The report is the first testing protocol of the Rockefeller Foundation, which has already issued several test-related reports and is working with 10 governors to purchase and distribute 5 million Kovid-19 tests. Written by a team of health policy experts, including former FDA commissioners, it aims to give specific guidance to states and communities on how often they should test people.
The report’s testing guidelines focus too much on keeping coronavirus outbreaks in schools under control – at least 175 million of monthly testing capacity will focus on teachers and students. Most of these will serve in areas with high coronovirus caseloid, yet schools will open, where the report’s authors recommend testing twice per week for all students and teachers. Another 18 million per month test will be conducted for the purpose of testing in nursing homes, where the population is the weakest.
The report does not meet the specific numbers required for other populations, but Mara Espinall – one of the report’s co-authors and a managing director at Bluestone Venture Partners – suggested that it be included in future protocols.
Experts have already warned that the reopening of schools could lead to re-emergence of Kovid-19 cases. In some areas, the number of cases is already increasing. The report suggests that a dramatic expansion of the test may help counter some of those trends.
“It’s a kind of risk-based, scientifically-based protocol that we would urge that the CDC really take forward,” Jondo Quick, managing director of epidemic response, preparedness and prevention.
The report is widely critical of the Trump administration’s testing practices, and states that the action taken so far “does not yet amount to a national strategy strategy.” Confusing guidelines and a lack of a coordinated federal response could hamper the epidemic’s response, the report concludes.
“There is an urgent need for federal action to provide greater clarity about the protocol and testing needs of the test,” it states. “The United States is at a critical point in the epidemic, facing several months of severe health and economic disruptions that coincide with significant infections spreading throughout the country – but now through the effective use of innovation that Large-scale testing, with the ability to avoid results. ”
Federal health officials have emphasized the idea that there is no test strategy. Assistant HHS Secretary Brett Giroir told reporters in August that he was “going to begin to personally humiliate” in response to questions that were not the US national test plan. “We’ve had a national strategy for months,” he said, citing a report made to Congress in May that emphasized state-level responses.
Most tests will not be the most accurate type of test used to diagnose Kovid-19; Instead, the report suggests screening tests that are potentially less accurate but may deliver results much faster.
“Creates frequency for the world of sins,” said David Paltiel, a professor at the Yale School of Public Health, who has modeled the effects of testing in colleges and universities and was not linked to the report. “If you can use it more often, then you would prefer to use less than a cheap and completely specialized test.”
“What I really like about this is that it’s saying smart things about different types of testing,” said William Heinz, an epidemiologist at Harvard’s TH Chan School of Public Health. “You want a very good diagnostic test that is going to be used in a hospital setting. It is not necessarily something that you want to do in school. “
Wednesday’s report also targeted a controversial set of Centers for Disease Control and Prevention Testing guidelines released in late August, stating that there is no need to test asymptomatic contacts of people diagnosed with Kovid-19. Might be possible.
“We continue to have great respect for the CDC as our leading public health organization, but we do not agree with the decision not to test those identified as important contacts. We just don’t agree with it, ”said Quick.
Although the US does not currently have the ability to recommend the report, Espinall said it is not a pipe dream. If manufacturing capacity increases as expected – and if more tests receive emergency use authorization from the Food and Drug Administration – more than 198 million trials could be produced in January 2021, she said. “It will meet the vast majority of demand,” Espinall said.
Quick praised the federal government for moving quickly to procure new tests, such as last week when it bought 150 million tests from Abbott, a major diagnostic company.
Moves around the purchase of ” [tests] – All this is clearly indicating recognition of the need for screening tests. You are not buying them for diagnostic purposes, ”said Quick. “I think the trajectory is going in the right direction.”
Quick said the foundation would partner with “four or five” cities to test the protocol suggested in Wednesday’s report.
However, Hange warned that testing programs work best when they are not limited to one school or one city – and that putting any recommendations into practice can be more difficult than anticipated.
He said, “For all these things we have not been able to do the basics in many places. Given that is the case, we have to keep this in mind when evaluating goods in this way. “That being said, things like this should remind us that another way is possible.”