While SARS-CoV-2 testing plays a critical role in controlling the COVID-19 pandemic, tests alone are just one element of a cascade of events that must occur for an effective testing strategy.
For the role of testing to be optimized, other elements of the cascade—including infrastructure, processes, people, other essential components, and an action plan—must be in place, operational, and continually monitored.
“Smart testing for COVID-19 virus and antibodies,” the third report in a multipart series titled, "COVID-19: The CIDRAP Viewpoint," was published today by the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. In the report, CIDRAP proposes a SARS-CoV-2 smart testing framework that helps ensure that the right test is available to the right person at the right time, with timely test results guiding actions that minimize illness, deaths, and disease spread.
CIDRAP SARS-CoV-2 smart testing framework:
- Right Infrastructure: Factors such as institutional support and supply chain availability must be in place.
- Right Population: Testing must be targeted based on the goals of testing.
- Right Test: Different types of tests (e.g., molecular, antigen, antibody) are appropriate in different settings.
- Right Interpretation: The test sensitivity and specificity—and how well it performs at low versus higher levels of disease in the population—must be considered.
- Right Action: Based on test results, what actions are needed to minimize illness, deaths, and disease spread?
In the report, CIDRAP also outlines some of the most important, but often overlooked components in the testing cascade that must be considered by policy makers, public health agencies, hospital administrators, and the public. These are material capacity, instrument capacity, skilled labor availability, instrument use and availability, and result reporting and action steps.
Because of the complexities involved in the SARS-CoV-2 testing cascade, CIDRAP recommends that the U.S. Secretary of Health and Human Services (HHS) should appoint by July 1, 2020, a blue-ribbon panel of national experts The panel should include representatives from public health, clinical laboratory, and medicine; the laboratory testing research and development, marketing, and product support industries; ethicists; legal scholars; and elected officials.
In addition, CIDRAP encourages HHS to review and evaluate the use of testing for SARS-CoV-2 in the public health response to COVID-19 by governments around the world to learn state-of-the-art approaches and best practices that could be incorporated into the U.S. response.
”If we don’t do smart testing for SARS-CoV-2, we unnecessarily limit the clinical and public health impact we can have in responding to this pandemic,” said Michael Osterholm, Ph.D., M.P.H., CIDRAP director and University of Minnesota Regents Professor, McKnight Presidential Endowed Chair in Public Health. “We believe that a ‘test, test, test mantra approach’ is actually counterproductive to using effective testing as one of our critical public health tools.”
Future reports in the "COVID-19: The CIDRAP Viewpoint" series will address surveillance, contact tracing, supply chains, epidemiology issues and other key topics.
COVID-19 is a respiratory illness that was first identified in Wuhan, China, in December 2019. Confirmed U.S. cases recently topped 1.5 million, and the global total has now topped 4.9 million confirmed infections, including more than 300,000 deaths.
The Viewpoint reports are made possible with support from the University of Minnesota Office of the Vice President for Research and the Bentson Foundation.
About the Center for Infectious Disease Research and Policy
The Center for Infectious Disease Research and Policy is a global leader in addressing public health preparedness and emerging infectious disease response. Founded in 2001, CIDRAP is part of the Office of the Vice President for Research at the University of Minnesota.