We must expand COVID-19 testing capacity before restarting the economy

Patrice A. Harris, MD, MA , Former President

The nation’s physicians, like all Americans, eagerly await a return to the lives we led before COVID-19. We want to hug our loved ones without worry, to celebrate birthdays and milestones, and to resume the simple patterns of our daily routines that we never thought we’d miss—until they disappeared.

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 A phased return to normalcy is the primary objective of the guidance issued Thursday by the Trump Administration. The new guidance plan outlines several conditions that must be met before restrictions are eased. They are:

  • A decrease in influenza-like illness and COVID-like syndromic cases;
  • A decrease in confirmed COVID cases and a reduction in positive COVID tests as a percent of total tests; and
  • The ability to treat all patients without crisis case, along with placing a robust testing program in place for health care workers.

However, the most important question we face is not how quickly we can “reopen the economy,” as many are calling for. The real question is how soon we can establish robust testing for the novel coronavirus in every part of the country, which, combined with contact tracing, is necessary to monitor community spread of the virus until there is a vaccine.

The hope is that in the future, antibody or serology testing could help guide recommendations for loosening current stay-at-home orders by providing insights as to how much of the U.S. population has been exposed to COVID-19, and whether individuals are susceptible to re-infection. Unanswered questions remain as to whether those who have recovered from COVID-19 have immunity to the virus, and how long that immunity lasts.

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It is critically important that we dramatically expand our testing capacity, both diagnostic and antibody testing. Only through that expansion will we have the data and information necessary for public health officials to determine when it is safe to resume a semi-normal way of life. Diagnostic testing tells us who is currently infected, so these individuals can be safely isolated to prevent further spread, while contact tracing is conducted to quarantine those who were exposed. For public health agencies to effectively conduct contact tracing, they will need to rapidly recruit, train and deploy a substantial new public health workforce.

Americans must be confident that public health is the primary consideration in all our decisions going forward. With that in mind, we must scale testing to the level needed to generate accurate and immediate data on the prevalence of the virus. Only then can we safely send people back to work, school, and all the other activities we enjoyed before the pandemic.

Widespread concerns remain about the availability of testing, which is why we have urged the federal government to use its full range of resources—including the Defense Production Act—to address production and distribution challenges.

While we are pleased to see FDA take decisive action to loosen regulatory barriers so that manufacturing can begin at scale, both the government and private sector must continue working in close coordination so that reliable tests can be made widely available.

But even in these most dire of circumstances, we must realize that our nation has faced public health crises like this before—and turned back those threats through evidence-based scientific breakthroughs by medical researchers. For example, the poliovirus struck tens of thousands of Americans—particularly children—each year during the 1940s and ‘50s. Quarantines were routinely imposed, and parents were reluctant to allow children to play outside in the summer months, when infections seemed to peak. Years of research led by a physician, Dr. Jonas Salk, yielded a vaccine that wiped out the dreaded disease in the U.S.

We must defeat COVID-19 in the same way, by relying on the scientific method and utilizing the tremendous resources now within our reach. Science and evidence-based research must shape our decisions and inform our actions.

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As you read this, researchers are racing to find an effective treatment for COVID-19, as well as the vaccine we will need to fully resume our normal lives and economic activity. But we cannot take aggressive steps on that path toward normalcy in the absence of widespread testing capability. To do so risks a second wave of COVID-19 infection that would negate the progress toward mitigation that we have already achieved—and place normalcy even further out of reach.

The fact remains, we are all in this together. Going forward, our response to the pandemic must be unified, evidence-based, and as free from political considerations as possible. Science will win the war against COVID-19; we must not damage that effort by waging war against science. Nor must we relinquish the progress we have made thus far by prematurely relaxing the measures now in place that have brought us encouraging signs of progress in this fight.

Physicians are fully aware of the disruption, economic distress and emotional pain the novel coronavirus has brought to every corner of our nation, and to every aspect of our lives. We, like you, want to bring this to an end tomorrow. But until that day arrives—and it will arrive—we must stay the course we have charted to rid our nation of this insidious, unrelenting and unmerciful foe.