Demand for COVID-19 tests could skyrocket in the fall with the reopening of some universities and schools, threatening to overload an already tense system.
Many schools and universities plan to regularly screen students and staff in an effort to stop the spread of COVID-19 on their campuses.
But public health officials and experts fear there is not enough capacity and supplies to evaluate thousands of people who do not show any symptoms of the disease.
“I think what we’re starting to recognize is that it really won’t be feasible in most areas of the US. Try to come up with some kind of testing strategy that you’re testing multiple times, especially if the results don’t.” Come back for a while, “said Dr. Tina Tan, board member of the Infectious Diseases Society of America.
“I don’t think it really gives him much information, and he’s using critical resources that could be better spent elsewhere.”
While COVID-19 testing capacity has improved significantly since the early days of the pandemic, there is still not enough to handle the increased demand caused by increasing outbreaks in the south and west.
About half of the COVID-19 tests in the US are done at commercial labs like Quest and Labcorp, which report response times of several days or even weeks.
Laboratories are still experiencing shortages of supplies needed to process the tests, including chemicals, pipettes, and personal protective equipment, due to global demand caused by the pandemic.
Experts caution that widespread testing of symptom-free students and staff could further overwhelm the nation’s testing capacity and drain resources.
“There is a thirst for nonmedical and non-clinical testing so that people can go back to work, to school,” said Scott Becker, executive director of the United States public health laboratories.
But, he added, it would require a “large amount of supplies” to evaluate people for non-medical reasons, and those are the supplies needed to evaluate people who have symptoms of COVID-19 or have had contact with a confirmed case.
“The answer will not be to evaluate everyone all the time. That is not possible.”
Concern for potentially infected students returning to school in the fall is intensified by concern that many potentially infected young adults do not show symptoms of COVID-19, but could pass it on to others who may experience serious illness.
Some universities such as the University of Virginia and Purdue University in Indiana will require returning students to show proof of a negative COVID-19 test before returning to campus.
Other institutions, such as Harvard, Yale, and Princeton, plan to screen students once they arrive, and multiple times throughout the semester, in an attempt to quickly crush any case of COVID-19 so that they don’t develop into major outbreaks that force closings.
Colby College in Maine will evaluate all students three times a week at the beginning of the semester, with results submitted by a local laboratory within 24 hours.
The secretary of the Department of Health and Human Services (HHS), Alex Azar, told the governors in a call this week that he is hearing too many cases of universities reaching agreements with private laboratories. He wants to discourage this, he said, because there simply isn’t enough supply.
Admiral Brett Giroir, the administration’s test czar, added that the United States should avoid placing 75 million students in the test group, and universities and schools should rely on vigilance rather than widespread testing. He gave the example of Louisiana State University, which plans to test 10 to 15 percent of its student population in the fall, instead of taking universal tests.
“In general, evaluating people before going back to college … is not a strategy we recommend, nor is it [Centers for Disease Control and Prevention] I recommend, because you are only negative at that time, you could be positive the next day and it does not alleviate the responsibility of wearing a mask and doing all that type, “Giroir told reporters on Thursday.
The CDC recommends against so-called “entrance tests” for all students, faculty, and staff because its effectiveness in stopping its spread has not been “systematically studied,” according to its guidance.
Giroir said schools should use surveillance tests instead of universal tests for all students. That could be done through group testing, Giroir said, in which samples from several people are combined and then tested together rather than individually.
Positive group tests are followed by individual tests for everyone in the group, while negative group tests are erased.
Group tests are believed to work best in areas where the spread of the virus is low.
“Nothing is a perfect solution, but it is not a burden on the healthcare system. It allows universities to keep control of how they want to do it, ”he said.
However, Dr. Thomas Tsai, an assistant professor in the Department of Health Policy and Management at Harvard TH Chan School of Public Health, said he believes it is important for students to be screened before entering campus followed by surveillance tests focused on certain populations afterward.
“I think everyone agrees that it is important to evaluate before students enter campus,” he said. “The hope is to really change the conversation and stop letting the ability dictate our direction.”
He argued that the United States has become too dependent on commercial labs like Quest and LabCorp when other options are available.
“We need to think beyond the traditional capacity to provide evidence and there is capacity available beyond commercial laboratories,” he said, as in healthcare systems, academic research groups.
Point-of-care tests are increasingly available, he noted.
The labs have also said that they cannot do it alone, and that new technologies are needed to ease the demand for their services.
“This is something we’ve said from the beginning: Labs can’t do this alone,” a spokesman for the American Association of Clinical Laboratories told The Hill. “Federal government laboratories, diagnostic manufacturers, providers, and public health officials have a role here.”
“I think when you look to fall, it’s still the case that we need to put the full range of testing tools that we have available to deploy where they are most needed and that includes point-of-care testing, which is not something that we currently do “The spokesman also said.” The bottom line is that it will take us all. ”
The Trump administration hopes to expand access to point-of-care tests that can give results in 15 minutes in a doctor’s office or in a patient’s bed without laboratory processing.
Giroir told NPR last week that he expects the US to have 15-20 million point-of-care tests ready for use in September.
“That is going to dramatically reduce the load [on labs],” he said.
The National Institutes of Health (NIH) is currently running a “Shark Tank” -like contest that seeks to accelerate the arrival of point-of-care tests to the market.
Still, ACLA and other groups are asking Congress for more funds to expand testing capacity through the fall. Some of the country’s largest laboratories have already reached their testing capacity due to a shortage of machines and chemicals required to process the tests.
“We share the goal of reopening the economy safely and returning to normal business, but this will require sustained federal investment in tests facilitated by the public health and existing health care system,” read a letter sent Tuesday to the leaders of Congress.
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