Test millions. Test early. Test late. Test over and over. Test until the whole damn pandemic is over - Umair Irfan
Here are four reasons that testing still matters, and how officials see the next months, and years, playing out.
Diagnosing people who are sick
Case numbers remain high, and clinicians still need to identify individuals who have contracted the virus so that these people can receive proper treatment and care. The gold standard for diagnosing Covid-19 is the polymerase chain reaction, or P.C.R., test, which can identify even small traces of genetic material from the coronavirus.
This kind of testing will be needed as long as there are Covid-19 cases, but as the disease becomes less common, diagnostic testing is likely to become less centralized.
“The game has changed a little bit,” Dr. Hong said. “Before, we just had infection popping up everywhere, and we just needed broad, blanket testing access. Now we need to be much more targeted.”
Diagnostic testing is shifting from large, government-run sites to smaller, more distributed sites that are spread across local communities, Dr. Hong said. Ultimately, when vaccination rates are high enough and cases are low enough, dedicated testing sites will not be needed at all. “Then we just return testing to the health care system,” he said, and coronavirus tests will simply be one of many options on the menu at the doctor’s office.
Slowing the spread
Testing is important not just for identifying individual patients who need treatment but also for public health. When the system is working, a timely Covid-19 diagnosis is what triggers contact tracing and quarantining and can stop virus transmission in its tracks.
“The vaccine — marvelous, miraculous as it is — is not in and of itself going to contain this pandemic,” said A. David Paltiel, a professor of health policy and management at Yale School of Public Health.
Slowing transmission means fewer people will get sick but it also gives the virus fewer opportunities to mutate. And that reduces the odds that dangerous new variants — some of which may be able to evade vaccine-induced immunity — will emerge.
Keeping community spread low will help give vaccines “a fighting chance,” Dr. Paltiel said. “The less work we give the vaccine to do, the better.”
As schools and offices reopen, routine screening of asymptomatic people will help minimize viral spread. These screening programs are now beginning to ramp up. Many will rely on rapid antigen tests, which are less sensitive than P.C.R. tests but are cheaper and can return results in 15 minutes. (Antigens are molecules, like the well-known spike protein, that are present on the surface of the coronavirus and trigger the immune system to produce antibodies.) When antigen tests are used routinely and frequently, they can be effective in identifying infectious individuals and reducing viral transmission, several analyses suggest.
As vaccination rates increase, these screening programs may become more targeted. If 70 percent to 80 percent of Americans are vaccinated, the prevalence of Covid-19 plummets, and outbreaks are not emerging in group settings, then it may be possible to ease up on widespread screening, said Dr. Mary K. Hayden, an infectious disease specialist at Rush University Medical Center in Chicago. “Then, yes, I think we could relax surveillance testing,” she said before adding, “But it’s a lot of ‘ifs.’”
Even then, however, officials may want to maintain some level of surveillance testing in high-risk settings, like nursing homes, or of high-risk individuals, like travelers, she said.
Assessing our progress
Testing can help public health officials gauge whether efforts to end the pandemic are paying dividends.
“Do we want to know how well vaccines are working? We’re going to have to test,” said David O’Connor, a virologist at the University of Wisconsin, Madison. “How are we going to know whether the variants are more contagious? We’re going to have to test. How are we going to know if the vaccines are effectively controlling the variants? We’re going to have to test.”
Large screening programs may also help institutions assess the effectiveness of their risk-reduction strategies. If cases begin to rise, schools and offices may find they need to change their mask policies, enforce greater social distancing or boost their ventilation rates.
Testing might also help uncover worrisome case clusters, which can signal that a community has not yet reached herd immunity and might benefit from targeted a vaccination campaign.
Preventing the next pandemic
Many experts now believe that the coronavirus is unlikely to ever disappear completely. But even if the virus continues to circulate only at very low levels, it will be important to keep tabs on it.
“It becomes less about trying to interrupt the transmission of the disease and more to understand, Where is the virus?” Dr. Nuzzo said. “What are we missing? And, you know, what could be coming down the road?”
The virus will continue to mutate, and new genetic variants will emerge. Some level of continued testing, even years down the line, could help scientists catch worrisome variants early.
Tests aren’t perfect, of course, and can produce false negatives and positives. But they provide a critical window into the activity of a pathogen too small to see.
“We’re going to want to make sure that after people are vaccinated, it’s not going to bubble up in some other unpredictable way that’s going to put us back where we started,” Dr. O’Connor said.
Source: Emily Anthes, Excerpt from Why Testing Still Matters, The New York Times, March 28, 2021.
Some scientists say the nose-only approach is missing early infections, but the FDA warns against throat swabbing.
The end result is a lot of confusion about testing and a lot of frequently asked questions. Here are some answers to queries you might have about COVID-19 tests.
Basically, the vaccines enable the immune system to detect the virus more quickly. Symptoms may therefore appear earlier, when levels of the virus are still too low to be detected by a rapid test. The discordance between symptoms and test results may seem scary, but it’s a promising sign that the vaccine has effectively fortified the immune response.
FDA has identified three COVID-19 molecular tests that are not able to detect the omicron variant and warned that the diagnostics from Applied DNA Sciences, Meridian Bioscience and Tide Laboratories will return false negative results.
The result so far has been around-the-block lines at testing sites and shortages of at-home tests at drug stores. And many Americans are facing the possibility that they'll have to scrap their plans altogether, as the number of testing opportunities dwindles ahead of the holidays.
Long covid testing lines and low availability for at-home rapid tests prove challenging for pandemic-battered Americans.
You want a coronavirus test? How about next month?
The amount of information coming out about new test development — from at-home testing to portable/point-of-care tests with faster results — can be overwhelming, and it may be difficult to keep track of when and where these tests will be available...
We now have an even greater urgency, due to the severe and single-minded policies already implemented. Treating COVID-19 “at all costs” is severely restricting other medical care and instilling fear in the public, creating a massive health disaster, separate from a potential world poverty crisis with almost incalculable consequences.
Problems with diagnostic testing have plagued the U.S. response to the coronavirus pandemic, leaving health officials unable to follow the virus as it spread throughout the country. So what happened?
The U.S. has never had enough coronavirus tests. Now a group of epidemiologists, economists, and dreamers is plotting a new strategy to defeat the virus, even before a vaccine is found.
The US lags just about every developed country on testing for Covid-19 disease.
A new generation of faster, cheaper coronavirus tests is starting to hit the market. And some experts say these technologies could finally give the U.S. the ability to adopt a new, more effective testing strategy.
New findings, scientists say, will speed up the mass production of affordable self-collection kits that can be dropped in the mail.
While not as sensitive as PCR, these antigen tests can be tremendously helpful in surveillance of new outbreaks. Their low cost and ease of use means they can be deployed frequently and for large numbers of people outside the clinic, such as at nursing homes, colleges, and workplaces, to quickly deliver results that prevent nascent outbreaks from spreading.
Intermediaries are finding labs with capacity for companies seeking to make sure workers are virus-free. But many employers choose to avoid the cost.
If physicians can do virtual consults, the thinking goes, patients should be able to do tests at home, instead of languishing in lineups.
“People will invest $7 to get a burger delivered to their house, so why not invest in some tech that will mean you don’t have to leave your house and go into a physician’s office and put yourself in potential harm’s way?” Thomson said.
Crack open the door of at-home diagnostics and behind it may lie an entire world of at-home health-care advances: vaccine delivery, urine analysis, flu shots and more.
I’ve called people from all walks of life, from highly paid executives to minimum-wage workers and the unemployed. The responses to the news I deliver is as varied as they are.
BioReference Labs shut down temporarily in July in a controversial move that helped it win new business and prepare for the coming flu season.
Rapid at-home tests are in the works, but without oversight, they could fail to live up to their potential.
Health officials are divided on whether home monitoring with a pulse oximeter should be recommended on a widespread basis during Covid-19. Studies of reliability show mixed results, and there’s little guidance on how to choose one. But many doctors are advising patients to get one, making it the go-to gadget of the pandemic.
To end social distancing, we need mass testing. America is not there yet.
We need more testing to safely reopen the country, but there’s a lot standing in the way.
As we approach two years of facing off against this virus, many of us, as hosts, are different now: more knowledgeable and, thanks to vaccines, far better defended. We have more and better tests. But like everything else in our pandemic toolkit, tests will fail when they’re asked to bear the prevention burden alone.
Testing can do things for us now that it couldn’t do before.
America’s complicated health-care system means everything is harder—even rapid testing.
Rapid tests could help us get the pandemic under control in the near term. And over the long run, they could become an essential tactic for reducing the spread of SARS-CoV-2 to low levels, so Covid-19 becomes more a nuisance than remaining a national emergency.
Faster than PCR and more accurate than lateral flow tests, the latest weapons against Covid-19 have four legs and a wet nose.
Widespread and frequent rapid antigen testing (public health screening to suppress outbreaks) is the best possible tool we have at our disposal today—and we are not using it.
States know very little about the results from rapid coronavirus tests.
It’s especially critical for finding those people who may be spreading the virus without showing symptoms.
But you probably haven’t had your last nose swab.
We asked some of the nation’s leading experts on testing to help answer common questions about how to get tested, what to expect and what the different tests and results really mean. Here’s their advice.
Testing is critical for staying ahead of the new variants.
With case numbers still high, coronavirus testing remains essential, experts say, but the goals and approach will change as vaccines roll out.
Tests can have up to a 30% false negative rate, meaning they miss that proportion of people with actual infections.
Coronavirus testing can be used to help understand if you have, or may have had, COVID-19. Patients who experienced symptoms of COVID-19 or believe they were exposed can consider two types of tests: antibody and active infection tests.
Schedule B2B at-home tests with Switch Health online. A Switch Health staff member will reach out to confirm your appointment. On the day of your appointment, a Switch Health nurse will arrive on-site at your desired time to perform the COVID-19 test. The nurse will do a quick symptom check, fill out a requisition form, and perform a bilateral anterior nasal swab in the shallow nasal cavity. This test is not intrusive and is done in 30 seconds. Your specimen will be sent to a Health Canada approved laboratory and results will be communicated to you in 24-48 hours.