By Jaimy Lee
There are still unanswered questions about the accuracy of some COVID-19 tests, the prevalence of antibodies among Americans, and whether those antibodies provide the kind of immunity safety net needed to protect people from future infection.
A new report from Harvard University’s Edmond J. Safra Center for Ethics calls for five million COVID-19 tests a day by early June and up to 20 million a day by late July “to fully remobilize the economy.” Those figures are in contrast to the roughly four million tests in total that have been conducted in the U.S. since the first stateside case of the novel coronavirus was identified in late January. (That also means that four million tests have been conducted, not that four million people have been tested, experts say.)
“Testing is the only way to get back to a semblance of normalcy,” said Alex Tabarrok, an economist at George Mason University and co-author of the report.
Read: CDC director warns second wave of coronavirus could be even worse
Cowen analysts expect the largest diagnostics companies to produce 30 million diagnostics tests per month by the end of June. Including serological tests, that would be 50 million tests a month by the end of the second quarter. While those estimates are likely sufficient for what is included in clinical settings, they don’t take into account “broad employer screening.”
More than 825,000 Americans have tested positive for COVID-19 and at least 45,000 people have died, according to data aggregated by Johns Hopkins University.
The testing process for COVID-19 in the U.S. has been troubled from the start. The test kits designed and shipped by the Centers for Disease Control and Prevention (CDC) in early February to public health laboratories had flawed components that “may be the result of a design and/or manufacturing issue or possible contamination,” a CDC spokesperson said in an email. The Department of Health and Human Services, which oversees the CDC, is conducting an assessment, he added.
There are also a number of scientific unknowns and technological limitations about the diagnostic and serologic testing being used in the three months since the first U.S. case was detected. For example, people who know they were exposed to the virus and have contracted it may still get a negative result if they are tested too soon. Separately, serological tests that reveal a past infection may indicate immunity to future infections, but it is unclear at this time how long that immunity lasts or to what degree it can protect someone.
“It’s important for everyone to understand that the timing of the response of the antibody to the infection isn’t completely known, but we know that it takes some time to actually develop that,” Food and Drug Administration (FDA) commissioner Dr. Stephen Hahn said Tuesday.
See also: Nurse in NYC shares what it’s like to test people for the coronavirus
Among the other issues cited by Tabarrok: the nasal swabs used to collect samples often cause people to sneeze, which can put the health care workers doing the testing at higher risk of exposure to the virus. That’s created additional demand for personal protective equipment like gowns, masks, and gloves. Tests should be processed and an individual notified of the results within 12 to 24 hours, which hasn’t always been the case, to prevent infection among an individual’s friends, family members, or co-workers.
The longer-term solutions to some of these problems include the creation of saliva test kits, mass testing centers and deposit boxes to drop off the saliva samples, and a workforce of 100,000 contract tracers, according to Tabarrok. Employers and churches may need to operate their own testing machines.
In fact, a new process is under way at Walmart Inc. /zigman2/quotes/207374728/composite WMT +0.42% testing sites. Individuals drive in, receive a swab from a health care worker, roll up the car window, and that worker observes them using the nasal swab themselves to collect the sample, according to comments made by Quest Diagnostics Inc. /zigman2/quotes/201001842/composite DGX +2.30% CEO Steve Rusckowski during an earnings call on Wednesday. “That’s proven to be highly efficient, and we’re looking at other ways of collecting that front-end on molecular side,” he said, according to a FactSet transcript.
Do the tests work?
That depends on whom you talk to and the test in question.