The earliest Christians took this statement literally. If they didn't, why did they spend so much time and effort to evangelize others? As time went on, it became clear that either not being exposed to Christianity or not accepting it in good conscience had to be addressed. The Catholic Church has done one of the better jobs of doing the former, but not so much the latter (link). Today, the more conservative Christian apologists get tangled in knots with incoherent defenses of the above Bible quote, as you can see in the links below:
