Covid Retrospective: Testing Our Way Out

Five years ago, many of us were in lockdown in the United States, unable to know for sure who had COVID and where. In April 2020, more Americans died than were killed during the entire Vietnam War. More than twenty million workers saw their jobs—and the American dream dependent on them—threatened. Roughly fifty-five million kids were locked out of schools and the services, meals, and education available there.

To help, a group of individuals and institutions, including The Rockefeller Foundation, came together to try to meet the moment by scaling COVID testing. As we look back on that time, we can mourn those we lost and look for lessons to inform how we need to meet the moment today—starting with a report published 5 years ago this week.

Partnering for Progress

From over a century of work in public health, the Foundation knew the only way to get Americans out of lockdown was through rigorously tracking the most fundamental data point of the pandemic: Who had the virus and who didn’t. Widespread testing was the only answer, and I wrote as much, alongside economist and Nobel laureate Paul Romer, in a Wall Street Journal op-ed titled “Testing is Our Way Out.”

When that piece ran in April 2020, the United State’s testing was behind other countries. While U.S. laboratories were only running 23 tests per million people, the United Kingdom was running 347 PCR tests per million, and the Republic of Korea was already up to 3,692 tests per million. There was a long way to go.

The op-ed led to waves of individuals and institutions offering to help get testing where it needed to be. Their assistance resulted in a Rockefeller Foundation report, released on April 21, 2020, calling for tripling the nation's testing capacity from fewer than one million a week to three million by July and thirty million by October—a target many considered ambitious. It quickly became known as the “1-3-30 plan.”

That model of convening likely and unlikely partners across political and sector lines proved essential during those chaotic and uncertain days. It was essential to a series of advances, including:

• We worked with a bipartisan group of governors to pool their purchasing power to buy tests.
• We built an ad-hoc consortium called the State and Territory Alliance for Testing (STAT), which included representatives from almost every state and territory to trade notes on what was and wasn’t working.
• We worked closely with the Trump administration’s Department of Health and Human Services (HHS), which eventually committed to purchasing 150 million rapid tests.
• We worked with grantees to pilot school testing programs — supported by HHS — across 335 schools to prove that getting kids safely back into classrooms was possible.
• We worked with experts, business leaders, local officials, teachers, and unions to develop protocols and playbooks that would use tests to get schools back open.
• And we worked with partners in India, Latin America, and Africa to make tests available in those markets.

In a time of great uncertainty, we partnered with governments, communities, and anyone else willing to make a big bet on COVID testing. That commitment to partnership saw us through: One year after it was impossible to find a test, the United States was administering around forty million per month.

Five years later, we’re still trying to collect the data and assess the damage done by COVID and the lockdowns. Still, I look back on The Rockefeller Foundation's contributions with pride and see a lesson in those uncertain days in April 2020—that improving the lives and livelihoods of people, especially the most vulnerable, requires us to work across political, sector, and border lines to find and scale solutions. That’s how we’ve faced the most complicated crises of the past, and it’s how we can solve the problems we face today.