ARI SHAPIRO, HOST:
More than six months into this pandemic, the federal government still has not created a national COVID-19 testing strategy. One organization that has stepped in to fill the gap is the Rockefeller Foundation. We should note they are a financial supporter of NPR. A bipartisan group of governors just signed on to work with the foundation to implement a national testing and tracing plan. Dr. Rajiv Shah is president of the Rockefeller Foundation and has been leading this effort. He joins us now.
Welcome.
RAJIV SHAH: Thank you, Ari. Thanks for having me.
SHAPIRO: You recently said in a public letter this terrifying tragedy was not and is not inevitable and that testing is the only way out of our present disaster. So put some concrete numbers on this for us. How many tests is the U.S. doing, and how does that compare to the number we need to do to get out of this disaster?
SHAH: Well, the first concrete number to know is that America accounts for 4% of the world's population, and we've suffered 25% of the world's deaths.
SHAPIRO: Sure.
SHAH: So that's an indicator that our current response is simply not up to the task at hand. Now, in terms of why testing is so important, unless you know who is positive with COVID-19 and take them out of the chain of transmission quickly, you don't stop COVID-19. And up to 50% of the transmission is people without symptoms. We're largely missing all of that with the current...
SHAPIRO: But I guess what I'm wondering is, given the raw number of cases the U.S. is looking at and the steep increase, can we even get the number of tests necessary to get this under control? What kind of scale are we talking about?
SHAH: Well, today we do about 4 1/2 to 5 million tests a week. And in general, almost all of those or the vast majority are PCR clinical diagnostic tests that go back to a laboratory that take anywhere from three to 10 days to return a result. And what we are proposing is a new strategy and a different strategy, a strategy that calls for going from the 5 million a week we're doing now to 30 million a week by investing in screening tests - cheap, fast, frequent, low-cost tests that get you a result in 15, 20 minutes that we can use to help teachers know that they're safe in their classrooms, that we can use to make sure nursing home residents are safe in their facilities and that we can use to make sure people going into a meatpacking plant know that they're negative before they're going to work on a regular basis.
SHAPIRO: And do you also then have to build a whole infrastructure system to move those millions of tests from one hotspot to another as cases crest in New York and start to boom in Florida, for example?
SHAH: You do. You have to have the capacity to do broad, ubiquitous screening testing everywhere in America and then scale it up as needed. And that's why six governors - three Republican governors, three Democratic governors - joined the Rockefeller Foundation and announced that we're going to jointly acquire millions of these antigen screening tests, which are a little bit less sensitive than the gold standard PCR tests. But frankly, for the purpose of making sure that people are safe in their day-to-day activities, especially those critical activities like schools and health facilities, it's really the only way out.
SHAPIRO: You have worked in government. You were USAID administrator during the Obama administration, and now you're in the world of foundations. Who should be responsible for an effort of this scale, the federal government or a charitable organization?
SHAH: Well, the answer is very clearly, you know, leadership in all walks of life. Like, in this case, you need federal government leadership. We've actually called for $75 billion of investment in this strategy from - in the next stimulus bill. And we've done that on a bipartisan basis. But you also need the companies themselves to invest in large-scale manufacturing. You need governors and mayors holding hands with the federal government and saying, we're going to do this. One thing we need that's missing right now is we need the CDC to issue protocols so that, you know, teachers and hospitals and principals around the country know, how do you go about putting screening programs in place? How frequently do you have to test, in what districts and under what level of community transmission? That is something else we need.
SHAPIRO: And just briefly, given the intense political pressure that the CDC has been under from the Trump White House, do you feel that you have a good partner in the Centers for Disease Control?
SHAH: You know, we're working with everyone. I have been and we have been - we represent maybe 150 experts, including Republican and Democratic experts, that have all called on CDC to issue these types of guidelines. They're not there yet, so we're waiting.
SHAPIRO: Rajiv Shah is the president of the Rockefeller Foundation, and we appreciate your speaking with us today.
Thank you.
SHAH: Thank you. Transcript provided by NPR, Copyright NPR.