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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: 0, Interesting) by Anonymous Coward on Sunday November 22 2020, @04:15PM (7 children)
A major study [nature.com] just released from China seems to suggest that asymptomatic people may not be spreading the virus. China engaged in a massive series of tests in 'post covid' Wuhan - nearly 10 million. They found exactly 0 symptomatic carriers, but they did find a few hundred asymptomatic carriers. But the interesting thing is that in following up every single person the asymptomatic cases have had any contact with, they found exactly 0 infections.
If this ends up being accurate (there are reason the study may be potentially valid, yet inaccurate for the US - such as viral mutation) it would throw everything we know about the virus upside down since testing of asymptomatic individuals would be pointless. Personally I do not understand why we, or China, simply do not engage in the obvious test. Take an asymptomatic person, have them interact in a way that would spread the virus to a compensated volunteer, and see if the volunteer catches the virus. This shouldn't be a mystery or something that needs to rely on models and testing results.
The US mainstream media is, predictably, not covering the story. If you'd like media coverage (instead of just the study link) there is coverage available here [rt.com].
(Score: 3, Interesting) by legont on Sunday November 22 2020, @04:38PM (1 child)
Such a low rate - a few hundred from 10 million - of people who a essentially healthy as they show no symptoms could mean anything from a mutated virus as you mentioned to a specific genome of the people who were carriers. Perhaps some people just don't shed the virus or shed, but an extremely weakened by immune system version.
Also, the theory that asymptomatic spread the virus is also based on super carriers - only some rare individuals infect, but they infect many many people.
"Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
(Score: 0) by Anonymous Coward on Monday November 23 2020, @10:21AM
It was false positives. Read the paper. They did 37 cycles for these positives and 40+ to be negative where CDC recommends no more than about 27 or 28 for positive cases.
(Score: 2, Touché) by Anonymous Coward on Sunday November 22 2020, @06:41PM (2 children)
A massive study just released on Breitbart and OANN has revealed that two plus two is equal to seventeen. If this ends up being accurate, it would throw everything we know about arithmetic upside down.
The US mainstream media is, predictably, not covering the story. *Shaking head* What is the lib'rul media trying to hide????
(Score: -1, Troll) by Anonymous Coward on Sunday November 22 2020, @07:42PM
Pretty obvious, but if you need it spelled out: Anything that might make Trump look good.
(Score: -1, Troll) by Anonymous Coward on Monday November 23 2020, @03:40AM
It's a peer reviewed study published in one of the most prestigious journals that exist. This is why the absence of coverage in the mainstream media is even more telling.
Most of the mainstream media has been pushing for even more authoritarian economy destroying lockdowns while simultaneous framing anybody and everybody, who is anything less than 100% on board, in all sorts of awful ways. That it may have been the case, as it often is, that the popular media was completely wrong is obviously not something they're especially happy to consider.
(Score: 0) by Anonymous Coward on Monday November 23 2020, @10:19AM (1 child)
Perhaps false positives?? Have you ever considered that? Have you read your article?
Oh right, you should have read the actual paper. These "asymptomatic cases" probably had no live virus in them in any case. Fragments of the virus they picked up, yes, but not live virus. Ct-value should have been at less 30 to be positive ;) But oh well. If you you look for needles carefully enough in a hay stack, maybe every piece could be a needle too?
(Score: 0) by Anonymous Coward on Monday November 23 2020, @05:24PM
Is looking for needles in a hay stack any worse than ignoring the hay stack? In real science you explore all the possibilities. Not just the results that prove your belief.