“Over the past week,
members of the Trump administration have issued justifications for why the
United States does not need mass covid-19 testing. Here’s what they get wrong:
“Mass testing will also
provide the reassurance that many need to resume normal activities. Having
enough tests to regularly check employees, students and teachers would help
provide confidence that we can resume work and school. And imagine if all
patients receive a test before they enter the hospital, and those who test
negative will then receive care in a separate ward from those who test
positive. Patients would not be so frightened to seek care for ongoing medical
issues such as cancer, pregnancy or heart disease, and hospital staff could
also conserve needed personal protective equipment.
“A person could test
negative today and contract the virus tomorrow. That’s true for any infectious disease — or indeed, for any
illness. We don’t stop screening people for HIV or diabetes because they could
develop the disease later. At the time of testing, people can be given guidance
about limitations of a negative test.
“Tests are not 100
percent accurate. Again, this is
true for every test. To be sure, we need to develop tests that have as high a
degree of accuracy of possible, and the federal government must stop fraudulent
tests from coming on the market. But perfect cannot be the enemy of the good.
We don’t stop doing tests for other diseases because there is a risk of false
positives or negatives.
“It’s not just testing
that we need to reopen society. It’s true that
there are other key
components, such as the public health infrastructure to conduct contact
tracing and social supports to isolate those are affected. But testing is the
linchpin. We must know who is testing positive before we can identify their
contacts and quarantine them. Just because other components must also be
present doesn’t change the necessity of testing.
“We shouldn’t focus on
manufacturing one test because there are other tests being developed. There are two main types of tests: the PCR swab test that identifies people who are currently
infected, and a blood serology test that looks for who has been exposed and,
therefore, has antibodies to covid-19. Most public health experts agree that
both types of tests are needed, but that the most urgent test that must be
mass-produced is the PCR test — and ideally one that can produce results within
minutes. The fact that the serology test is also being manufactured doesn’t
replace the need for the PCR test; indeed, both should be produced and deployed
in large numbers.
“In lieu of testing,
there are other ways of doing surveillance by looking at the rate of
influenza-like illnesses. Waiting for
hospitals to register an increase in the number of visits for flu-like symptoms
is acting too late. Two weeks could pass before a patient who contracts
covid-19 ends up in the hospital; the key needs to be prevent the spike in
illnesses through early detection. In addition, some studies suggest that most
people with covid-19 may never develop symptoms but can still transmit the
virus to others. The rate of flu-like illnesses is, at best, a proxy for when
mass testing cannot be done, but it does not replace the need for it.
“We don’t need to test
every single American. Why not? If
everyone is at risk for contracting covid-19, everyone should be able to get
tested — and not only once, but many times if needed. We routinely screen
people for high blood pressure. We encourage everyone to be tested for sexually
transmitted infections. There is no limit to the number of times people receive
these screenings. Why shouldn’t everyone have access to covid-19 testing, too,
when they want and need it?
“The bottom line is that
there are many reasons for the United States to implement mass testing. The
Trump administration needs to stop coming up with reasons for why we don’t need
tests and instead get to work on a national strategy to secure the millions of
tests needed every day. It is a daunting task, but as a country, we can rise to
meet the challenge. Our health — and our economy — depends on it” (Washington Post).
Leana S. Wen is an
emergency physician and visiting professor at George Washington University
Milken Institute School of Public Health. Previously, she served as Baltimore’s
health commissioner.
Commentary:
We all know why lying,
incompetent and narcissistic Trump does not want more testing: it will reveal
how many more Americans are infected with the coronavirus that he purposely ignored for
two months, and he is afraid that more testing will also damage his chances for
re-election.
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