What’s the news: Continuing shortages of reagents, viral transport media, pipettes and other supplies means 2020 will continue to negatively affect the nation’s COVID-19 polymerase chain reaction (PCR) testing capacity. Given that sobering fact, the AMA and other organizations with expertise in medical testing are urging Health and Human Services Secretary Alex Azar to ensure the nation’s limited testing resources go to patients with medically identified needs or to public health surveillance efforts.

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It’s not just the surge of COVID-19 cases that is straining the nation’s testing capacity, but also a big jump “in demand for testing of asymptomatic individuals with no medically indicated need for testing services. These include tests for employees going back to work, students returning to colleges and universities, and individuals wishing to engage in nonessential travel,” says the letter sent to Azar by the AMA, American College of Medical Genetics and Genomics, American Society for Clinical Pathology, Association for Molecular Pathology, Association of Pathology Chairs, College of American Pathologists, and Infectious Diseases Society of America.

“Given that laboratories already face significant issues in providing access to medically indicated tests and timely return of results, we urge the administration to consider the utility of new testing prioritization guidelines,” says the letter. “Without improvement in available supplies, we simply do not have the resources to meet the huge demand for testing by asymptomatic individuals without exposure to COVID-19.”

HHS testing priorization guidelines should ensure that patients with a medically indicated need for SARS-CoV-2 diagnostic testing can get it. That includes patients with:

  • COVID-19 symptoms.
  • Known exposures to COVID-19.
  • Need for pre-procedure testing.

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Why it’s important: In public health emergencies such as the COVID-19 pandemic, “limited testing resources must first be directed towards those who need them most—those at immediate risk of infection and serious illness,” says the letter to Azar from the AMA and the other organizations.

“Outside of necessary public health surveillance strategies, limited resources should not be utilized by those with no symptoms or known exposure and whose needs could be equally served by following quarantine measures,” the letter adds. “Without adequate testing capacity to rapidly serve those with a medically indicated need for testing, we risk continued widespread transmission of this disease. We also threaten the ability of health care facilities to continue to offer critical medical services to those in need of care.”

As long-postponed procedures ramp up, “laboratories are struggling to accommodate demand for pre-procedure COVID-19 testing, which further jeopardizes clinical care for millions of Americans,” the letter says, noting that the supply-chain problems also are taking a toll on the nation’s capacity to perform other diagnostic tests.

“Testing for other infectious diseases are at risk, and our colleagues report that many molecular tests are being delayed as they simply cannot all be offered while attempting to meet the demands for COVID-19 testing.”

The AMA and the other organizations advised that “rapid screening tests, designed to be administered at home or at the point of care, could play a significant role in asymptomatic screening and surveillance efforts, as well as reopening efforts, without placing additional strain” on the PCR diagnostic test market.

The administration should “prioritize support for development” of such rapid testing tools.

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Learn more: Physicians can stay up to date on all of the AMA’s COVID-19 advocacy efforts and track the pandemic with the AMA's COVID-19 resource center, which offers a library of current resources from the JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.

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