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Logistics Failures In The COVID War

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Guest post by Dr. Smith

It has been said that in war amateurs discuss tactics and professionals discuss logistics.  Before becoming a physician, I was a military history major in college and an infantry officer and understood this maxim well.

One of the core tenets of both Trump and Biden’s plan for COVID was early identification of cases through widely available testing to ensure populations were COVID-free for various life activities (school, work, travel, etc.).  As a doctor in the “trenches” assessing and treating hundreds of COVID for the entirety of the pandemic, I am not privy to Presidential discussions. 

However, I am able to share my observations and experiences with availability of testing kits—a vital tool in accomplishing the above-mentioned core tenet of recovering from the COVID pandemic.  It goes without saying that medical personnel need the proper tools (equipment, test kits, medications, hospital beds, etc.) to do their duty.  In a medical crisis, the duty of the government and larger organizations is to keep medical personnel supplied so they can do their jobs.

Here is a brief timeline in the COVID testing saga:

2020 MAR  Democrats criticize President Trump for not having COVID test kits

2020 APR-NOV FDA approves test kits for hospitals and later for home use

2020 NOV Biden wins presidency

2020 DEC Dr. Fauci warns the US of the delta variant as a cause of later surge in cases

2021 JAN Biden assumes Office of President of the United States

2021 AUG Rapid test kits widely available to hospitals, urgent cares, retail stores for home use

2021 AUG New York Times publishes article that Abbott is destroying rapid kits and laying off workers in its factory

2021 SEP Biden announces 6 pillars of COVID plan, including widespread testing

2021 SEP Hospitals no longer have enough test kits; home test kits are sold out and unavailable

2021 SEP Hospitals are rationing COVID testing

Today is 16 SEP 2021.  We are nearly two years into the COVID pandemic.  I just received a text from my medical director that our ER (in a major city) is down to 35 rapid COVID test kits with no resupply date in site.  Extreme rationing is now in effect.  Today a query online shows that CVS, Walgreens, Walmart, and Amazon are out of rapid test kits without any way to pre-order/backorder.  There is little to no news about this critical issue on an online search.

PCR testing is more accurate but is more expensive and time-consuming.  The machines are expensive and many ERs and urgent care centers do not have them.  PCR tests mailed from ERs, urgent care centers, or home take days to give results.  

The previously available low-cost rapid test kits are invaluable in this pandemic in all settings:

Emergency Rooms (increases the capability of life-saving decision-making): Appropriate categorizing of patients into COVID/non-COVID wards, rapid identification of COVID status for emergency procedures, rapid identification and schedulingof COVID patients who may be eligible for antibody infusions since the infusions must be given within 10 days of onset of symptoms.

Urgent Care (improves decision-making for providers and patients with regard to resuming or remaining in essential life activities): Appropriate categorizing of patients into COVID/non-COVID to clear them for return to school/work/travel to business productivity and students don’t miss yet more days of school.

Home (contributes to lowering the rate of spread and unnecessary trips to Emergency Rooms and Urgent Care Centers): Informs people with milder symptoms as to whether or not staying home, quarantining, or seeking medical care is most appropriate.

Logistics of COVID testing is easy.  During deployments to war zones, I would attend nightly meetings where commanders would discuss the logistics status of key items (fuel, ammunition, maintenance of weapons/vehicle, computers, etc.  Similarly, the President should be having weekly meetings with CEOs of companies that make test kits and CEOs of the major hospital systems to discuss production capability, availability, reserve of tests for spikes, and any production/distribution problems.  

Congress has authorized the spending of trillions (with a T) of dollars through COVID-related bills.  With the average cost of a home kit at $10, 10 billion dollars of those trillions could have resulted in a billion reserve test kits for hospital and home use during inevitable spikes. Congressional-approved spending could have been used to preposition warehouses of test kits around the country to rapidly distribute when needed.  Not only should the destruction of rapid tests cease, reserves of test kits should begin immediately.  

At nearly two-years into the pandemic, we have sufficient data on the most effective policies and strategies used by cities, counties, states, and countries.  And, yet, we have now come full circle and are experiencing the same supply shortages.  Dr. Fauci warned us 9 months ago about the delta surge.  More surges will come and the demand for test kits during these spikes is predictable.  For the sake of our nation’s public health, security, economic recovery, and the education of our children, our government officials and medical leadership need to act now to fix this current shortage and not let political opinions impede interpretation of evidence nor influence policy decision. 

Dr SmithPenned under pseudonym due to US Medical organizations trending towards censoring physicians

This letter is the opinion of the author and does not represent the stance of any organizations or corporations

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