Even in the third calendar year of the pandemic, it seems we keep failing the test of getting COVID tests in the hands of Americans.
From the beginning, we bungled COVID testing. The CDC wanted everyone to use only their test, but the test didn’t end up working. We had to play catch up as new variants and society's reopening created even more need for COVID testing. Things seemed in a better place after the delta variant ran its course, so what happened?
To understand how we got here and what's needed to for the U.S. build a strong testing infrastructure, NBCLX sat down with someone whose actual business is finding people COVID tests and helping them figure out what to do with the results. Andrea Stone is the business director for Colorado-based COVID Consultants, a group of infectious disease experts who assist individuals and businesses with COVID testing.
How did we end up with a testing shortage when omicron hit?
STONE: We’ve seen strains on COVID testing since the start of the pandemic, and what’s different this time is that it was the perfect storm. Omicron being the most wildly contagious variant yet, the timing when it was introduced – right before the holidays when everyone was getting together — and screening requirements are a big one. You need a COVID test to go back to work. If you want to go to an event, in some states you need an antigen test to attend, whereas this time last year, a lot of things were simply shut down and the in-person activities were lesser, so the need for screening was not there.
How did nuances within COVID testing contribute to the recent bottleneck?
People say “COVID testing,” and lump them all together, whereas in my mind antigen testing and PCR testing are totally different animals. Many people don’t appreciate how labor-intensive PCR testing is. From when the medical professional administers the sample all the way until it’s processed at the lab and the results are communicated to the patient, it is an incredibly labor-intensive process. As for antigen testing, the bottleneck comes from the manufacturer’s inability to keep up with the demands of the community.
What are some solutions that COVID testing companies are exploring?
There's a lot of discussion around coming up with a COVID test that detects the person when they're most contagious. That's really the most important thing. If you're going to be testing for screening, you want to be able to detect the person with the highest viral load that will be transmitting it in that event.
One of the great things about PCR testing is that it's so sensitive. That’s also one of the bad things about PCR testing because there's been reports that it can pick up a positive test at 12 weeks after the person has had COVID, so they're no longer contagious at that point. Testing for screening using a PCR has some drawbacks. Focusing on COVID testing for high viral loads is something that would be very helpful for the community. It would help with COVID fatigue. People are tired of isolating, quarantining and staying home. Everyone wants to get back to work and back to their regular lives, and this would be a really good compromise.
What flaws with testing most need to be improved?
The technology is actually quite good. There is always room for improvement, and a lot of companies are working on that. The testing strategies and communication from the top levels could be a little bit better. For example, if you require COVID testing to attend a hockey game, that means somebody who's perfectly healthy is taking a COVID test away from somebody who is sick and looking for testing to diagnose their symptoms. If you require COVID tests to do absolutely everything, then you just have to make sure that there are enough available, as everybody wants them for different reasons at exactly the same time.
Are there any upcoming innovations within the testing industry that could prevent in the future the challenges we saw during recent surges?
Rapid PCR should be a focus for 2022. This would alleviate a lot of the delays with results, which are exceeding five days, which is now the time that's recommended for isolation. By the time you get your the results for your test, you're already out of isolation anyway. The rapid PCR machines have the ability to produce results in 30 minutes. It's also much more environmentally friendly because you don't need to send the test to a laboratory.
Everybody in the testing space needs to be extremely adaptable. The landscape is always changing, and people in the industry always need to be on their toes and be able to adapt to the needs of the community.