In mid-March, Pete Massaro felt like he was in over his head. The global coronavirus pandemic was spreading quickly through the U.S., and Massaro, an engineer at Verily, the life sciences unit owned by Alphabet Inc., had suddenly been tasked with heading up the company's efforts to help speed testing people for covid-19, the disease caused by the virus. He now had three days to open two drive-through testing sites.
It was a tall order. Massaro's team would have to find suitable locations, staff them, source supplies and figure out how to safely do the tests. Then, adding to the stress, President Donald Trump announced out of the blue that Google, Verily's sister unit under the Alphabet umbrella, was working on a nationwide system to coordinate testing. While Trump mistook Verily for Google, he also overpromised on the effort behind the fledgling operation, which was to start with only two counties in California.
The announcement on March 13 threw Massaro's team abruptly into the spotlight. After a sleepless weekend, Verily's project went live on Monday March 16. "This didn't feel as serious until it became very serious," said Massaro, who is director of automation at Verily. "It sort of shook us into action."
In the nearly two months since Trump's announcement, the pressure hasn't let up. Verily, along with local health officials, private clinics and large corporations, have scrambled to quickly open thousands of pop-up testing sites across the country in an effort to fill gaps in the American health-care system. But it's not clear that this patchwork model of testing sites will ever reach the level of testing necessary, or the right people, to ease up on national social distancing requirements and help businesses safely reopen.
As of May 4, Verily had facilitated testing for about 42,000 people. That's a fraction of the nearly 7 million tests done across the U.S. since early January, according to The COVID Tracking Project. But that isn't nearly up to the 500,000 tests a day experts say the U.S. will need -- at a minimum. Right now, the country is doing about half of that on the most active days. Testing is still limited to people who are ill or part of high-risk populations such as health care workers and nursing home residents. But it will need to expand to include everyone who comes into contact with a person who is positive.
Even for a company like Verily, backed by Alphabet with its immense financial and human resources, getting a testing program up and running is extremely complicated. Verily is, at its core, a technology and research company, not a medical facility. Its initial proposal for covid-19 testing was to create a website to help screen people with symptoms and send them to one of two Verily sites where they could be tested. On its first day in operation, Verily's website was overwhelmed with applicants. The company tested just 20 people.
Since then, it's moved towards coordinating testing, rather than conducting its own tests or processing the results. Partnering with convenience store chain Rite Aid Corp. and the California Department of Health, Verily is now involved with 37 locations in eight states. Those sites can each do about 250 tests a day. Verily is also looking at mobile and walk-in testing sites to help serve people who don't have cars or live far from a permanent site.
"By scaling to more states and more individual sites, we aim to not only help individuals who need to be tested for covid-19 but also play a supportive role in driving evidence-driven policy that will successfully manage this health crisis," a Verily spokesperson said in an email.
The U.S. government is pushing for more testing efforts as it seeks to reopen the economy as soon as possible while hoping to avert a second wave of infection. Last week the White House announced that it's expanding efforts with Rite Aid, Walmart Inc., CVS Health Corp. and Walgreens Boots Alliance Inc. to open parking-lot testing facilities nationwide. The administration is helping determine the locations and is offering funding assistance.
As the U.S. moves toward creating more long-term testing solutions, CVS Chief Medical Officer Troyen Brennan has said the company expects small, nimble testing sites in vans or kiosks will become more common, rather than places like a shuttered casino and college where the company opened its first testing sites. CVS is planning to expand its operations to offer testing at 1,000 locations, including in its store parking lots and drive-through windows, and eventually hopes to process 1.5 million tests a month.
"This is the blunt part of the pandemic response where we put up big tents and try to keep people socially isolated," he said in an interview last month. The next step is moving past the emergency phases and designing a system that works smoothly all over the country, Brennan said.
Finding locations for testing sites can be difficult, especially with social distancing efforts enforced.
"We got chased out of a lot of spots," Massaro said. Local officials had seen news footage of huge crowds of potentially sick people queueing up for tests elsewhere and didn't want that in their community, he said.
Getting enough equipment to do the tests is also still a problem.
"Every day is a struggle to match the amount of PPE and swabs you need," Massaro said, referring to personal protective equipment for health care workers. "That's the way the world is right now, getting those supplies in place has taken a lot of work."
Diagnostic testing is just one part of a multipronged effort to get people back to work, eating in restaurants and going to school. Widespread contact tracing, or tracking the disease as it spreads from person to person, will need to be in place to contain new outbreaks, as will antibody tests that help public health officials judge how much a disease has spread within a community and who might be potentially immune to infection. Disagreements between President Trump and state governments over the best approach suggest it's unlikely a truly coordinated national effort to stop the disease will come together.
Still, the private efforts are pushing forward, ramping up testing as best they can on their own. Verily, for instance, has rapidly diverted company resources toward its own testing efforts, sometimes setting up sites virtually overnight."Scaling the test sites is absolutely doable," Massaro said. "There's a lot of innovation happening."