test kits to launch drive-thru testing at the former Michigan State Fairgrounds, he turned to Dr. Roberto Romero.

Romero heads the National Institutes of Health Program for Perinatal Research and Obstetrics, which is housed in Detroit. So he does a lot of research and testing on high-risk pregnancies¹².

“One day I got a phone call from [Duggan], and he asked me if the perinatal research branch could help the city by providing swabs in a format¹³ that would allow collection of the samples, storage and shipment to the laboratory,” Romero said. “And what we did is pretty straightforward¹⁵: repurpose Dacron swabs that I use in our prenatal clinic, and in labor¹⁴ and delivery, to collect samples from patients suspected to have COVID-19.”

Romero also had the tubes and sterile solution needed to transport the swabs. “In essence, we provided approximately 14,000 swabs with tubes of media, and they were prepared by volunteers working in our branch,” he said.

Romero has continued to provide some test kits for the city on an as-needed basis, but Duggan says the city looks for supplies everywhere.

“We recognized early on that the federal government was not going to take the lead in doing this,” Duggan said. “And rather than complain about it, we just went to work.”

“You have states and counties out on the open market competing against each other for these supplies.”

Oakland County Executive Dave Coulter echoes Duggan’s thoughts on the federal government’s failure to leverage¹⁶ its buying power, and create a pipeline¹⁷ to filter testing supplies down to states and local governments.

“If you looked at the pandemic playbook, it would have said that the state or the federal government would be supplying these things,” Coulter said. “But this is such a massive undertaking¹⁸, and that just wasn't happening. And so we really have learned to, you know, be creative on our own and scramble¹⁹ on our own.”

Coulter said the scramble for testing supplies takes up a lot of time and bandwidth at Oakland County’s Emergency Operations Center, which is already going full-speed during the pandemic. And it creates a perverse²⁰ type of market for the supplies.

“I think one of the sad realizations²¹ in this pandemic is that you have states and counties out on the open market competing against each other for these supplies,” Coulter said. “And then think about it, because this is a global pandemic, we’re not only just competing against Ohio and California, but we're competing against other nations. And so the supply chain issues have been very, very challenging.”

Coulter said things have been getting “incrementally²² better” when it comes to testing, especially as more labs to process the tests have come online. But when it comes to test kits, “We are out on the market purchasing our own supplies as we can get them.”

At the beginning, states and local governments hoped the federal government’s stockpile was going to provide them with sufficient supplies, at least for awhile.

But that hope turned out to be misplaced. And even when the federal government has stepped in with supplies, they’re sometimes not really what the state or local governments need.

For example: the state of Michigan recently received a large shipment of swabs from the federal government. But they were 100% foam²³ swabs. And that turned out to be a problem, according to Governor Gretchen Whitmer.

“Each of these tests depend on a specific type of swab,” Whitmer said. “And so when our shipment from the federal government comes in, and it is 100% foam swabs, it means we can't execute those for all of these other tests that we have.”

So where do things stand now?

If you’re a person who wants to get tested for COVID-19 in Michigan, your chances of actually getting a test have improved a lot. Whereas in the past, tests were restricted to the highest-risk and most seriously symptomatic people, more places will now test you regardless of symptoms. In the past seven days, the state has tested an average of nearly 18,000 people per day. That’s a marked improvement since the start of the month. And fewer people are testing positive.

But that’s still far short of the 30,000 tests per day the state has set as a goal. And even that goal is short of the level of testing some public health experts say is needed to truly re-open Michigan's economy—more like 58,000 per day, according to one model.

So things are getting incrementally better. But we’re not where we need to be to start returning to anything like the pre-pandemic “normal.”

1 kits   

衣物和装备( kit的名词复数 )； 成套用品； 配套元件

参考例句：

• Keep your kits closed and locked when not in use. 不用的话把你的装备都锁好放好。
• Gifts Articles, Toy and Games, Wooden Toys, Puzzles, Craft Kits. 采购产品礼品，玩具和游戏，木制的玩具，智力玩具，手艺装备。

2 kit   

n.用具包，成套工具；随身携带物

参考例句：

• The kit consisted of about twenty cosmetic items.整套工具包括大约20种化妆用品。
• The captain wants to inspect your kit.船长想检查你的行装。

3 remarkably   

ad.不同寻常地，相当地

参考例句：

• I thought she was remarkably restrained in the circumstances. 我认为她在那种情况下非常克制。
• He made a remarkably swift recovery. 他康复得相当快。

4 sterile   

adj.不毛的，不孕的，无菌的，枯燥的，贫瘠的

参考例句：

• This top fits over the bottle and keeps the teat sterile.这个盖子严实地盖在奶瓶上，保持奶嘴无菌。
• The farmers turned the sterile land into high fields.农民们把不毛之地变成了高产田。

5 interfere   

v.(in)干涉，干预；(with)妨碍，打扰

参考例句：

• If we interfere, it may do more harm than good.如果我们干预的话，可能弊多利少。
• When others interfere in the affair,it always makes troubles. 别人一卷入这一事件，棘手的事情就来了。

6 entities   

实体对像； 实体，独立存在体，实际存在物( entity的名词复数 )

参考例句：

• Our newspaper and our printing business form separate corporate entities. 我们的报纸和印刷业形成相对独立的企业实体。
• The North American continent is made up of three great structural entities. 北美大陆是由三个构造单元组成的。

7 scrambling   

v.快速爬行( scramble的现在分词 )；攀登；争夺；（军事飞机）紧急起飞

参考例句：

• Scrambling up her hair, she darted out of the house. 她匆忙扎起头发，冲出房去。 来自《现代英汉综合大词典》
• She is scrambling eggs. 她正在炒蛋。 来自《简明英汉词典》

8 illuminated   

adj.被照明的；受启迪的

参考例句：

• Floodlights illuminated the stadium. 泛光灯照亮了体育场。
• the illuminated city at night 夜幕中万家灯火的城市

9 embargoed   

禁止贸易，禁运( embargo的过去式和过去分词 )

参考例句：

• They embargoed oil shipments to the US. 他们对美国实施石油禁运。
• They embargoed those ships. 他们禁止那些船只出入港口。

10 warehouse   

n.仓库；vt.存入仓库

参考例句：

• We freighted the goods to the warehouse by truck.我们用卡车把货物运到仓库。
• The manager wants to clear off the old stocks in the warehouse.经理想把仓库里积压的存货处理掉。

11 procurement   

n.采购；获得

参考例句：

• He is in charge of the procurement of materials.他负责物资的采购。
• More and more,human food procurement came to have a dominant effect on their evolution.人类获取食物愈来愈显著地影响到人类的进化。

12 pregnancies   

怀孕，妊娠( pregnancy的名词复数 )

参考例句：

• Since the wartime population needed replenishment, pregnancies were a good sign. 最后一桩倒不失为好现象，战时人口正该补充。
• She's had three pregnancies in four years. 她在四年中怀孕叁次。

13 format   

n.设计，版式；[计算机]格式，DOS命令:格式化(磁盘)，用于空盘或使用过的磁盘建立新空盘来存储数据；v.使格式化，设计，安排

参考例句：

• Please format this floppy disc.请将这张软盘格式化。
• The format of the figure is very tasteful.该图表的格式很雅致。

14 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

15 straightforward   

adj.正直的，坦率的；易懂的，简单的

参考例句：

• A straightforward talk is better than a flowery speech.巧言不如直说。
• I must insist on your giving me a straightforward answer.我一定要你给我一个直截了当的回答。

16 leverage   

n.力量，影响；杠杆作用，杠杆的力量

参考例句：

• We'll have to use leverage to move this huge rock.我们不得不借助杠杆之力来移动这块巨石。
• He failed in the project because he could gain no leverage. 因为他没有影响力，他的计划失败了。

17 pipeline   

n.管道，管线

参考例句：

• The pipeline supplies Jordan with 15 per cent of its crude oil.该管道供给约旦15%的原油。
• A single pipeline serves all the houses with water.一条单管路给所有的房子供水。

18 undertaking   

n.保证，许诺，事业

参考例句：

• He gave her an undertaking that he would pay the money back with in a year.他向她做了一年内还钱的保证。
• He is too timid to venture upon an undertaking.他太胆小，不敢从事任何事业。

19 scramble   

v.爬行，攀爬，杂乱蔓延，碎片，片段，废料

参考例句：

• He broke his leg in his scramble down the wall.他爬墙摔断了腿。
• It was a long scramble to the top of the hill.到山顶须要爬登一段长路。

20 perverse   

adj.刚愎的；坚持错误的，行为反常的

参考例句：

• It would be perverse to stop this healthy trend.阻止这种健康发展的趋势是没有道理的。
• She gets a perverse satisfaction from making other people embarrassed.她有一种不正常的心态，以使别人难堪来取乐。

21 realizations   

认识，领会( realization的名词复数 )； 实现

参考例句：

• Popular realizations of MPI standard are CHIMP and LAM and so on. 目前，公用的MPI实现有CHIMP、lam等。
• The author presents some realizations from the certificate assurance work. 本文介绍了笔者在ISO9001质量体系认证工作中的几点体会。

22 incrementally   

adv.逐渐地

参考例句：

• Incrementally update the shared dimensions used in this cube. 增量更新此多维数据集中使用的共享维度。 来自互联网
• Grand goals are inspiring, but be sure to approach them incrementally. 辉煌的目标令人鼓舞，但一定要逐步实现。 来自互联网

23 foam   

v./n.泡沫，起泡沫

参考例句：

• The glass of beer was mostly foam.这杯啤酒大部分是泡沫。
• The surface of the water is full of foam.水面都是泡沫。