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Testing half the population weekly with inexpensive, rapid-turnaround COVID-19 tests would drive the virus toward elimination within weeks—even if those tests are significantly less sensitive than gold-standard clinical tests, according to a new study published today by CU Boulder and Harvard University researchers.
Such a strategy could lead to "personalized stay-at-home orders" without shutting down restaurants, bars, retail stores and schools, the authors said.
"Our big picture finding is that, when it comes to public health, it's better to have a less sensitive test with results today than a more sensitive one with results tomorrow," said lead author Daniel Larremore, an assistant professor of computer science at CU Boulder. "Rather than telling everyone to stay home so you can be sure that one person who is sick doesn't spread it, we could give only the contagious people stay-at-home orders so everyone else can go about their lives."
[...] They then used mathematical modeling to forecast the impact of screening with different kinds of tests on three hypothetical scenarios: in 10,000 individuals; in a university-type setting of 20,000 people; and in a city of 8.4 million.
[...] When it came to curbing spread, they found that frequency and turnaround time are much more important than test sensitivity.
For instance, in one scenario in a large city, widespread twice-weekly testing with a rapid but less sensitive test reduced the degree of infectiousness, or R0 ("R naught"), of the virus by 80%. But twice-weekly testing with a more sensitive PCR (polymerase chain reaction) test, which takes up to 48 hours to return results, reduced infectiousness by only 58%. When the amount of testing was the same, the rapid test always reduced infectiousness better than the slower, more sensitive PCR test.
That's because about two-thirds of infected people have no symptoms and as they await their results, they continue to spread the virus.
"This paper is one of the first to show we should worry less about test sensitivity and, when it comes to public health, prioritize frequency and turnaround," said senior co-author Roy Parker, director of the BioFrontiers Institute and a Howard Hughes Medical Institute investigator.
Journal Reference:
Daniel B. Larremore, Bryan Wilder, Evan Lester, [et al]. Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening. Science Advances, Nov. 20, 2020; DOI: 10.1126/sciadv.abd5393
(Score: 5, Insightful) by gringer on Sunday November 22 2020, @09:35AM (4 children)
It's a waste of money to test when the case rate is as high as it is in the US. What possible benefit could it have? Are people going to be more likely to stay at home if they think they've got COVID-19?
In the US, the probability is essentially 1 that one of the people you have been next to for more than 15 minutes in the last two weeks has COVID-19. In which case you should stay home and isolate away from others, because there's a high risk that the virus has also infected you.
Spend that testing money on people who need it. Assume that everyone is infected (or every second person, if it makes people act more urgently), and behave accordingly. That means staying at home. It means shutting down any work that doesn't keep people living and healthy. It means freezing anything that could increase the debt people have. It means giving people whatever they need to survive away from others.
Complete lockdown. For at least a month. It needs to be done six months ago, but now is the second-best time. Lock down now, or COVID-19 will do it for you, decimating the population because there'll be no hospitals available to help people live with the disease.
Ask me about Sequencing DNA in front of Linus Torvalds [youtube.com]
(Score: 0) by Anonymous Coward on Sunday November 22 2020, @09:57AM (1 child)
Agreed. Unfortunately, people still need money for necessities and the federal government doesn't have any interest in providing that and the states can't afford it, so instead we're stuck hoping the current trend magically reverses and we somehow manage to not completely run out of hospital capacity.
Testing does (1) let you know your progress and (2) let you know your true testing capacity which is part of what determines at what infection rate you could accept weaker measures.
(Score: 3, Informative) by Anonymous Coward on Sunday November 22 2020, @07:48PM
I'd point out that a bill to *specifically* address your concerns was passed by the House on 20 May 2020, but over the past six months has yet to be voted (or even debated) on the floor of the Senate. [congress.gov]
As such, it's not strictly true that "the federal government doesn't have any interest in providing that." Rather it's the Senate that hasn't debated the bill (except for a hearing held on 23 July 2020 in the Committee on Small Business and Entrepreneurship).
Why hasn't this bill been debated on the floor of the Senate? I'll leave the answer as an exercise for the reader.
(Score: 0) by Anonymous Coward on Monday November 23 2020, @04:56PM (1 child)
Agreed. Now what is your plan for locking down the entire world for a month? How effective is a lock down, when 24 hours after lock down an asymptomatic world traveler walks through airport security and the whole thing starts over again. I mean, we can't even eliminate TB from the world and it's far more contained than covid every will be.
There will always be a source of covid in the world for as long as there are people with no immunity who are able to get it and spread it. Our goods and services depend on a global market. No country in the world can afford to close it's borders forever. Especially the so called first world countries. So really, nothing short of permanent lockdown will ever work. How many years will you be comfortable with lockdown? One? Two? A decade? Maybe an entire generation?
(Score: 0) by Anonymous Coward on Tuesday November 24 2020, @04:48PM
Not at all the same thing. TB is a bacterial infection and bacteria are very different from viruses. Most importantly, unlike viruses, bacteria are organisms that reproduce on their own.
This is not a given. Because viruses can only reproduce with the help of an infected host cell, then if you can sufficiently reduce the spread rate of a virus then it will eventually die off. Once that happens then people with no immunity cannot get it or spread it because there is simply no virus left to infect them.
Most people alive today have no immunity to smallpox. Yet we don't need to worry about these people getting or spreading smallpox. It is quite possible we will see Polio go the same way in the near future. And if the vaccines end up being as effective as initial signs suggest maybe we will add COVID-19 to the list (but this is being very optimistic).