CIDRAP Advocates for COVID-19 "Smart Testing" - Public Health Watch

Testing, testing, and more testing may be the key to reopening the economy as the coronavirus 2019 (COVID-19) pandemic rages on, but it may not make for optimal public health practice, a new report from the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota suggested.

The guidance, “COVID-19: The CIDRAP Viewpoint,” advises against universal testing of asymptomatic patients by hospitals and clinics and shoots down the idea of antibody testing of the entire US workforce, as part of the process for getting employees who can’t work remotely back to work.

Both would be a waste of the country’s already limited testing capacity, according to CIDRAP, and antibody testing still may not provide accurate enough data to be relied upon to such an extent.

As of this week, according to the COVID Tracking Project, the US has tested more than 14.6 million people for the new coronavirus, SARS-CoV-2. Although this is an astronomical figure, the nation’s per-capita testing rate remains behind those of several other countries, including Germany and South Korea, based on estimates from Our World in Data.

While it’s important for the US to ramp up testing, an ideal approach would involve “testing smarter as well as harder,” Howard Koh, the Harvey V. Fineberg Professor of the Practice of Public Health Leadership at Harvard T.H. Chan School of Public Health, said during a conference call with reporters last week

This would entail a focus on at risk populations—such as those living in nursing homes as well as prison inmates, for example.

“We’re so focused on numbers of people being tested, and we are not focusing on what the accomplishment of that testing is all about,” said Michael Osterholm, PhD, MPH, Director of CIDRAP, told the Minneapolis Star-Tribune last week.

CIDRAP is pushing for a national “smart testing” strategy that moves beyond so-called “‘Test, test, test!’ mantras.”

As such, it recommends that the US secretary of Health and Human Services (HHS) should appoint a blue-ribbon panel of national experts on testing by July 1 that will, among other objectives:

• Establish national guidelines for both virus (diagnostic) and antibody detection (serology) testing.
• Draft a strategy for how testing should be used to monitor COVID19 hotspots.
• Determine steps needed to create a streamlined national laboratory testing reporting system and defined reporting standards .
• Develop protocols for rapid review of new testing technologies and modalities.

“We strongly encourage that HHS review and evaluate the use of testing for SARS-CoV-2 in the public health response to COVID-19 by governments around the world to learn state-of-the-art approaches and best practices that could be incorporated into the US response,” the authors of the CIDRAP report note. “Effective testing for SARS-CoV-2 will require a concerted effort that combines laboratory testing technologies with other critical components to optimize a US public health response that includes increased SARS-CoV-2 testing.”

Now, the only question is: can the US implement a smart testing approach before COVID-19 costs even more lives?