 Bloomberg Opinion -- Many of the recent stories are familiar, but still distressing and perplexing.There was the gentleman in Tucson who waited 27 days to get results from a Covid-19 test, only to discover he didnt have the virus and the two weeks he spent in quarantine had been pointless. There was the nonprofit nursing home chain in the Phoenix area that waited five days for test results, only to learn that several staff members and residents had the coronavirus; the asymptomatic staffers had roamed freely until the results arrived. And there have been many tales of Arizona residents waiting a week, on average, to get test results and sometimes much longer even though their state has been a coronavirus hotspot for more than a month. Texas, Florida, California and many other newly resurgent corona-states have similar stories.Test results, to be useful, should arrive in less than two days. If they take longer, opportunities to isolate infected people and trace their contacts with others wither, undermining broader containment efforts. So why cant the wealthiest and most innovative country in the world have more rapid-fire testing during a pandemic?Several other wealthy countries already set good examples around testing that the U.S. might have emulated, measures including national testing strategies and aggressive contact tracing. The U.S. also had a lag between its first coronavirus outbreaks in the spring and the current surge, which gave private and public stakeholders in the testing community a chance to catch up. Yet even though testing has ramped up massively to about 780,000 tests a day, from 145,000 per day in early April some experts say that to combat the coronavirus effectively the country should be conducting at least 5 million tests a day. Federal health authorities recently said the U.S. has already reached its daily testing capacity, but by fall should have the ability to conduct about 1.3 million to 1.7 million tests a day. That would be an improvement, but clearly not enough especially if a second coronavirus wave washes across America come October or November.Even now, the spread of the virus has outpaced testing increases. In Arizona, in-state testing volume jumped 50 while the growth in new Covid-19 cases exceeded 100. More testing isnt a solution anyhow if results arent prompt. And the sheer number of cases in the U.S. adds to the problem. During the spring, coronavirus cases peaked at about 36,000 a day. Last Thursday, more than 75,000 infections were reported a new record. That same day, a bipartisan group of health care experts, scientists, former senior public officials and investors released a report warning of further economic and social devastation if Covid-19 is left unchecked.Testing is the only way out of our present disaster, and it will remain the case until a vaccine or effective therapeutics are widely available, noted the report, which was sponsored by the Rockefeller Foundation. The authors call for 75 billion in immediate public spending to buttress the testing effort, which would be the single best investment America could make in averting an even more tragic and pending disaster.Even if you dont believe the coronavirus has brought on an apocalypse, it still makes sense to fix and fortify national testing to protect public health before other disasters arrive. A civilized, equitable and well-functioning country shouldnt be satisfied with the current testing regime. Rather, it should set to work to establish effective public-private partnerships, embrace the role of the federal and state governments as problem solvers, and hold the private sector to higher standards.While the Trump administration and the federal government have drawn ample criticism for leadership failures around testing, the private sector has also proved unequal to the epic challenges a pandemic presents.Federal agencies such as the Centers for Disease Control and Prevention, state labs and hospitals all provide testing services, but commercial labs dominate the market. The clinical testing business, which generates annual revenue of about 80 billion, has a number of big players, including ARUP Laboratories, BioReference Laboratories, Mayo Clinic Laboratories, and Sonic Healthcare Ltd. But two aggressive competitors, Quest Diagnostics Inc. and Laboratory Corporation of America Holdings, dominate the field.Quest earned 858 million on revenue of 7.7 billion in 2019. The company says its operations touch the lives of 30 of the U.S. adult population and it boasts of relationships with about half of all physicians and hospitals in the country. LabCorp earned 824 million on revenue of 11.5 billion last year. It says it interacts with 3 million patients weekly, controls proprietary data derived from 35 billion lab test results which includes about 50 of the U.S. population, and has contributed to the development of all 50 of the countrys top-selling drugs.Both companies were assembled through decades of mergers and acquisitions, diagnostic ingenuity and an unrelenting focus on expanding their market share. Quest and Labcorp are preferred or exclusive providers for many of the largest private health insurance companies in the U.S., and they process a large portion of tests covered by Medicare and Medicaid.Quest, in its securities filings, describes the testing market as fragmented and highly competitive. But Quest and LabCorps sales suggest they jointly control about a quarter of the business. Smaller competitors have complained over the years that Quest and Labcorps tight relationships with insurers and the federal government make it hard for them to break into health care networks to offer alternatives. Some consumers have alleged that the companies charge exorbitant prices for tests administered to uninsured patients, and both companies have drawn scrutiny for possibly overbilling Medicare and Medicaid charges that theyve denied.In the spring, questions about how readily insurers would cover charges from all companies for Covid-19 tests, along with many patients reluctance to visit doctors offices, brutalized the testing industrys bottom line. Quest and LabCorp seem to have weathered this better than most; the stocks of both companies are trading around their 52-week highs. Yet even they havent been able to meet the testing demands imposed by Covid-19.As the virus rampaged in June and July, both companies, having rapidly upped their testing game, still lagged. A three-to-five-day turnaround time for test results they announced at the end of June gave way to a four-to-five-day delay by the first week of July. After announcing the second delay, Quest said it didnt expect to get any faster until the coronavirus stopped spreading nationally. Dont expect that to happen anytime soon. In an interview with the Financial Times on Tuesday, a senior Quest executive said it will be impossible for his company to increase coronavirus testing capacity to cope with demand during the autumn flu season.That leaves patients, hospitals and society in a bind. Consider Arizona, which has the highest Covid-19 positivity rate of any state. The virus has spread there so quickly and deeply that a public health official in the states most populous county has said contact tracing may have become worthless. Sonora Quest Laboratories a partnership between Quest and the Banner Health hospital chain handles 80 of Covid-19 tests in Arizona, making it the largest testing network in the state. And it can take 11 days for Sonora Quest to deliver test results.Arizona Governor Doug Ducey, a Republican caught flat-footed by the outbreak, recently channeled 1 million in state funds to Sonora Quest to help buy equipment to process tests more quickly. Hes also started pushing a new testing partnership with Arizona State University, and hes working with the federal government to set up free testing sites. Perhaps he will have better luck than Phoenix Mayor Kate Gallego, a Democrat, who said she requested federal testing sites in April and was rebuffed by the White House.But Ducey comes late to his testing push, having been reluctant to impose other public health measures such as stay-at-home orders, masks and lockdowns. And regardless of his new incentives, its not clear how quickly Sonora Quest can ramp up testing and improve turnaround times.Another governor decided to circumvent the major labs altogether. New Yorks Andrew Cuomo, a Democrat, has advised his states residents to patronize local labs rather than Quest or LabCorp to get timely test results. About 70 of New Yorks tests are now processed by 200 local labs that return results in one to three days, the state said.Smaller labs around the country have excess capacity theyre unable to deploy because they havent been able to break into the insurance networks dominated by the big guys. And labs of all sizes struggle to operate at full capacity because a balkanized supply chain forces them to compete against one another for frequently scarce resources.Those resources include reagents the chemicals labs use to detect the presence of a virus, swabs for collecting patient samples, personal protective equipment, tubes and other media used to transport samples, and proprietary test kits that work with diagnostic machines from companies such as Hologic Inc., Thermo Fisher Scientific Inc. and Abbott Laboratories. Those kits are a special challenge because theyre not interchangeable: Labs that use machines made by Hologic, for example, cant use kits designed for machines made by Thermo Fisher. A dearth of testing kits was a problem in the spring. Now theres a dearth of testing machines. All of this has become a tar pit for labs and their employees working around the clock. 