Author Archives: Pandemic Testing

ON APRIL 27, THE CDC CHANGED ITS GUIDANCE TO SUPPORT BROADER USE OF TESTING NOT ONLY FOR THERAPEUTIC PURPOSES, BUT ALSO FOR DISEASE CONTROL. In the most recent guidance, released May 3, first priority goes to hospitalized patients, first responders with symptoms, and residents in congregate living contexts with symptoms. But there is now also a second priority category that includes asymptomatic individuals from groups experiencing disparate impacts of the disease and “persons without symptoms who are prioritized by health departments or clinicians, for any reason, including but not limited to: public health monitoring, sentinel surveillance, or screening of other asymptomatic individuals according to state and local plans” (bold in original, italics added). The last phrase supports broad testing of contacts of COVID-positive individuals and of essential workers, even when they have mild symptoms or none at all. This Supplement to our Roadmap to Pandemic Resilience offers guidance to help…

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Analysts have recently focused their attention on two pathways for the United States to reopen prior to the development of a vaccine for COVID-19. The first is to accept a series of rolling openings and closings: reopening as infection rates decrease, then reclosing as they rise again due to increased interactions. This approach is generally thought to be enormously costly both economically and socially, as people will be kept in their homes and commerce restrained for considerable amounts of time. The second approach is to massively ramp up the production of testing, either through a universal testing regime (which would require capacity to test all 300+ million Americans once a week) or a system of testing, tracing, and supported isolation (which would require testing 5 million Americans a day, plus tracing those who were in contact with the infected and isolating them). The testing pathway would enable the United States…

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COVID-19 IS A PROFOUND THREAT TO OUR DEMOCRACY, COMPARABLE TO THE GREAT DEPRESSION AND WORLD WAR II. As ever, the greatest bulwark of democracy is us. What we do together—for one another and, even more, with one another—to fight this terrible disease, protect human life, secure our institutions, and prevent the destruction of our economy will determine whether free societies will prove resilient in the face of existential emergency. What we need to do is much bigger than most people realize. We need to massively scale-up testing, contact tracing, isolation, and quarantine—together with providing the resources to make these possible for all individuals. Broad and rapid access to testing is vital for disease monitoring, rapid public health response, and disease control. We need to deliver 5 million tests per day by early June to deliver a safe social reopening. This number will need to increase over time (ideally by late…

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There is a growing consensus that we must use a combined strategy of medical and technological tools to provide us with response at a scale that can outpace the speed and proliferation of the SARS-CoV-2 virus. A process of identifying exposed individuals who have come into contact with diagnosed individuals, called “contact tracing,” has been shown to effectively enable suppression of new cases of SARS-CoV-2 (COVID-19). Important concerns around protecting patient’s confidentiality and civil liberties, and lack of familiarity with available privacy-protecting technologies, have both led to suboptimal privacy implementations and hindered adoption. This paper reviews the trade-offs of these methods, their techniques, the necessary rate of adoption, and critical security and privacy controls and concerns for an information system that can accelerate medical response. Proactive use of intentionally designed technology can support voluntary participation from the public toward the goals of smart testing, effective resource allocation, and relaxing some…

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