COVID-19 Testing Is Still Crucial to Ending Pandemic, Experts Say

While testing people for COVID-19 has been a critical issue during the pandemic, its importance seems to be on the downslide as vaccinations take precedence. But that’s a mistake, health experts say. 

“Testing is a core part of a public health campaign to defeat any epidemic or pandemic," Jeremy Levin, chairman of BIO, the global Biotechnology Innovation Organization, tells Verywell. He explains COVID-19 testing serves several key functions, including:

• Early detection of outbreaks
• Ongoing monitoring of the effectiveness of vaccination in the population
• Rapid detection of spread of new variants
• The ability to rapidly treat those who develop symptoms, even if they’re vaccinated.

The rate of COVID-19 testing declined between January and early March, 2021, according to the Johns Hopkins Coronavirus Resource Center. Considering about 2,000 people died of the virus every day in the first two months of 2021, the rollback on testing is especially concerning. Only about 10% of the U.S. population had been fully vaccinated by the second week of March.

Testing Is Essential to Managing the Pandemic 

In a March 2 editorial from the Infectious Disease Society of America (IDSA), a dozen infectious disease experts emphasized the importance of continued COVID-19 testing to manage the pandemic. Beyond just diagnosing the virus, say the researchers, testing also allows healthcare providers to:

• Counsel patients who are positive about how to limit spread
• Alert hospitals about incoming patients so they can protect other patients and staff
• Reduce spread among staff and patients at nursing homes by keeping ill employees at home and isolating residents who have the virus
• Reduce spread at schools by keeping staff and students at home if they test positive 

Two of the editorial’s authors, Mary K. Hayden, MD, chief of the Division of Infectious Diseases at Rush University Medical Center in Chicago, Illinois, and Romney M. Humphries, PhD, Medical Director of the Clinical Microbiology Laboratory at Vanderbilt University Medical Center in Nashville, Tennessee, spoke at a reporter’s briefing on behalf of the IDSA on March 4, 2021, regarding COVID-19 testing in the U.S.

“We are seeing very little respiratory infection in the U.S. right now other than COVID, so one reason for testing—even if a person has had the virus—is because we want to know how vulnerable they are to a second infection, perhaps from a variant,” Hayden said. 

“If you don’t test, you don’t know how much infection you have. And while infection rates are much lower, they are still high,” Humphries said. “The public health reasons to test are to know how much disease is in the community and who might be part of the chain of transmission so you can do contact tracing.” 

Balancing Testing Efforts With Vaccination Efforts 

During the IDSA briefing, Humphries shared that researchers worry that one reason for the drop in testing is that tests are being supplanted by vaccines when public health departments don’t have enough bandwidth to do both.

Fortunately, the federal government is focused on ramping up testing. On March 11, President Biden signed the American Rescue Plan Act of 2021, a $1.9 trillion COVID-19 relief package. Within the package, almost $48 billion is earmarked to expand and support testing and contact tracing, including in priority settings like schools and shelters. The money will help the U.S. invest in testing capacity so that public health officials can track the virus in real time.  

These initiatives are on top of new testing capacity added in February when the Biden Administration announced an expansion in testing resources, including:   

• Expanding testing for schools and underserved populations 
• Regional coordinating centers to organize the distribution of COVID-19 testing supplies and partner with laboratories across the country
• Increased domestic manufacturing of testing supplies and raw materials that have created shortage issues
• Expanded funding to identify, track, and mitigate emerging strains of SARS-CoV-2 through genetic testing (called genomic sequencing) 

Expanding At-Home Testing 

On an individual level, accurate COVID-19 testing has become more accessible at home. On March 5, 2021, the Food and Drug Administration (FDA) issued emergency use authorization to a new test by Cue Health, the first non-prescription molecular test for COVID-19 that offers results at home.

Molecular tests, also known as PCR (polymerase chain reaction) tests, detect RNA (genetic material) in patient samples from nasal swabs. The molecular tests are generally more accurate than antigen tests, which detect only protein fragments specific to SARS-COV-2, the virus that causes COVID-19. 

While many at-home COVID-19 tests have received FDA emergency use authorization, the at-home component largely refers to sample collection. Then, users have to send their sample to a lab for analysis and wait for results. BinaxNow and Lucira are FDA-authorized and deliver results at home, but they require a prescription. Ellume is an OTC test that delivers results at home, but it’s an antigen test.

At the IDSA briefing, experts expressed concern about whether or not at-home testing with at-home results will help us get a true picture of the state of COVID-19 in the country, since the results won’t necessarily be reported to a public health department. 

Cue Health says a next generation version of its test will have the capacity to transmit results to public health departments.  

While not a part of any current federal plan, free at-home testing could be a boon to helping end the pandemic, researchers say. A study from the Yale School of Public Health estimated that mailing a package of COVID-19 tests to every household in America and asking people to use them once a week could greatly reduce total infections and mortality, based on a mathematical model the researchers developed.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.