[Goose]

I believe that the bottleneck is testing reagents.  Like literally not enough pipettes or extraction solution, etc.

https://www.mckinsey.com/industries/phar...ic-testing

Executing a test requires some 20 different reagents, consumables, and other pieces of equipment. Of those materials, major shortages have been reported in RNA-extraction kits and certain reagents, including enzymes and primers.7 The global manufacturing capacity for molecular-assay tests is estimated to be between 37 million and 38 million tests a week, given current availability of the various test components, with RNA-extraction kits being the bottleneck to higher capacity (Exhibit 3).8 That compares with fewer than 10 million tests a week being conducted around the world, according to our research.

BC

Just to be clear, I think you mean that pipettes or extraction solution, etc. are not the limiting factor in testing. After reading the McKinsey document, I conclude it is a consultant's document. The relevant explanation of the reagent issue is

There are two potential explanations for the gap. First, a significant quantity of the reagents being manufactured are those that run on open systems—that is, less integrated systems that can run a wider range of test methods. Such reagents cannot be used with the high-throughput machines that tend to be used in developed countries and are closed systems requiring cartridges loaded with proprietary reagents manufactured by the OEM. Second, as Exhibit 3 shows, most of the available manufacturing capacity is based in China, potentially making access to it more difficult, given validation and export considerations.

Keyword is "potential". Unfortunately they offer no evidence that Roche, ABI etc. aren't delivering on time all that has been ordered. It should be easy to find out if that is the case, but the authors didn't. I have no idea myself, but if it were a bottleneck, I would have expected to hear about it from the press, or from places like UW and Stanford who are running such tests. We have heard about shortages at Stanford early on, but not subsequently. If I ran a testing lab with samples backing up and my vendor wasn't delivering, I assure you I wouldn't be quiet about it. It would seem to me the authors can't justify the statement that the 10M tests per day limit is caused by reagent limitations, given the capacity limit there of 38M tests and no real evidence that the proprietary reagents are actually the bottleneck. 
There has been a significant difference between reported testing capacity and actual tests being performed since the beginning. My first post noting this was on April 19th. I didn't know why then, and even after reading the McKinsey document, I don't know why now. Apparently nobody does, or it would be fixed by now. What I can't understand is the reason that e.g. Quest would not increase capacity if they are running flat out. They have had time to do so. Even if the lead time on a high throughput PCR machine is 90 days (and as I understand it it is more like 30 days), that can't be the issue. I can only conclude they aren't at capacity yet. WTFO?

[Goose]

I believe that the bottleneck is testing reagents.  Like literally not enough pipettes or extraction solution, etc.

https://www.mckinsey.com/industries/phar...ic-testing

Executing a test requires some 20 different reagents, consumables, and other pieces of equipment. Of those materials, major shortages have been reported in RNA-extraction kits and certain reagents, including enzymes and primers.7 The global manufacturing capacity for molecular-assay tests is estimated to be between 37 million and 38 million tests a week, given current availability of the various test components, with RNA-extraction kits being the bottleneck to higher capacity (Exhibit 3).8 That compares with fewer than 10 million tests a week being conducted around the world, according to our research.

BC

Just to be clear, I think you mean that pipettes or extraction solution, etc. are not the limiting factor in testing. After reading the McKinsey document, I conclude it is a consultant's document. The relevant explanation of the reagent issue is

There are two potential explanations for the gap. First, a significant quantity of the reagents being manufactured are those that run on open systems—that is, less integrated systems that can run a wider range of test methods. Such reagents cannot be used with the high-throughput machines that tend to be used in developed countries and are closed systems requiring cartridges loaded with proprietary reagents manufactured by the OEM. Second, as Exhibit 3 shows, most of the available manufacturing capacity is based in China, potentially making access to it more difficult, given validation and export considerations.

Keyword is "potential". Unfortunately they offer no evidence that Roche, ABI etc. aren't delivering on time all that has been ordered. It should be easy to find out if that is the case, but the authors didn't. I have no idea myself, but if it were a bottleneck, I would have expected to hear about it from the press, or from places like UW and Stanford who are running such tests. We have heard about shortages at Stanford early on, but not subsequently. If I ran a testing lab with samples backing up and my vendor wasn't delivering, I assure you I wouldn't be quiet about it. It would seem to me the authors can't justify the statement that the 10M tests per day limit is caused by reagent limitations, given the capacity limit there of 38M tests and no real evidence that the proprietary reagents are actually the bottleneck. 
There has been a significant difference between reported testing capacity and actual tests being performed since the beginning. My first post noting this was on April 19th. I didn't know why then, and even after reading the McKinsey document, I don't know why now. Apparently nobody does, or it would be fixed by now. What I can't understand is the reason that e.g. Quest would not increase capacity if they are running flat out. They have had time to do so. Even if the lead time on a high throughput PCR machine is 90 days (and as I understand it it is more like 30 days), that can't be the issue. I can only conclude they aren't at capacity yet. WTFO?