In 2022, We Need to Shift Our COVID-19 Focus to Testing

2022 is the year for testing, if 2021 was the year that the vaccine became available. COVID-19 vaccines are essential for controlling the pandemic, but since getting a shot to everyone on the planet is time-consuming and stymied by unequal global distribution; because many who do have access to vaccines refuse to take them; and because the vaccines aren’t 100% able to prevent infections, the world is going to need more in order to stay ahead of SARS-CoV-2.

That extra something should be widespread testing—not just the kind that labs administer to confirm a case of COVID-19, but also the at-home, rapid tests that people can perform themselves. The world’s ability to determine COVID-19 status is determined by how easily it can be obtained. The more people who know if they are positive, the better they can practice mitigation measures like self-isolating and wearing masks so they don’t spread the virus to other people—especially since many infections don’t cause symptoms at all, so people won’t know if they are positive unless they test.
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Just before the new year, the U.S. Food and Drug Administration (FDA) authorized the latest at-home rapid antigen test, from Siemens, which—like the other 12 such authorized tests—can be useful either by people who have symptoms and suspect they’ve been infected with SARS-CoV-2, or by those that don’t have symptoms but want to be sure they aren’t infected before or after attending a gathering with others.

In recent weeks, U.S. health authorities have been emphasizing self testing as more holiday travelers boarded buses, trains, and planes to celebrate the season. Self-testing is a great way to cut down on the risk of spreading this virus to other people.

Testing as a practice, however, isn’t as robust in the U.S. as it should be. Since the outbreak, when the only labs that could verify SARS-CoV-2 cases were the CDC, the U.S. has struggled to make COVID-19 testing affordable and readily available. This is due to a variety of reasons.

The CDC initially didn’t allow academic or commercial labs to perform SARS-CoV-2 tests because the agency wanted to ensure that a standard, scientifically validated assay was used to verify all COVID-19 cases and provide an accurate picture of how much virus was in the country, and where it was circulating. Unfortunately, the first test kits that the CDC sent out to state health departments were compromised by a laboratory contaminant. This problem caused a slowdown in U.S. testing capabilities beginning in 2020. The United States was still in a catch-up mode even though the FDA allowed commercial laboratories to carry out COVID-19 test results in spring 2020.

The U.S. response then shifted to vaccines—devoting considerable resources, personnel, energy and attention to developing and then distributing the shots. Meanwhile, the public also began to believe that once vaccines were available, they wouldn’t need to get tested as much. That was an intuitive response, but the reality is that SARS-CoV-2 can infect people without causing any symptoms, and those infected—whether symptomatic or not—can still spread the virus to others.

The virus started to change, and vaccines were no longer effective in protecting people. It was important that people knew if they had been infected, even though vaccines were available.

However, many Americans are still unable to afford testing. While the National Health Service in the U.K. makes test kits available without charge, sending packs of kits directly to people’s homes, in the U.S., Americans have to purchase them for about $20 to $40 online or at pharmacies. The President Joe Biden declared that self-testers will be reimbursed by private insurances. Previously, self-tests were only covered by insurers if ordered or performed by doctors. These requirements are counterproductive to the goal of the self-tests, which allow people to monitor their COVID-19 status at home and avoid being exposed to the public if necessary.

It didn’t help that health experts were also sending mixed messages about the importance and reliability of testing to the public. SARS-CoV-2’s gold-standard test, also known as a PCR or molecular testing, checks for genetic traces. The PCR test is used by doctors to confirm COVID-19.

These at-home tests can give results within 15 to 20 minutes. The tests are able to detect proteins in people infected by the virus and can provide results in as little as 15 minutes. The rapid tests can detect all variants of SARS-CoV-2. However, the FDA stated that they may not be sensitive to Omicron.

However, some doctors have noted that they’re not as accurate as PCR tests since the PCR tests can take a small amount of virus and amplify it to ensure any SARS-CoV-2 isn’t missed. However, self testing can prove to be effective for surveillance. It’s better to be safe than sorry, and encouraging people to test themselves more frequently before or after potentially high-risk behaviors like boarding a plane or attending an indoor public event, could help people avoid spreading the virus to others by self-isolating until they test negative.

That’s why in recent weeks health officials are drawing more attention to testing. CDC director Dr. Rochelle Walensky has been promoting the agency’s Test to Stay program for schools, which encourages students of all ages to get tested frequently. Many parents, however, have struggled to purchase the kits at their local pharmacies, which haven’t been able to keep enough tests in stock to meet demand. Biden declared a plan of purchasing 500 million at-home kits, which would be free for all Americans to meet the increasing demand. The federal government is planning on standing up a website to take requests for shipping the kits directly to people’s homes, but as of Dec. 29, the site has yet to go live.

Omicron continues to spread rapidly and leaders are reluctant to resort back to lockdowns. Testing, particularly home testing, is essential for containing this pandemic. That’s the only way Americans will be able to take the proper precautions to prevent spreading the virus, and potentially causing further surges in cases in the coming year. The sooner infected people, whether they are symptomatic or not, isolate themselves so the virus can’t spread to other people, the sooner the pandemic will peter out.


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