As the coronavirus spreads in the US, with more than 270 known cases, the biggest question that’s emerged is how many infections remain undetected in a testing crisis that’s swept the nation.
The CDC has come under fire for failing to catch the virus during its first, crucial weeks in the US. The agency distributed a diagnostic test to state labs that was faulty, and established rigid, narrow criteria for who could be tested.
With the tests since fixed and the criteria expanded as of last week, the White House is now arguing that the crisis is effectively under control.
“I’m pleased to report that all state labs have the test,” Vice President Mike Pence, who oversees the White House Coronavirus Task Force, said Friday, adding that this week, enough tests for 75,000 patients had been distributed.
But as coronavirus cases are confirmed by the hour across the country, most of all in Washington state, it is becoming clear to public health experts that there are many more that just aren’t getting detected.
To find out how many coronavirus tests are being conducted, BuzzFeed News contacted the public health departments of all 50 states and Washington, DC, between Tuesday and Friday.
The answers revealed stark discrepancies in each state’s capacity for testing, and how they are sharing that information. The hard-hit Washington state, for example, says it can now test nearly 900 people a day. But Wyoming has yet to get state testing off the ground.
Even so, some common answers did come up: Few states have access to commercially produced tests, despite promises to the contrary from the FDA earlier this week.
As of Friday evening, BuzzFeed News confirmed that at least 2,187 people have been tested across the US, either at the state level or by the CDC. (Alabama and Pennsylvania did not provide information on how many tests they had done to date, and their information could not be found online.) An analysis published by the Atlantic on Friday found similar numbers.
Below are each state’s responses to our questions about testing, as well as information from the state agency websites and local news reports. These numbers are a snapshot in time, and will no doubt change rapidly over the next week. But they show just how far behind some state health departments are in getting their testing capabilities off the ground. And even after more tests are distributed, experts worry whether public health services will be able to keep up with the demand.
“We cannot be in a situation where people who are well just walk into the ER and demand a test,” Ryan Stanton, an emergency physician in Lexington, Kentucky, and a spokesperson for the American College of Emergency Physicians, told BuzzFeed News. “We are already handling everything else going on and flu season is still in full swing.”
In the responses below, “test kits” refers to the large batches of materials sent to state public health labs by the CDC. Each test kit contains roughly enough material to test 350 patients, unless otherwise specified by a state health department.
Karen Landers, of Alabama’s public health department, did not disclose how many test kits the state has received. The state lab went live with testing Thursday night. “My lab has advised me that we have adequate supplies to do testing in our state lab,” Landers said.
At least 14 people have been tested, as of Friday.
Arizona has received about 300 tests from the CDC. The state has tested at least 51 people, with at least one confirmed diagnosis, as of Friday. At full capacity, the state lab can do 450 tests a day, a spokesperson said.
Arkansas received one test kit from the CDC on Feb. 10. Between samples submitted to the CDC and tests done in Arkansas’ public health lab, at least six people have been tested, all negative, as of Friday.
Arkansas can run tests for four to five people per day, according to a spokesperson.
As of Thursday, California had the capacity to run tests for about 6,000 people, and was expecting to increase that number to about 7,400 people Friday with the arrival of four new test kits from the CDC. About 15 labs throughout the state can now conduct those tests.
As of Friday, at least 516 people have been tested.
Until this week, Colorado was sending samples to be tested by the CDC. As of Monday, the state said it is now running its own tests and can now test up to 160 samples per day. As of Friday, there have been at least 124 total tests, with one positive diagnosis and 92 negative. (These results are from both the CDC — which conducted 14 of the tests — and the state.)
As of Thursday, Connecticut had tested 18 people, 13 of whom were negative and five still pending, according to the Hartford Courant. The state currently is capable of testing more than 500 patients. Gov. Ned Lamont has asked the CDC for more tests.
District of Columbia
As of Friday, Washington, DC, had tested at least nine people.
According to NBC Washington, it was capable of testing about 25 cases a day this week, and was expecting to increase its capacity to 80 tests a day by next week. Previously, Washington, DC, had sent samples from six possible patients to the CDC for testing (five of whom tested negative, one awaiting results), according to the local news station.
Delaware received one test kit from the CDC. The state clarified that 100 of the tests in the kit were used for quality control, leaving about 300 tests. It’s capable of testing about 50 patients a day, due to a need to run two tests per person, according to a Division of Public Health spokesperson.
Delaware has ordered more test kits from the CDC and expects that some commercial labs will be able to begin testing next week.
As of Friday, the state has tested at least 10 people, all negative.
As of Friday, 115 people have been tested.
“If there is a limit to how many tests can be run per day at these labs, we have not yet reached it,” a spokesperson for the state Health Department said. “We will work with CDC if we need additional kits or reach an overwhelming volume of tests.”
Georgia’s state lab, which began testing people Thursday, has tested about 50 people and has the capacity to test about 40 people daily, according to a spokesperson. Local news reports Friday said that it was awaiting confirmation on a positive test for one patient.
The CDC (which is in Atlanta) has sent the state one test kit, which the Health Department has estimated will provide it with around 150 tests, according to the spokesperson.
Hawaii began testing late last week and is capable of doing 250 tests a week. As of this week, there have been at least six negative results. There are 72 people who are self-monitoring with public health supervision, 65 of them on the island of Oahu.
Idaho has enough testing supplies for about 600 people, with an influx of testing supplies from the CDC just this week, and it can test 15 to 20 patients per day. As of Friday, 27 people had been tested and 36 were being monitored, with no positive results.
“Idaho was one of the few states that was able to use the tests CDC sent in the original shipment,” said a spokesperson. “We currently have no confirmed cases, but testing is being done every day at the state lab. We expect that it’s only a matter of time before we have a positive result.”
As of Friday, Illinois has done 185 tests, with five confirmed cases and two recovered. The state has materials for 2,000 tests and has asked the CDC for more.
Public health officials said Indiana has tested at least 12 people, and reported its first positive case Friday, according to local news reports. A spokesperson said that its state lab is using CDC-issued kits.
As of Friday, Iowa had conducted 17 tests total, all negative, and was waiting on two pending results. The CDC performed two of the five tests, and the remaining three have been performed at the State Hygienic Lab at the University of Iowa, which has supplies provided by the CDC.
A university spokesperson said that the lab is capable of testing about 500 patients.
Kansas has received the CDC’s test and used it for 11 people under investigation, all of whom have tested negative.
As of Wednesday, Steven Stack, Kentucky’s public health commissioner, said that 10 tests had been conducted: one positive and nine negative. Three of those tests were done by the CDC and seven were conducted by state officials. All future tests in Kentucky will be done in state labs. The state can test close to 1,000 people.
The state has been able to conduct tests using modified CDC tests since Monday, according to the commissioner.
“The kits that were sent out and reported to be defective had one of the components that didn't operate as they anticipated,” Stack said. “But with the remaining components they were able to come up with an alternative way to use the test kit that works and is validated. We had hoped to be up and running last week, but it took a few days for the laboratories to create the technical solution they found. We now have an operational test that we believe to be valid that we can use here in Frankfort.”
He added: “State labs reacted quickly to innovate to address the problem … Whatever it was it has been solved — it was a transient bump in the road.”
As of Friday, Louisiana had completed five tests within its state lab. There have been no confirmed cases in the state.
State health officials said they currently have the capacity to run between 150 and 650 tests, depending on how many patients are being tested at one time. If necessary, the lab could run all of those tests within one to two days.
“Along with many other states, the Department of Health was not able to validate the initial test kits received from the CDC,” a spokesperson said. It took the state about a week from requesting new ones to receiving them.
The state has a “limited” number of test kits, but “we have not had a need to send lab specimens to the CDC, before we were able to complete our own testing, or since we have been able to complete our own testing,” the spokesperson said.
As of Friday, Maine has recently received new testing equipment. Its Health and Environmental Testing Laboratory is calibrating it and is “positioned to do testing” within the next several days. In the meantime, it has sent approximately a dozen samples from people to the CDC for testing. It did not have problems with the initial tests it was sent by the CDC.
At least 41 people have been tested, with three positive cases, as of Friday. Maryland wasn’t able to start testing until Tuesday. A spokesperson said the state has “an ample supply of tests at this time” but was unable to provide a specific number.
In the first three days of this week, epidemiologists in Massachusetts responded to more than 1,000 calls from people who thought they had coronavirus symptoms, a spokesperson said.
The number of people who have been tested to date isn’t clear, but at least eight people are presumed or confirmed to have the virus, as of Friday.
The Massachusetts State Public Health Laboratory said it had an “adequate” number of tests and is able to meet the current demands for testing.
Michigan received its first test kit from the CDC on Feb. 8, then two others on March 5, which are still being validated. Until then, the state has testing capacity for about 300 people. It can test about 86 people every eight hours. It initially encountered issues with the CDC test, but the revised test is now working.
As of Friday, at least eight people have been tested (five by the CDC, three by the state’s Bureau of Laboratories). All were negative.
The state added that it has ordered a test kit from an undisclosed commercial vendor, but has not received it yet. “We have ordered a test kit from a private vendor and will be working through the validation process once we receive it,” a spokesperson said. “If the validation process is successful, we will provide our results to CDC/FDA for approval to use the kit for COVID-19 testing.” Each commercial kit costs $234 per 500 reactions, they said.
As of Friday, at least 49 tests had been done, with 48 negative cases and one positive. Minnesota has three test kits, and said it can test about 400 people per kit. Sara Vetter, who manages the infections disease laboratory for the Minnesota Department of Public Health, estimated that the lab was capable of running about 400 to 500 tests per day.
It received the first test kit in February, which was faulty, though Vetter said it was now working. A second kit arrived last week, and the third in early March.
Mississippi did not answer questions about how many patients it has tested, but said it had tested 14 “samples.” There are zero confirmed cases to date.
The state has received one test kit from the CDC, capable of running 225 tests, according to state epidemiologist Paul Byers. It initially had issues with the CDC test, but the current test is functioning. The state has ordered more kits from the CDC.
Missouri has the capacity to test about 800 patients, according to a spokesperson. The state has tested 12 people and another nine cases were sent to the CDC. There are zero confirmed cases to date.
At least 11 people have been tested, all negative, as of Friday. Montana has received two test kits from the CDC to date: the first a few weeks ago, the second on Thursday.
At least 23 people had been tested as of Friday, with zero positive results.
As of Friday, Nevada has tested at least 14 people. It has the capacity to do more than 600 tests using the CDC’s materials, and received an additional 800 tests from a commercial provider earlier this week. It can run about 100 tests per day, according to Mark Pandori, director of Nevada’s State Public Health Laboratory.
As of Friday, 25 people had been tested in New Hampshire, with zero positive results.
At least 22 people in New Jersey have been tested, with 18 negative tests and four presumed positive, according to a spokesperson, as of Friday. (Of the 22, five were tested by the CDC before New Jersey’s state lab was conducting testing.)
The state has received two test kits from the CDC — one in February, one this week — and said that it’s able to test about 216 people with each kit.
New Mexico received a test kit Feb. 8 and another this week, and said that it was able to run a total of 1,400 to 2,000 tests. Like other state labs, it initially encountered issues with the CDC’s first test. As of the end of the week, it had tested 16 patients, all negative cases.
“We have yet to reach capacity,” a spokesperson said. “The number of tests we would be able to do would be dependent on the number of shifts required in a work day.”
New York state has tested at least 278 people, with 29 positive cases, 68 negative, and the rest pending, as of Friday.
BuzzFeed News reported last week that the state of New York was developing its own test after the CDC’s proved faulty. This week, the state said that it was using a test developed by scientists at the Wadsworth Center, which “will soon be able to perform testing for thousands of patients,” a spokesperson said.
“In addition, a number of commercial labs and large hospitals will also be able to test very soon,” the spokesperson said. “We are working closely with the large hospital labs in New York state to enable them to perform testing as soon as possible.”
As of Friday, North Carolina has reported two positive cases, though those test results had not yet been confirmed by another lab.
As of Friday, North Dakota has received supplies for 100 tests from the CDC. It is capable of running 50 to 100 tests in a given day, with the capability of doing more as needed. North Dakota hasn’t tested anyone yet, however.
As of earlier this week, Ohio hadn’t received test kits from the CDC — but was hoping to receive them by the end of the week, according to a spokesperson.
“When the test kits were sent last month, Ohio did get a malfunctioning test kit,” a spokesperson said. “We continue to work [with] CDC to get the current test kit.” Until that happens, Ohio has been shipping the samples to the CDC to be tested.
As of Friday, 10 people have been tested — eight of them cleared, two of them pending.
Since the last week of January, Oklahoma has sent six samples to the CDC for testing: five negative and one pending. Oklahoma received test kits from the CDC last week and is validating them now. Once they’re up and running — no timeline was given — the state expects to be able to run 100 tests a day, according to a spokesperson.
Oregon has received two test kits from the CDC, on Feb. 8 and Feb. 29. It has not had issues with the tests. It has the capacity to run about 80 tests a day.
As of Friday, at least 95 people have been tested, with three positive and 64 negative.
Pennsylvania is currently using a test kit sent by the CDC in mid-February. “As many state and local health departments did, we did have issues validating the test kit originally,” a spokesperson said, but the tests are now up and running.
The state has the ability to test 20 to 25 samples per day, and expects to see that number increase in the near future with added equipment. It isn’t releasing the numbers of people who have been tested.
As of Friday, Rhode Island has tested at least 21 people. It has not had issues with testing capacity, a spokesperson said. There are at least three confirmed cases.
South Carolina has received two kits from the CDC — one during the initial release in February, the other this week — and is successfully testing after encountering issues with the first kit. It’s capable of running 80 to 100 tests per day, and has so far run five tests.
South Dakota has conducted five tests and all were negative, according to the state’s Department of Health website. State officials did not respond to repeated requests for more information.
Tennessee has tested at least eight people, with one positive diagnosis. As of Thursday, its state lab has the capacity to test 85 additional people, and is prioritizing testing for those who have come into contact with an infected person. A spokesperson said the CDC is providing overflow testing, if needed.
After initial issues with the CDC test, a spokesperson said that Texas’s state public health labs had the ability to test as of this week. A lab in Austin, for example, has run two tests and is capable of running 52 tests a day.
“If someone has COVID-19 symptoms and travel[s] to an area where it’s spreading or other possible exposures, they should see a doctor,” and the doctor will consult with officials about whether a test is warranted, according to Chris Van Deusen, a spokesperson for the Texas Department of State Health Services. “It’s not always black and white, but with limited capacity, we need to prioritize testing for people who really need it and that helps us learn more about the situation in Texas.”
Utah has received two test kits from the CDC, most recently on Feb. 29, and initially had issues with the CDC tests. It has also paid an undisclosed amount for a test from a commercial provider.
The state has tested at least five people as of Friday and is capable of running 60 tests a day.
As of Wednesday, Vermont had enough supplies from the CDC to conduct about 250 tests. As of March 6, the state has tested eight people, all negative.
“We can currently run 26 tests/per day, but we have plans in place to ramp up to 52 tests/per day and later 78 tests/day, if needed,” said Ben Truman, a Vermont Department of Health spokesperson, in an email to BuzzFeed News.
Virginia has received two kits from the CDC, on Feb. 10 and March 3, and has requested a third. Due to extensive validation required for each test, the state estimates having the capacity to test 50 to 60 people per kit.
It’s tested at least 31 people, with 21 negative and 10 pending.
Although it’s been able to meet the demand so far, “we will need additional test kits from the CDC in order to be able to meet the increased demand for testing,” Dena Potter, a Department of General Services spokesperson, said by email.
In the state hardest hit by the outbreak so far, “when testing first began, there was a problem with the supplies we received,” a spokesperson said. “But we have been running tests in our lab since Feb. 28 with the corrected tests.”
As of March 4, 209 tests were run in the state, representing 91 people. The spokesperson said that Washington’s state public health lab can run up to 200 tests (100 people) per day. The University of Washington Virology Lab, which came online this week, is expecting to run 1,500 tests (750 people) per day.
In West Virginia, testing is currently done by the CDC and must be approved by the state’s Division of Infectious Disease Epidemiology.
West Virginia’s public health lab has received one test kit, which it said can run 400 to 500 patient specimens, and expects to receive another kit next week. “The state public health lab is in the verification process and is expected to be able to run tests in the next few weeks,” said Allison Adler, a West Virginia Department of Health and Human Resources spokesperson.
As of Friday, the state has tested three people; one was negative and two are pending.
Asked how many tests Wisconsin has received from the CDC, Allen Bateman, assistant director in the Communicable Disease Division at the Wisconsin State Laboratory of Hygiene, said it isn’t easy to quantify, but that the state can currently run “about 100 tests” a day and is capable of testing “hundreds of patients.”
This test “isn’t like a pregnancy test where one stick is one result for one patient,” Bateman said. Instead, it “uses a lot of different parts, or inputs that go into each test. At any given time, one particular input may be the limiting factor.”
Wisconsin received the first batch of test kits from the CDC on Feb. 7, found that the tests were faulty, and has since received new kits that have passed Wisconsin’s own verification testing. These tests are now working. As of Friday, the state has tested at least 44 people, with one positive case.
As of Friday, Wyoming had submitted one request for testing to the CDC.
No specific numbers were given for testing capability, but a spokesperson said, “Based on the low demand we’ve seen so far, we feel confident we will be in good shape for some time. Keep in mind our population is quite low as well.”