March 5, 2021 – A recent drop in the number of Americans checking for COVID-19 tests has experts on alert. Accurate and timely testing remains crucial in the treatment and isolation of people with COVID-19 infection. Widespread testing can also help you track the spread of the virus and any variants that appear.
“While it feels like things are slowing down a bit with this pandemic, it’s still very important to get examined,” said Romney M. Humphries, PhD, during a press conference Thursday, sponsored by the Infectious Diseases Society of America (IDSA).
“If we don’t test, we don’t know how much infection there is,” added Humphries.
Although infection rates are much lower than they were a few months ago, “they are still high,” Mary K. Hayden, MD, said during the briefing.
In some areas, rates are still higher than they were in summer 2020, said Hayden, IDSA fellow, director of the division of infectious diseases and director of the division of clinical microbiology at Rush University Medical Center in Chicago.
“So we’re still seeing a good amount of infections,” said Hayden. “I don’t think we’re in a place yet where we can really loosen up our general strategies and reduce the number of tests.”
Testing to put vaccination in the background?
While getting more Americans vaccinated is good news, COVID-19 vaccinations could divert attention and limited resources from COVID-19 testing. “While the public is currently prioritizing and considering vaccination, widespread infection control testing is still essential,” said Humphries, IDSA member and medical director of the Clinical Microbiology Laboratory at Vanderbilt University Medical Center in Nashville .
I am concerned that testing will go down in the US. Some of this may be due to a decrease in the number of infections, but a greater shift in focus to vaccination. As we continue to worry about variations, now is not the time to call our surveillance back. https://t.co/W1YKuOHwUf
– Jennifer Nuzzo, DrPH (@JenniferNuzzo) March 1, 2021
Vaccination is replacing testing in some public health countries and is partly responsible for the recent decline in testing numbers. “Health officials may not have the bandwidth to do both comprehensive testing and vaccination, so they are currently focusing on vaccinations,” said Hayden.
Additionally, the fatigue of Americans who have had a pandemic for more than a year could keep some people from getting tests. “I think a lot of people are sort of done with the pandemic,” said Hayden.
Initially, many asymptomatic people or people with mild symptoms sought a test for peace of mind. Although it’s anecdotal, “it seems we’re seeing less of it now,” said Hayden.
Why testing remains essential
“Given the drop in testing numbers, are we really seeing a decrease in cases?” Asked Humphries.
Tests will help public health officials track variants of interest and concern and measure vaccination success and protection from previous infections, she added.
The message remains that people with symptoms consistent with COVID-19 should seek a test. At the individual level, an accurate and rapid diagnosis can promote appropriate treatment and help protect close contacts.
On a societal level, testing is the most accurate way to determine how much coronavirus is circulating in a given community, to adjust quarantine requirements, and to allocate resources to areas with an outbreak.
Additionally, Hayden said, someone who tests positive could be part of an important chain of transmission. In this case, public health officials can initiate contact tracing to contain further transmission.
“In addition to diagnosis, tests are an important tool for enrolling people in therapeutic clinical trials,” said Humphries.
Continuing emphasis on COVID-19 could also help answer the remaining questions: How many people who were previously infected with COVID-19 will test positive afterwards? And if so, is the new infection the same or a variant?
Home Testing: Convenience with Precautions
A number of home tests for coronavirus infection available under FDA approval for emergency use could help increase the number of tests. Having a variety of test methods available will help “really get a lot of tests done,” said Hayden.
While some data suggests that point-of-care testing “isn’t as sensitive as some of the laboratory tests we can run, there may be other benefits that outweigh them,” she added. Examples are more convenience and testing by people who might not otherwise go to a public test site.
Unlike federal and state-level test sites that routinely report positive test numbers, some at-home tests report results via a smartphone app, while others do not. As a result, some positive cases found at home could go untold, an issue that could increase as the use of home tests increases.
“We want to be able to look at the results of this test,” said Hayden. Linking home test results to a health care provider could encourage counseling to people based on their results.
At-home testing could also rule out genomic sequencing of samples to detect and track virus variants. In commercial and government laboratories, there is often enough sample left after testing to test additional variants of interest.
“The reality is that people who test positive at home are pretty unlikely to get these samples,” said Humphries.
On the plus side, Hayden pointed out that while sequencing samples for variants is still important, not every sample needs to be sequenced to track the spread of new variants.
The cost of convenience?
Out-of-pocket costs of $ 25 or more for home testing could be an obstacle for some people, the experts agreed. “I think the price point is a challenge. Realistically speaking, bringing that price point down to a very low level will be a difficult challenge,” said Humphries.
“The populations hardest hit by COVID-19 are the ones least able to afford that kind of price from a home testing perspective,” she added.
Although COVID-19 testing has been more common and accessible, Humphries said other concerns remain. “One of the challenges we face is that some of the really important control strategies that have been used to contain this pandemic are far away.” Areas in which the public space is fully occupied or, for example, mask mandates are eliminated, create, in my opinion, “a feeling for the public that the pandemic is over.”
“And that’s by no means true,” she added.
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