testing for Covid-19

What’s It Gonna Take for the U.S. to Reopen for Business? Testing.

Testing for COVID-19 remains one of the biggest obstacles in reopening the U.S. economy and returning to a pre-COVID life or at least a “new normal.” Our country’s COVID-19 expert, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN April 28 that the country needs about 3 million tests per week. (That was the day after government officials announced the U.S. should have the capacity to test 2 million people per week by the end of May, while according to The Hill, in the prior two weeks an average of less than 1.5 million tests per week had been conducted.)

Dr. Fauci went on to tell CNN he hopes that by the end of May or beginning of June, everyone who needs a COVID-19 test will be able to receive one. But, that doesn’t mean that everyone will get one.

Let’s do the math

According to the UN, the U.S. has a population over 331 million. So far, according to Worldometers.info, as of May 4th,  7,462,597 people in the U.S. had been tested for COVID – or 2.3% of the population. We have about four more weeks until the end of May. So even if we accelerate testing to 3 million tests a week, and get 12 million more people tested, with roughly 20 million tested, we’ll still have 311 million more tests to go. At 3 million tests a week, it will take us nearly two years to get everyone tested.

So, based on those stats, we better get used to sheltering in place, as we await a vaccine.

BUT, what could change that painful trajectory? More tests! 

In Los Angeles, Mayor Eric Garcetti announced April 29 that all residents can receive free COVID-19 testing. No longer do you need to have COVID symptoms or be a front-line worker: that’s the good news. The bad news is that testing is by appointment only at city-run sites, with priority testing for critical front-line workers or people with symptoms. Not surprisingly, with more testing of largely symptomatic patients, on April 29, LA County saw its largest known increase of new COVID-19 cases in a single day: over 22,400.

In fact, according to The Hill, 1,015,289 people in the U.S. have already tested positive for COVID-19 – who are assumably recovering, sheltered at home, in a hospital, or were asymptomatic to begin with.

So, how many tests do we really need to reopen?

Well, of course, that depends on whom you ask…

NPR quoted public health officials who said, if a high percentage of tests come back positive, that’s an indication that there are not enough tests to capture the total infected population in a community. However, an epidemiologist at Harvard told NPR that testing would be sufficient if 10% of tests or fewer come back positive. Nationally, about 17.5% of COVID-19 tests have come back positive, as of April 29, according to data from Johns Hopkins. However, state by state, the percentage of positive tests varies significantly. For example, in the five states with the most confirmed COVID-19 cases as of April 28: in New York 34.9% are testing positive; in New Jersey, 48.6%; Massachusetts is better at 22%; in Illinois, a little better at 19.9%. And, in California, only 8% are testing positive.

Plus, more funding is on the way to produce more tests, according to Becker’s; last week the NIH announced a new program with $1.5 billion in federal stimulus funding to speed up development of COVID-19 diagnostic tests called the Rapid Acceleration of Diagnostics, or RADx, initiative. Through the program, the NIH is encouraging all scientists to compete in a national COVID-19 testing challenge for a share of up to $500 million, with the most

successful candidates being paired with manufacturers and business experts to help scale up production of their tests. And already the latest coronavirus stimulus bill included $25 billion for testing.

Appropriately the CDC also updated its testing guidelines last week, placing residents in long-term facilities, such as nursing homes or prisons, who have COVID-19 symptoms as high priority to receive a test. Others having priority for testing include anyone who has symptoms including fever, cough, shortness of breath, chills, muscle pain, a new loss of taste or smell, vomiting or diarrhea, and/or a sore throat.

Meanwhile, the private sector is mobilizing, too.

Kaiser Permanente is converting a warehouse in Berkeley, into a $14 million testing site that will process 70,000 COVID-19 tests a week that will produce a result within 24 hours. The site will be fully operational by June 1 and serve as Kaiser’s main testing site in Northern

California – initially only testing Kaiser members who are at high risk of contracting the virus based on CDC guidelines, but later they’ll broaden the criteria to include asymptomatic patients. According to Becker’s, Kaiser is also increasing the testing for its hospitalized patients from 1,000 to 1,500 tests per day using tests that produce results in 10 minutes.

Of course, in addition to tests to check if you have COVID-19, increasingly tests are coming onto the market to determine if you have had it. Most recently, Quest Diagnostics launched the first consumer-ordered COVID-19 antibody test. For $119, anyone can get a QuestDirect COVID-19 antibody test – with no doctor referral needed – so patients can check whether they have the antibodies that indicate they’ve had COVID and may have some immunity to it. According to Fierce Healthcare, these serology tests are available with an appointment at all of Quest’s 2,200 patient service centers. Meanwhile, the FDA has also approved a Roche coronavirus antibody test that claims 100% accuracy, plus Roche says it will be manufacturing tests in the “high double-digit millions per month.”

Several other companies, including Abbott Laboratories, Becton Dickinson and Co, and Italy’s DiaSorin, have also received emergency approval from the FDA for their tests.

For more details on where to get either test, according to TechCrunch, Johns Hopkins has recently launched a new hub called the COVID-19 Testing Insights Initiative that breaks down what kinds of tests are available, as well as where, and in what volume they’re being administered in the U.S. The new hub offers answers to commonly asked questions about the differences between the two major types of tests used (molecular and serological), and what’s required for testing in terms of both payment and qualifying symptoms and exposure risk. Taking a deeper dive into this very issue is the Chan Zuckerberg Initiative that’s pledged $13.6 million to understand the scope and spread of COVID-19 in the Bay Area. With research conducted by UCSF, Stanford, and the Chan Zuckerberg Biohub, the funds will be put towards two studies: one to specifically understand the scope of the coronavirus in the Area (with data given to policy makers). The second is zeroing in on healthcare workers in the area and looking at whether the antibodies from COVID-19 protect them from reinfection.

With all this money and talent pouring in to solve The TESTING Problem, hopefully, by the time a vaccine does arrive we’ll know just who to prioritize its use for. And, we’ll have discovered who doesn’t need it, because they’ve already recovered from COVID – many never realizing they even had it, until they were tested.