Prioritizing COVID testing for symptomatic people: Are health care providers right?
- On January 10, 2022, CNN reported on their “The latest on the coronavirus pandemic and Omicron variant” page that both the University of Washington and the University of North Carolina have instructed multiple testing locations to test only those with COVID symptoms or known exposure to COVID-19 “as laboratories struggle to keep up with the increased demand for Covid-19 tests triggered by the surging Omicron variant.”
- The CDC reported the Omicron variant is the cause of 705,264 new cases, which is “more than double” the January 2021 peak.
- On January 4, 2022, the CDC reported that data shows that most SARS-CoV-2 transmission occurs in the early stages of infection between “one day before symptom onset and declines within one week of symptom onset, with an average period of infectiousness and risk of transmission between 2-3 days before and 8 days after symptom onset.”
- The CDC released new COVID-19 quarantine recommendations on December 27, 2021, shortening the isolation period from 10 days to five days given no symptoms or lessening symptoms (without fever).
At the beginning of the COVID-19 pandemic in 2020, healthcare workers intentionally asked everyone to test for the virus—symptomatic or not. But now, in January 2022, nearly two years later, the same healthcare workers insist that only symptomatic individuals should be tested. The primary reason they offer is that there is a shortage of testing kits. But this new switch in their approach is concerning for several reasons.
First, a significant number of people with COVID will have no symptoms. In this scenario, the inability to test all Americans will likely contribute to the undetected spread of the virus, regardless of whether a community has a high or low vaccination rate. Likewise, asymptomatic individuals might be a societal risk because they may not know without testing to take precautions to prevent virus transmission, or others may see them as less of a threat because they have no symptoms.
Secondly, it is established that undetected spread of COVID occurs from asymptomatic individuals, and more importantly, the incubation period is up to two weeks. Many outbreaks have already been reported in airplanes, nursing facilities, social gatherings, and cruise ships. Thirdly, testing asymptomatic individuals can help curb COVID transmission, especially when considering opening schools and businesses. Without surveillance testing all individuals, including the vaccinated, the spread of COVID throughout at-risk communities is a given. Surveillance screening is vital to prevent infectivity in high-risk communities as it introduces early quarantine/isolation of the infected individual, thus limiting the spread. More data, not less, will help end this pandemic. Without consistent guidelines in testing, our pandemic precautions for such a highly transmissible virus are likely to persist.
Recent headlines such as “America’s Covid testing system buckles under weight of Omicron surge,” and “Can’t find a COVID Rapid test? Why they’re so hard to find,” illustrate exactly why healthcare professionals are signaling that only symptomatic people should be tested. There simply aren’t enough tests available for non-symptomatic (or asymptomatic) people to take them regularly, as is the case in several European countries. Right or wrong, both the Trump and Biden Administrations have focused the vast majority of resources on vaccination campaigns and focused less on testing. Now in the middle of a major surge, medical manufacturers simply cannot scale up production and distribution in time for mass testing. Medical professionals are right that we must prioritize these tests for the symptomatic.
Although the Omicron variant of the Coronavirus has several distinct symptoms, many people have reported their experience to be similar to having a moderate cold. Unfortunately, it is currently cold and flu season, and we cannot afford to use the nation’s limited supply of tests on anyone who has a sniffle or has a bit of congestion. This isn’t about testing less frequently; it’s about using our limited resources in the most effective way possible.
Finally, there is simply no valid reason why any person living in America without a valid medical exemption should not have been vaccinated and most likely boosted by this point in the pandemic. Vaccines are readily available, safe and effective; testing should not be used as an excuse or an option to avoid getting the vaccine. Testing should be for symptomatic individuals, not merely as a reason to remain unvaccinated.