Congressional Challenger Suraj Patel on Universal COVID-19 Testing

Suraj Patel volunteering during the COVID-19 pandemic. Photo provided by Suraj Patel for Congress.

As governors across the U.S. start reopening their state economies, they will have to grapple with a significant rise in COVID-19 cases. Public health experts recommend universal testing as the key to a safe reopening until the expected delivery of a vaccine. Universal testing refers to the system in which any person who wants or needs a test for COVID-19 can have access to one. Currently, there are two types of tests available to the public. There is a test for the viral antigen itself, which only presents a positive result if a person is currently infected at the time that the test is administered. The other test determines if individuals have created antibodies, which would imply that they were exposed to the virus at some point in the past and have subsequently built up a degree of immunity. 

Universal testing can be implemented through mobile or drive-through testing facilities, or self-administered testing kits sold over-the-counter at pharmacies and online. Strong infrastructure, including testing labs, equipment, and hospital systems, must be in place to efficiently read these tests on a mass scale. In light of frequent misreporting of COVID-19 test results, both national and international oversight is needed to ensure this data collection is transparent and accurate. 

Testing must be made universally available to all Americans, especially marginalized groups that are disproportionately affected by the virus. Multiple studies show that Black, Latinx, and Indigenous communities have the highest rates of infection by the virus compared to their share of the total U.S. population. Black Americans represent 12.4% of the population, but they have suffered 24.3% of deaths. In New York, the Latinx community—while only comprising 19.2% of the state population—has suffered 26.6% of the total deaths. The Navajo Nation has a higher per-capita rate of infections than any state in the U.S. 

Despite being most at risk for COVID-19, these vulnerable populations often lack access to adequate testing facilities. Testing inaccessibility can be attributed to social factors such as narrow eligibility criteria, lower rates of insurance coverage, and, most often, the location of public testing sites. An NPR investigation revealed that in four out of Texas’s six largest cities—Dallas, El Paso, Austin, and Fort Worth—testing sites are disproportionately concentrated in white neighborhoods. In Dallas, for example, 22 testing sites are located in majority-white neighborhoods, while only seven testing sites are located in predominantly-minority neighborhoods. Even when testing facilities are located in low-income neighborhoods, many residents lack access to transportation to the sites and experience language barriers in obtaining testing information. The specific needs of these communities must be addressed as part of a national effort to implement universal testing. 

Suraj Patel, an Obama White House staffer, activist, and progressive running for the Democratic nomination to represent New York’s 12th congressional district, has developed comprehensive plans for universal testing, specifically what it would look like and what logistical measures would need to be put in place for its success. Suraj says he has committed to addressing the racial and socioeconomic disparities in access to testing and inequities within the U.S. healthcare system at large. Last week, I spoke with Suraj to learn more about his plans for universal testing and overall fiscal recovery. 

The first time I heard about you and your campaign was through your feature on NowThis, in which you speak about being diagnosed with COVID-19. First, how was your battle with this disease? Second, how did your personal experience with it affect your perspective as a prospective policymaker? 

Having had the coronavirus, I can definitely speak to my experience and the effect that it had on me. My brother is an emergency room doctor here in New York City, and fairly early into the quarantine phase, we knew we’d be a high-risk group of folks regardless. It was just a few days into quarantine, and I started feeling really short of breath, realizing that something was up. I thought it might be allergies or something, because I didn’t really feel sick at all. No fever, no congestion, no sniffles—no nothing. And then the next day, I woke up with a 102, 103-degree fever, and that lasted for about a week like that, which was pretty miserable even for someone young, who hasn’t had such a fever probably since I was a toddler. And there’s nothing good about that. But, we didn’t just rest on our laurels; I spent seven days sick and seven days recovering, and in those seven days, we said, “You know what—we were fortunate enough that my brother was able to get us tested. Why doesn’t everyone in New York have the opportunity to get tested? Why did Congress leave Washington, D.C. without a universal testing plan? So we sat down and wrote that plan, and that was published in Wired magazine—the first policy proposal for universal coronavirus testing. Congress left Washington, D.C. on March 27th and did nothing about it. They then Tweet and blame Trump about it. But as a coequal branch, Congress has the opportunity to also deliver. And the excuse can’t always be that the Republicans did this or that. That’s where we are coming at this from: we need new energy, new ideas, and a new type of leadership in this post-coronavirus moment. And what we’ve been doing for so many years is no longer working—for any of us. And so I will say it has a personal impact on the way I view what representation and leadership should look like. 

In a Wired article you wrote last month, you gained great traction for being one of the leading voices in the call for a national, coordinated plan for universal COVID-19 testing. Specifically, you call for the widespread distribution of two varieties of tests—one that tests for the viral antigen itself and one that tests for antibodies. Which of these tests, or both, do you see as the priority for universal testing?

When I wrote the Wired article, testing was still barely talked about. I think a lot of advancements have been made since then, luckily, and I think so much about where we’re going—that we’re not there yet on finding a really easy, safe, and rapid antibody test and an easy, safe, rapid antigen test. But I think we’re well on our way, and anytime in the next four weeks, we’re going to see more advancements and approvals on that. So what I think befalls the government, Congress, and our leadership is preparing for the eventuality that these tests will be made available and ending the pain as soon as possible by having a plan in place to logistically get that test out to everyone. The expertise of the science will follow, but it’s upon us to make sure these tests are not disseminated to some neighborhoods and not others.

How do we scale up and adapt our distribution channels to ensure that anyone in the U.S. who wants or needs a test can have one, taking into account the barriers that race, socioeconomic status, and geographic location pose?

That’s the million-dollar question here: we’re now seeing the inequality in our society laid bare. It turns out that 6% of [positive] coronavirus tests in New York City comes from [individuals living in] public housing when only 4% of our city lives in public housing. That means you have a 1.5x higher chance of dying by simply living in public housing. And this is not a new problem; this is a problem that’s been exacerbated over the last thirty years. I think the whole point is that we have to have leadership that acknowledges these issues and prioritizes them. 

While you call for the dispensation of “self-administered, self-reported antibody testing to every American,” currently, many individuals have reported false positives and/or false negatives from their serological testing results. I know you’re not a physician or scientist, but from a policy perspective, what are some ways local governments can ensure that a false positive doesn’t lead to a false sense of confidence?

I think guidelines must be continued to be observed regardless of your test results. That’s first and foremost. I mean, I had coronavirus and I still wear a mask, even though I can’t give it to anybody—to lead by example. Secondly, we’re finding that, rather than the false-positive, the false-negative seems to be the issue, thankfully. Public health is very different from personal health, and you’re talking about statistics and probabilities that are not 100% certainties when you’re looking at public health versus your own personal health. And so anything that has even an 80% accuracy rate is akin to social distancing. It’s not 100% effective, but it significantly dampens and flattens the curve. 

From an economic and logistical standpoint, on what fronts and to what degree must this coordination and mobilization occur to bring the concept of universal testing to fruition? 

I think we need to have some semblance of a public-private dialogue that looks at the expertise available across all sectors and says, “Here’s a logistical problem, here’s a scientific problem, and here’s the funding problem—where can we go from here?” The country is reeling economically because we don’t have a plan that can get people out safely. The economic and logistical implications impact everyone across the board: it doesn’t matter if you’re not in an industry “related” or in a “hotspot area.”

Thanks for the informative foray into your policy on universal COVID-19 testing. I’d like to now turn attention to your policy proposals regarding the government’s fiscal response to the epidemic. In an article you published, you explained that the current and impending recession “is not like a typical recession—it should be treated like a natural disaster that has hit the entire country.” What do you mean by this, and what measures would you enact in these circumstances that wouldn’t “normally” be enacted for a recession?

I think that when you have a typical natural disaster, say a hurricane in Florida and you have to rebuild all this infrastructure and all of these homes, you don’t ever ask whose fault it was. In that scenario it’s no one’s fault: you just fund. You have to look at this the same way. There’s no moral hazard; this isn’t like the 2008 bailout. You just have to fund workers, do something about grants, do something about mortgages. No one’s planning to live with zero cash flow for several weeks or months. You essentially have to pump money into the economy because you then make economic recovery much more sustainable in the long-run. 

In terms of financial relief, the government has vowed bailouts for large industries, notably the airline industry. At the same time, small businesses in this nation are floundering, and I’ve experienced this very closely, as my parents are small business owners, who’ve had a hard time—like so many others—with filing for the Payment Protection Plan and Small Business Administration relief loans. What specific policy proposals or amendments do you have for small businesses that are suffering at this time?

Yeah, we’ve actually put out a lot of on this and have done a lot of town halls on this. On our website is a progressive response for coronavirus that we wrote, and you can draw from that, but to your point, this is a very personal issue to me and my family and many other immigrant families that are in the same boat. Small businesses, especially in New York City, give us the character of our neighborhoods—it makes New York worth living in and being in. That, I think, is something we’re all losing a lot of. Even before coronavirus, this was an issue, where we lost many small businesses to higher rent, and vacancy rates are at record highs. Major national corporate chains are the ones that are filling up the spaces when they can. We have to make sure that this crisis doesn’t exacerbate or accelerate losing much of the character of New York. 

Before I let you go, what do you see as the immediate first step the nation’s government should be taking to allow for universal COVID-19 testing and fiscal relief?

First, I think governments should subsidize wages for companies in the same way that England and Denmark have done successfully; rather than dump a bunch of people on the unemployment program and then have businesses hire them back and create a massive disruption. Subsidizing wages helps prevent workers from being kicked off the system in the first place. Maybe we’re at the endpoint of that point for intervention, so then we really need to look at a substantial double-sided approach, which would be a universal basic income program for workers, families, et cetera, which would help them get through this crisis and get restart loans approved. I think lots of businesses—small businesses specifically—need restart loans to be able to get back on their feet and hiring. 

Roshan Setlur is a staff writer at CPR and a rising sophomore in Columbia College planning to study Economics, Political Science, and Linguistics. He is from New Jersey and is interested in matters pertaining to public and global health policy. He is also an intern for Suraj Patel’s campaign.