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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) by Anonymous Coward on Monday November 23 2020, @04:11AM
But you are making one huge and, in my opinion, unsupported assumption: that lockdowns work. It's an obvious and intuitive idea, but so are many things that are ultimately found to be incorrect. Various studies that have looked at the topic have found that internal lockdowns have been mostly ineffective. I'll look at this in three ways:
1) Some guys with doctorates and grandeloquent language saying [thelancet.com] the same thing. The one primary thing that predicts how well or how poorly a nation will fare against COVID is personal health. Obesity is the primary predictor of poor results and is directly predictive of on increased mortality, increasing hospitalization rates, etc. Obese people are very vulnerable to this virus (among countless other things) and the average obesity level of a nation is reliable predictor of how it will do against COVID. This is made even more interesting by the fact that lockdowns in the US have been substantially increasing our obesity problem due to increasingly sedentary lifestyles alongside greatly increased alcohol consumption. And the mortality rate of the virus is increasing. Go figure.
2) Increasingly obvious evidence. Sweden has had an aggregate death toll of 633/million after running on a response of basically 'do nothing'. They had no major lockdowns and life continued on pretty much business as usual. The US in the middle of the pack with a death toll of 792. And finally there is Spain which has not only had some of the most extreme lockdowns on this planet, but also has the 5th highest death rate at 911. There are obviously some countries that had lockdowns that did okay, and some countries that did not have lockdowns that did not do okay. The point I make is that the evidence shows with reasonable clarity that lockdowns do not really correlate with success, at all.
3) Anecdotal. A member in my family is immunocompromised due to an organ transplant. They are also a healthcare professional and did all they possible could to ensure a perfectly safe lockdown, even including sterilizing the packaging of foods and groceries to ensure no surface level contamination was possible, wearing eye protection very early on, etc. They still caught it, somehow. Interestingly enough they also recovered, more or less fully, after about a month without hospitalization being necessary.
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So you can put me into a third group. I propose not only are lockdowns ineffective, but I also believe that vaccines will also ultimately prove ineffective for reasons outside the scope of this post. And so the only solution will ultimately be to do as we have done for the countless plagues throughout history, many much worse than this: get on with it, ride it out, and come out stronger as a result. And to help avoid such outcomes in the future people need to gain some self discipline and stop eating so damned much, but we also need to start taking obesity more seriously. The 'body positive' movement, embraced by the media and by politicians, was one of the dumbest and most self destructive things possible.