Kudos to Robert Baird for the article in The New Yorker on the idea.
Can group testing happen in the United States? If so, it may be a good idea to explore.
The concept is taking place currently in the state of Nebraska where Governor Pete Ricketts is claiming that he is expanding testing capacity to 400+ tests/day at public labs for his citizens.
How It Works
Instead of testing samples of suspected cases individually, you mix X samples together (let’s say 5 for clarity) and test the mixed pool. If the test returns positive, you test every contributor to the pool. The value of X is 0, you can confirm that not of the subjects in the test have contracted COVID-19 symptoms at this time. X depends on the prevalence in the population due to dilution.
You can further improve outcomes if you don’t pool random contributors, but you pool samples from socially connected, geolocated or exposed individuals. Pooling samples from families, friends, neighbors or large social groups.
Will This Help Speed Up Testing
Not in the near term. The current process uses a specific technique in genetic research called Polymerase Chain Reaction (PCR), which takes 30 minutes to accomplish. The part of the testing scenario that holds us back is our number of supplies and testing resources. The Centers for Disease Control and Prevention (CDC) has stated that they must conduct all the COVID-19 testing in-house so they could monitor quality control, and they’ve been slow to authorize new labs to use their test kits.
As more labs came online, though, they beginning to run low on everything from the swabs they stick up people’s noses to the reagents that power the PCR’s chemical reactions to the human lab techs who do the tests. Some of that is due to all of the online retailers like Everlywell, Carbon Health and Nurx who have been selling those supplies and shipping them out to customers without federal approval.
This past Friday, The Food and Drug Administration (FDA) updated its Emergency Use Authorization guidelines to private labs that specifically bar the use of at-home sample collection. This means these startups have to immediately discontinue their testing programs even if they have been distributed.
How Can South Korea Test People In One Day?
Compare these facts to South Korea, where people can get their results in about a day. There, the government has been stockpiling the necessary chemicals for years after COVID-19’s cousin MERS briefly hit that country in 2015. That helped the country move quickly to approve and decentralize testing as soon as COVID-19 arrived.
A lesson we in the United States will definitely learn in the future.
What Can We Do About It?
We can ask our local and state representatives like the state of Nebraska did to consider pool testing for groups that may have been exposed to people with COVID-19 symptoms. For those groups that have exposed, you should gather and identify the people you have been most exposed to together and propose this solution to your local testing centers.
This is not a full-proof solution, and if done randomly, can hold us back from proper results for months. But may be worth a shot, especially in isolated, less catastrophic regions of the country.
References:
Group Testing For The Coronavirus
How Coronavirus Tests Actually Work
(Predicts 13 people as best batch) Technical and Mathematical Details On Group Pooling
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