Division Over COVID-19 Testing Threatens Our Progress

COVID-19 is dividing the country in many dangerous even deadly ways and now, those divisions threaten to further stall urgently needed action.

At a time when science and data must drive policy – and we have seen that such policy works – too many are instead dismissing facts and evidence to advance shortsighted goals.

Americans are eager to get back to work, but only when we can do so safely, responsibly, and with the hopes of not having to shut down again.

The public debate at the moment is between those calling for ubiquitous testing (and I’m among them) and those saying we can’t do it or don’t need to.

Adding to this disagreement, there is now debate about whether we should be testing for COVID-19 at all, and instead test for antibodies that might reveal immunity to the disease.

At a time when urgent, widespread action is necessary, these divisions are becoming a roadblock. I’m reminded of the image of protesters screaming from their cars at health care workers silently preventing them from moving forward. No one advances.

The fact is, we need ubiquitous testing because we need to know who is actively infected and a danger to others and who is not currently infected.

Testing for active infectious disease is a bedrock of controlling that disease, borne out of years of evidence and experience.

There is no questions about whether we should do this and there should not be any question about whether we can do it.

We must. And while “we need more testing” may seem a tired verse, we still are not testing for the virus at the levels we need. PCR tests – which look for the presence of the virus – have topped out at about 150,000 per day nationally.

This is simply not enough to yield an accurate and actionable picture of the epidemic and at this moment, we are surely missing a majority of the people who are actively infected and spreading to others. 

Our analysis suggests that we need a minimum, 500,000 per day, and that assumes we maintain social distancing for a bit to bring case numbers down further.

Antibody tests, which are receiving a lot of attention, aren’t an alternative to the PCR test that looks for virus. They are a complement – we need both.

These antibody tests are essential for getting an overall picture of the epidemic, how many have had silent infections, and whether people might be immune.

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While these tests are great at the population level, there is too much error at the individual level.

Given high rates of false positives and false negatives population we currently see as this technology is still being developed, it would be risky to tell people that they are immune when they may not be.

Still, they are helpful when applied more broadly to a community or state and we should add them to our arsenal, but not be distracted from the challenge of tracking the virus as it moves.