https://www.cnn.com/2021/01/23/health/pandemi...index.html
Testing
While the FDA has given emergency authorization to many tests for Covid-19, the entire testing ecosystem has been hamstrung by a lack of unified testing strategy: whom to test, when to test, and which kind of test to use. And although the world is one year into this pandemic, there are still supply bottlenecks as well as delays in getting results. All of these issues render testing -- as a way to get infected people quickly into quarantine and even for diagnostic purposes -- almost moot.
"Obviously, we have other tools like mask wearing and vaccinations, but testing alone if deployed widely can end up making a very large difference in controlling the pandemic," says Dr. Ashish Jha, dean of the Brown University School of Public Health.
The first step of making testing an effective tool is to aggressively scale up manufacturing. Jha says we should use the Defense Production Act to "ramp up this kind of testing because if you really want to do society-wide testing of all high-risk situations, you probably be need to be doing 10 to 15 million tests a day."
View this interactive content on CNN.com
The type of strategy he'd like to see is using rapid antigen tests for essential workers and people in high-risk places that include schools, nursing homes and prisons -- basically, "any place where large numbers of people gathered indoors." And how often would they get tested? "In the ideal world based on the modeling data -- twice-a-week testing," Jha says.
Jha has seen this strategy work at his own university's campus where he said everyone was tested regularly. "It was a great reminder that if you take a population of people and do regular testing twice a week, that you can actually keep outbreaks under control and you can continue, not totally normal operations, but operations like with in-person classes throughout the fall," he said.
By targeting testing, Jha argues it can bring total numbers down. "The bottom line is you want to be doing ongoing regular testing of these populations. It wouldn't just protect them -- it would keep infection numbers in the entire community so low that would end up benefiting everybody else as well."
Like Jha, Dr. Michael Mina, assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health, is also an advocate for rapid antigen tests. "The surveillance PCR testing that we've been doing, like I said, it catches about 5% of people in time to act and it's extremely difficult to scale up PCR much." Mina says his advice to Biden would be, "Ask Congress to appropriate $5 billion, which is a drop in the bucket for this virus at this point, to scale up and deploy rapid antigen testing so that every American can use a test twice a week."
Mina explains the twice-a-week interval using rapid antigen testing: "Let's say it's a Monday or on Day Zero you get exposed. Day three, you might turn positive on a PCR later that night. Day three and a half or maybe early day four you might turn positive on an antigen test. And so, the whole idea of twice a week is to shave off a considerable part of people's infectious course," he said.
"And so, if you're using it twice a week, even if you turn positive in the middle of your two tests, by the time you do test, especially because it's rapid, you'll be able to pull yourself out when you've only been spreading for one and a half or two days instead of five days and six days."
Mina also emphasizes that the tests need to be affordable for every American to have access. "Five bucks is a good price. And it's the right price that if Congress appropriates $5 or $10 billion, we could really, really make a major, major difference in this pandemic with that amount of money still giving the companies what they want," he said.
Also, important: privacy. Mina says that it's important to "meet the American public where they are at" and make reporting test results voluntary. "You pick up your iPhone if you want and do a one-click reporting if you want," he said.
"And if not, you keep it to yourself and you yourself know that you're infectious today. And so, you won't go visit your grandma in the nursing home, maybe you won't go to church, maybe you won't eat lunch with your buddies, but it's on your terms."
And that's key to making this one of the most successful tools of the pandemic. "I think this test is the most equitable way to approach fighting this pandemic today. It is a test that can truly be scaled to every household, rich or poor. People can use it on their own terms, regardless of any politics, regardless of how they feel about this virus. You know, and if people don't want to use it, that's their prerogative. But as long as we can get a large number of people using it twice a week, we can actually start to really contain this virus," Mina said.
Testing
While the FDA has given emergency authorization to many tests for Covid-19, the entire testing ecosystem has been hamstrung by a lack of unified testing strategy: whom to test, when to test, and which kind of test to use. And although the world is one year into this pandemic, there are still supply bottlenecks as well as delays in getting results. All of these issues render testing -- as a way to get infected people quickly into quarantine and even for diagnostic purposes -- almost moot.
"Obviously, we have other tools like mask wearing and vaccinations, but testing alone if deployed widely can end up making a very large difference in controlling the pandemic," says Dr. Ashish Jha, dean of the Brown University School of Public Health.
The first step of making testing an effective tool is to aggressively scale up manufacturing. Jha says we should use the Defense Production Act to "ramp up this kind of testing because if you really want to do society-wide testing of all high-risk situations, you probably be need to be doing 10 to 15 million tests a day."
View this interactive content on CNN.com
The type of strategy he'd like to see is using rapid antigen tests for essential workers and people in high-risk places that include schools, nursing homes and prisons -- basically, "any place where large numbers of people gathered indoors." And how often would they get tested? "In the ideal world based on the modeling data -- twice-a-week testing," Jha says.
Jha has seen this strategy work at his own university's campus where he said everyone was tested regularly. "It was a great reminder that if you take a population of people and do regular testing twice a week, that you can actually keep outbreaks under control and you can continue, not totally normal operations, but operations like with in-person classes throughout the fall," he said.
By targeting testing, Jha argues it can bring total numbers down. "The bottom line is you want to be doing ongoing regular testing of these populations. It wouldn't just protect them -- it would keep infection numbers in the entire community so low that would end up benefiting everybody else as well."
Like Jha, Dr. Michael Mina, assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health, is also an advocate for rapid antigen tests. "The surveillance PCR testing that we've been doing, like I said, it catches about 5% of people in time to act and it's extremely difficult to scale up PCR much." Mina says his advice to Biden would be, "Ask Congress to appropriate $5 billion, which is a drop in the bucket for this virus at this point, to scale up and deploy rapid antigen testing so that every American can use a test twice a week."
Mina explains the twice-a-week interval using rapid antigen testing: "Let's say it's a Monday or on Day Zero you get exposed. Day three, you might turn positive on a PCR later that night. Day three and a half or maybe early day four you might turn positive on an antigen test. And so, the whole idea of twice a week is to shave off a considerable part of people's infectious course," he said.
"And so, if you're using it twice a week, even if you turn positive in the middle of your two tests, by the time you do test, especially because it's rapid, you'll be able to pull yourself out when you've only been spreading for one and a half or two days instead of five days and six days."
Mina also emphasizes that the tests need to be affordable for every American to have access. "Five bucks is a good price. And it's the right price that if Congress appropriates $5 or $10 billion, we could really, really make a major, major difference in this pandemic with that amount of money still giving the companies what they want," he said.
Also, important: privacy. Mina says that it's important to "meet the American public where they are at" and make reporting test results voluntary. "You pick up your iPhone if you want and do a one-click reporting if you want," he said.
"And if not, you keep it to yourself and you yourself know that you're infectious today. And so, you won't go visit your grandma in the nursing home, maybe you won't go to church, maybe you won't eat lunch with your buddies, but it's on your terms."
And that's key to making this one of the most successful tools of the pandemic. "I think this test is the most equitable way to approach fighting this pandemic today. It is a test that can truly be scaled to every household, rich or poor. People can use it on their own terms, regardless of any politics, regardless of how they feel about this virus. You know, and if people don't want to use it, that's their prerogative. But as long as we can get a large number of people using it twice a week, we can actually start to really contain this virus," Mina said.
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