The Original Sin of the United States response to the COVID-19 Pandemic was the inability to get enough tests to isolate and contain the outbreak. The US missed a critical window to ramp up testing and implement precautionary procedures to get on top of the virus.

January 2020: The World Health Organization opted to use an approach developed by Germany to test for COVID-19. The United States instead decided to develop its own testing approach. The German testing method was made public on January 13, 2020 and the American testing method was made public on January 28 2020. The American tests were defective and gave inaccurate readings. Because of this, The United States had a very slow start in widespread testing. The CDC gave restrictive guidelines on who could be eligible for COVID-19 testing. The initial criteria were people who had recently traveled to certain countries, or people with respiratory illness serious enough to require hospitalization, or people who have been in contact with a person confirmed to have coronavirus.

On February 19, 2020 the first U.S. patient with COVID-19 of unknown origin (a possible indication of community transmission) was hospitalized. The patient’s test was delayed for four days because he had not qualified for a test under the initial federal testing criteria. By February 27, 2020 fewer than 4,000 tests had been conducted in the U.S. Although academic laboratories and hospitals had developed their own tests, they were not allowed to use them until February 29, 2020 when the FDA issued approvals for them and private companies.

On February 25, 2020 a group of researchers from the Seattle Flu Study defied federal and state officials to conduct their own tests, using samples already collected from flu study subjects who had not given permission for COVID-19 testing. They quickly found a teenager infected with COVID-19 of unknown origin, indicating that an outbreak had already been occurring in Washington State for the past six weeks. State regulators stopped these researchers’ testing on March 2, 2020.

On March 5, 2020 Vice President Mike Pence, the leader of the coronavirus response team, acknowledged that “we don’t have enough tests” to meet the predicted future demand. By March 11, 2020 the U.S had tested fewer than 10,000 people. On March 12, 2020 Dr. Anthony Fauci acknowledged “a failing” of the U.S. system and that the demand for SARS-CoV-2 tests was not being met.

The first COVID-19 cases in the U.S. and South Korea were identified at around the same time. Critics say the U.S. government has botched the approval and distribution of test kits, losing crucial time during the early weeks of the outbreak, with the result that the true number of cases in the United States was impossible to estimate with any reasonable accuracy. South Korea’s aggressive testing, contact tracing and isolation of those infected succeeded where the US response failed. They flattened the curve.

By March 22, 2020 drive-through testing had started in more than thirty states, although the Associated Press reported that “the system has been marked by inconsistencies, delays, and shortages,” leading to many people waiting hours or days even though they showed symptoms and were recommended by a doctor to get a test.

On April 6, 2020 Federal health inspectors released a report stating that hospitals were experiencing shortages of test supplies, personal protective equipment (PPE), and other resources due to extended patient stays while awaiting test results.

By early May, 2020 the U.S. was testing around 240,000 to 260,000 people per day, but this was still an inadequate level to contain the outbreak.

By June 24, 2020 thirteen of the forty-one federally funded community-based testing sites originally established in March were set to lose federal funding. They remained under state and local control. Trump administration testing czar Admiral Giroir described the original community-based testing program as “antiquated”. In June 2020 Trump said several times that the U.S. would have fewer cases of coronavirus if it did less testing—”If we didn’t do testing, we would have no cases”—and he told a June rally that he had ordered a slowdown in testing. In July 2020 he continued to suggest that “if we did half the testing we would have half the cases”.

In August 2020 the CDC quietly lowered its recommendation for who should be tested, saying that people who have been exposed to the virus but are not showing symptoms “do not necessarily need a test”. The previous recommendation had been that people exposed to the virus should be “quickly identified and tested” even if they are not showing symptoms, because asymptomatic people can still spread the virus.

In December, 2020 the FDA authorized the use of a rapid testing kit developed by Brisbane, Australia-based Ellume Health. The test is available for purchase without a prescription for about $30 and can give results in about 20 minutes. The FDA approved the test for people with and without COVID symptoms.

Effective January 26, 2021 the CDC will require all air passengers two years of age and over entering the United States (including U.S. citizens and Legal Permanent Residents) to present a negative COVID-19 test, taken within three calendar days of departure​, or proof of recovery from the virus within the last 90 days.

March 5, 2021 the FDA issued an Emergency Use Authorization (EUA) to Cue Health Inc. for its over-the-counter at-home diagnostic test for COVID-19. As of March 9, 2021, there are 340 tests and sample collection devices are authorized by the FDA under EUAs.

Joe Biden met his goal of 100000 vaccine shots in arms early (58 days) and reset his goal for 200000 shots in arms in his first 100 days. He called for Americans to do their part to end the pandemic by wearing masks and keeping up social distancing as the vaccine rollout ramps up. “We’re in a war with this virus,” he said. Had testing been rolled out with the same level of resolve, hundreds of thousands of lives could have been saved.