Widespread testing is the foundation and the fastest response to any epidemic.

To accelerate the recovery and limit the spread of the potentially deadly SARS-CoV-2 virus, the U.S. must test extensively to identify infected people, trace their contacts, who might also have been infected, and socially isolate and quarantine potentially infectious groups from the rest of the population.

Broad and rapid access to testing is imperative.

Quickly scaling up reliable tests has been challenging. Although the U.S. performs hundreds of thousands of tests a day, that number falls far short of the several million of daily tests recommended for a safe return to normal. Additionally, the CDC’s (Centers for Disease Control and Prevention) early RT-PCR (reverse-transcription polymerase chain reaction) tests failed to perform correctly, leading to a series of costly delays. The test works by analyzing a sample taken from cells or fluid in a person’s nose or throat for a specific viral RNA from SARS-CoV-2. If the viral sequence is found, the procedure magnifies it to levels that can be detected.

A road map to pandemic resilience released by Harvard’s Safra Center for Ethics, suggests that we need to deliver 5 million tests per day to initiate a safe social reopening of the economy. This number will need to increase over time to 20 million a day to remobilize the economy fully and that even this number may not be high enough to protect public health. However, the current PCR test, about 20 years old, is not something that could be scaled up to 20 million tests a day without new technologies.

The current PCR test, about 20 years old, is not something that could be scaled up to 20 million tests a day without new technologies.

Pooling testing for COVID-19

The turnaround time for COVID-19 tests takes anywhere from days to a week or longer. Researchers are now developing diagnostic test procedures beyond the traditional PCR to detect viral material in different ways—some are tweaks that make the test faster or easier to use.

As supply shortages continue to impede coronavirus testing, a testing strategy that tests groups of people together and helped fight other viruses, including HIV, is getting more attention.

As supply shortages continue to impede coronavirus testing, a testing strategy that tests groups of people together and helped fight HIV, is getting more attention. In pooled testing, multiple people are tested as a group. Dr. Deborah Birx, coordinator for the White House’s coronavirus task force, stated, “pooling would give us the capacity to go from a half a million tests a day to potentially 5 million individuals tested per day.” Pool testing includes identifying asymptomatic or pre-symptomatic people and using aggressive contact tracing to prevent widespread outbreaks, said Birx. It’s about trying to get the same amount of information from fewer tests.

Dr. Deborah Birx, coordinator for the White House’s coronavirus task force, stated, “pooling would give us the capacity to go from a half a million tests a day to potentially 5 million individuals tested per day.”

How does pooled testing work?

Rather than doing a coronavirus test on every specimen, take a sample of each and combine it with samples from other specimens. Then run a single test on the pooled sample. If the results are negative, undoubtedly, all of the original samples are negative. Therefore, a single test has done the work of five or 10, compared with testing each sample individually.

The caveat is that if the pooled test comes back positive, it’s then necessary to test each original specimen individually, which requires more time and more supplies. However, if a lab is testing samples that return negative at least 90% of the time, the lab comes out ahead using the pooled approach.

South Korea, and other countries, have tested at far higher rates by quickly ramping up tests in the same week that their first cases were confirmed. The result was far fewer deaths because they were able to identify sick people and isolate them so that they didn’t infect others. Without adequate testing, the U.S. was forced to implement shelter-in-place orders, assuming that if you don’t know who’s infected, you have to believe everyone is.

The U.S. was forced to implement shelter-in-place orders, assuming that if you don’t know who’s infected, you have to believe everyone is.

There’s little doubt that if we have any hope of life returning to a life that somewhat resembles normal, we need to be performing many times more tests per day than we are doing now. COVID-19 is very expected to be a part of our lives for at least the next 18 months until a vaccine or therapeutic option is found. We need to be prepared.