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Why Testing Improvements Are So Critical
With improvements in testing life could get closer to normal
It’s time to talk about testing again. Everyone thinks we are doing it badly and we are. Until we do better we are not going to be close to back to normal.
We need tests for three different purposes:
- Confirming people are sick
- Testing where the outbreak goes
- Using tests to allow entry into buildings, schools, and activities
Tests to confirm people with symptoms are sick need to be quick turnaround time. We’re currently not doing that. The only way there is to reduce cases and infection levels. The last three months have made it impossible.
The PCR tests should be able to keep up with demand if we lower demand and if we specialize on using them for sick people. Accuracy is important, but it’s also time that PCR tests are required to meet a turnaround time standard.
The second use for tests are to test asymptomatic people. These can be run at state labs by health agencies and should be available everywhere. The primary purpose for these tests should be to see where the virus is spreading so we can catch invisible cases and isolate.
These tests need to be accurate but not as accurate as PCR tests. Mostly they need to be cheap and easy and not compete for the same resources — swabs and specialized reagents — as the first type of test.
SalivaDirect is a roughly $5 test. It uses (you guessed it) saliva. And interchangeable reagents. Because these are asymptomatic people, they can be run in pools, another reason they can be done more cheaply.
These tests can add millions to the stockpile of tests we can do each day. Even if they’re not perfect, they will help us fight the virus.
Neither of these tests matter without two other things — isolation capabilities and contact tracing.
Dr. Tom Frieden will be on my podcast on Monday. He has pioneered many of these approaches. One of the key things Tom points to is a place we are falling short and that is looking at some of the most important data. How many positive cases are successfully isolated so they are terminal…
