President Trump’s announcement in March that Google was developing a tool to screen and schedule people for covid-19 tests heralded the yet-to-be-launched website as a way to streamline testing.
Verily’s slow expansion across the United States underscores just how complicated coronavirus testing remains. Mass testing is key to lifting stay-at-home orders, health experts say, and has not been implemented widely enough.
Verily last week rolled out testing with Rite Aid in eight states, including Virginia, New Jersey and Michigan. That’s because Verily is reliant on partners — it doesn’t conduct its own tests or process the results, and many patients have not heard of it.
When Verily opened a testing site in Stockton, Calif., this month in partnership with the state, only nine people were tested on the first day. Verily said federal guidelines asked it to cap testing at 250 people a day at each site to conserve testing kits, though that cap was recently lifted. It took two weeks to reach 186 patients in a single day.
The fragmented combination of testing efforts by federal health departments, local health officials, private clinics and corporations is causing communication breakdowns, doctors and other health experts said. That has created confusion for patients and scientists.
“It’s not centralized at all,” said Yvonne Maldonado, an infectious-disease epidemiologist at Stanford University. “We don't have one dial-in number. There’s no 911 for public health.”
Establishing a foothold in the chaos is even tougher for Verily, the doctors and experts said. That’s because the venture, a life sciences company under Google parent firm Alphabet, has roots in technology and research, not in clinical medicine. The company’s focus even before the crisis has been on developing the Project Baseline study, which aims to “map” human health by recruiting people to participate in clinical trials that give health-care researchers a window into specific health issues.
The coronavirus testing is part of Project Baseline and operates as a tool to bring together screening, scheduling and results for patients. In California, Verily partners with the state government and multiple private companies to verify screening and actually conduct and process tests. Broadly, it aims to give health officials a view of the virus’s spread in different areas.
For coronavirus testing, Verily is relying on partners too and faces an additional hurdle of little name recognition among those searching for testing sites. Ultimately, federal guidelines and common practice drive people to call their doctors when they feel unwell, the experts said.
“It’s hard to do laboratory testing when you’re not part of an integrated health system,” said Alex Greninger, assistant director of clinical virology laboratories at the University of Washington Medical Center.
Verily spokeswoman Carolyn Wang pointed to the fast-moving nature of the coronavirus pandemic to explain the company’s limited expansion.
“It’s been a really complex and rapidly evolving situation because there are so many interdependencies, including availability of testing supplies and PPE, collaborations to operationalize sites, and community readiness to stand up sites,” she said. “We’re moving as fast as we can and are proud of how quickly we’ve been able to assist our partners, including local government entities, with helping to ramp up testing nationally.”
Verily was thrust into the national spotlight on March 13 when Trump said during the daily coronavirus briefing that Google had 1,700 engineers working on the screening website. Deborah Birx, the White House coronavirus response coordinator, said they wanted to bring the approach “across the continent.”
“Google is helping to develop a website,” President Trump said. “It’s going to be very quickly done, unlike websites of the past, to determine whether a test is warranted and to facilitate testing at a nearby, convenient location.”
In reality, Verily had only begun working on launching a small pilot of the website to begin screening people in the Bay Area. The White House announcement sent the company scrambling to roll out a public launch of the project over the weekend after Trump’s announcement.
It was the latest in a string of confusing pronouncements around testing by Trump during his daily briefings. He also said that anybody who wanted to get tested could — but the country was struggling with a shortage of tests, and many who sought testing were denied.
The Washington Post has reported that Trump’s son-in-law and senior adviser Jared Kushner was instrumental in the announcement after pressing tech executives to help build a testing website and retail executives to help create mobile testing sites — but the projects were only half-baked when Trump revealed them.
Deputy White House press secretary Judd Deere said in an email that the administration appreciates Google’s efforts to “help America defeat COVID-19.”
“It is because of President Trump’s leadership that he has brought together government and private industry for an unprecedented collaboration to curb the spread of the virus, expand testing capacities, and expedite vaccine development,” he wrote.
Verily offers a screening form online that people can fill out — once they connect to it with a Google account, which has raised some privacy concerns. If Verily determines, using public health guidelines, that the person is eligible for testing, it schedules a time for the person to visit a testing site operated by Verily and its partners. But that applies only for those living in one of the handful of locations where Verily offers screening.
Verily partners with diagnostic testing companies to actually conduct the swab tests and then sends samples to be processed at lab processing centers including those run by Quest Diagnostics. Because it does not have its own lab infrastructure, it has to partner with companies at each testing site it sets up, likely slowing expansion.
In mid-March, it started with just two locations in the Bay Area in partnership with the California Department of Public Health. The first weekend, there were reports of people trying to schedule appointments but instead receiving notices that no more appointments could be made at that time.
In California, Verily has expanded to nine sites as part of the partnership with the state, including in the Central Valley and Los Angeles County.
In the Central Valley city of Stockton, the Verily site‘s slow start confused some officials.
Tiffany Heyer, spokeswoman for the office of emergency services in San Joaquin County, where Stockton is located, said she and others at the office were confused as to why Verily was not immediately meeting its capacity when they had heard of so many people wanting to be tested. Some potential patients told them they were rejected due to screening criteria, something that may have lowered the number.
Verily last week expanded its testing efforts outside California when it partnered with Rite Aid to screen and schedule people to get tested at the Rite Aid chain’s 25 testing locations across the country. That more than doubled the number of sites where Verily is screening to 34.
Verily says it has screened more than 175,000 people nationally and found more than 64,000 eligible for testing. Public health guidelines require symptoms or high-risk factors for testing, Verily says, but some private health clinics are starting to test people who do not meet the criteria. A much smaller number of people have been tested because of capacity and no shows.
Verily spokeswoman Rachel Ford Hutman said the company is in talks with multiple organizations to further expand across the country.
But the Rite Aid rollout last week confused some local health officials, who said they weren’t aware of many details or Verily’s involvement — once again underscoring the confusing communication surrounding testing among different levels of government and companies.
Local health officials are often the ones pointing patients to testing sites and operating information hotlines.
At least five local health authorities in areas where the Verily website now says it has screening said they weren’t aware of its involvement. Many had been informed Rite-Aid was setting up operations in the region but only knew that the drugstore chain was working with the federal government.
“You want to work cooperatively, especially during a pandemic,” said Angela Musella, health officer of Northwest Bergen Regional Health Commission in New Jersey, where Rite-Aid is conducting tests in Waldwick. “It would have been nice to have been consulted.”
Rite-Aid spokesman Chris Savarese said he hadn’t heard that local health authorities felt uninformed and said he understood the federal Department of Health and Human Services, with which Rite Aid is working, was communicating with them. The drugstore chain decided to work with Verily to help people easily screen and schedule appointments online, he said.
It may not be the solution federal officials touted, but local health authorities in some cities where Verily operates said it’s helpful to have more testing options, even if they aren’t huge operations.
“I don’t know how helpful it will be,” said Donna Skoda, health commissioner for Summit County Public Health in Summit County, Ohio, where Rite Aid has opened a testing location. “Except it will give us more testing, and we desperately need more testing.”
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