US planning to expand coronavirus testing, Fauci says

By Virginia Langmaid, CNN

Coronavirus testing in the United States is down from where is has been at previous points in the pandemic. However, health officials are working to get those numbers up again.

In a discussion on Tuesday hosted by the Center for Strategic and International Studies, National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci said there are plans to expand testing capacity in the United States, and that research is ongoing into improving test access.

In a briefing by the White House Covid-19 Response Team on Monday, White House Covid-19 Response Coordinator Jeff Zients said the federal government has communicated to states that it is prepared to help increase testing capacity.

“Last week we reiterated to all governors that we stand ready to help them in meeting this moment, whether that be through more testing, increasing treatments, vaccine access and uptake, or other state-specific needs,” he said.

The 7-day average of new tests is now just over 584,000 per day, down from over 1.5 million per day six months ago and about 900,000 per day a year ago, according to data from the US Department of Health and Human Services.

Dr. Patrick Godbey, president of the College of American Pathologists, agreed that there is a need for greater testing.

“I think more testing is a good thing, for many reasons. One of the important things to remember is, first of all, bad data is worse than no data at all,” Godbey told CNN.

“When we talk about testing, we need to remember that all testing is not created equal. And we need to have reliable, accurate testing. That’s always been, and continues to be, fundamental in dealing with this pandemic. The basic question is, do you have it or not? Only good testing can answer that question.”

Testing at this stage of the pandemic takes many forms, including at-home tests performed alone or with a virtual aide, or a test administered by a doctor or pharmacist. The “gold standard” of Covid-19 tests is an rt-PCR test, a type of nucleic acid amplification test, which detects viral RNA.

PCR tests are what the CDC uses to assess community positivity rates, or the percent of positive tests in a community, which is typically a county.

“A person’s risk for SARS-CoV-2 infection is directly related to the risk for exposure to infectious persons, which is largely determined by the extent of SARS-CoV-2 circulation in the surrounding community,” the CDC said in its latest guidelines for Covid-19 prevention strategies.

The agency uses the percentage of positive PCR tests in an area combined with the weekly number of new Covid-19 cases per 100,000 people to assign communities a transmission level ranging from low to high. Transmissions levels then feed into decisions about Covid-19 mitigation efforts in an area.

PCR tests are also what Godbey would get in a scenario where he is a vaccinated person worried he’s been exposed to Covid-19.

“I would like nucleic acid amplification test. I would like it performed in a laboratory close to home so that I can get the results quickly,” he said.

Under guidelines released last week from the US Centers for Disease Control and Prevention, people vaccinated against Covid-19 should be tested three to five days following “a known exposure” to the virus. The guidance is a change from the agency’s previous recommendation that vaccinated people don’t need be tested for Covid-19 following exposure unless they became symptomatic.

“The advantage in getting a vaccine is to keep you from getting severely ill. It doesn’t mean that you can’t harbor the virus for some time. And in order to keep the spread down, it’s still important for you to be tested,” Godbey said.

Godbey said some available testing options, like over-the-counter tests which a person performs themselves, may present accuracy issues. To get an accurate result, the person getting the test would need to follow the directions “meticulously,” and even then, environmental factors can get in the way.

“If you buy it, and you put it in your car in Atlanta and then leave it in the car for a while, it gets to be over 100 degrees in the car. That can affect the accuracy of the test. The ones that you have to send away, you have to be careful about how they’re shipped,” he said.

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