Despite vaccines, COVID-19 testing remains priority

Antigen, antibody testing need to be integrated into public health measures

WHEN THE NEWS BROKE late last year that multiple pharmaceutical companies had successfully developed vaccines for COVID-19, we all breathed a sigh of relief. Finally, there was light at the end of the tunnel.

Even as the vaccine rollout has accelerated, it is still uncertain when we will reach herd immunity. New variants have emerged that spread more easily and may not be controlled by the current vaccines. And the Centers for Disease Control (CDC) guidance on safety precautions continues to evolve—most recently with its announcement that fully vaccinated people do not need to wear masks indoors.

At the same time, a new epidemic of undiagnosed health issues is building in the US, just as COVID-19 caseloads are declining rapidly and America is returning to pre-pandemic activities. Large numbers of Americans are putting off medical care they may need – including COVID-19 diagnostic lab tests as well as preventive and chronic care – due to fears and other barriers, with likely long-term consequences for patients and the US healthcare system.

The reality is that comprehensive testing will continue to be a crucial tool in controlling the spread of COVID-19 and keeping our schools, businesses, and the broader economy open during 2021 and beyond.

There are three kinds of COVID-19 tests, each of which plays a different role in a comprehensive testing program: PCR tests, which are considered the gold standard of COVID-19 tests; rapid antigen tests that provide a fast result when needed, such as before boarding a long flight; and antibody tests that can detect previous COVID-19 infections.

Together with PCR tests, adopting a more widespread regimen of rapid antigen tests and antibody tests under the right circumstances can help serve the public interest in the following ways:

Screening: COVID-19 spreads among asymptomatic carriers. Using rapid antigen tests can support safer re-entry to schools, workplaces, public transportation, and a variety of indoor venues such as concerts, sporting events, museums, and restaurants.

Surveillance: Making antigen tests available to the public can identify hot zones and show when and where individual cases exist. Knowing where there are pockets of positive tests allows public health officials to direct resources and take swift action to reduce the spread before it gets out of control. Antibody testing can also help track the virus’s progress and indicate the prevalence of new variants in a community.

Health outcomes: Making rapid antigen tests and antibody tests widely available allows more individuals and healthcare providers to make more informed healthcare decisions. A positive COVID-19 antigen test on an asymptomatic person, for example, allows them to immediately take preventative measures while they await the results of a confirmatory PCR test. For those who have a positive antibody test result, their physicians might take steps to help address “long-haul” COVID-19 conditions that can affect even those who never experienced symptoms.

To reap the benefits of strategic COVID-19 testing at scale, leaders should integrate antigen and antibody testing, alongside PCR testing, into public health measures immediately. Federal, state, and local officials should initiate or renew efforts to:

  • Educate the public about the different tests and when to use them
  • Encourage clinicians to include antibody testing when ordering other tests for their patients
  • Use federal and state funds to reduce costs
  • Address cultural barriers in communities that may be wary of public health initiatives
  • Establish and maintain safe testing sites that are accessible to all communities.
Meet the Author

Tim Murray

President and CEO, Worcester Regional Chamber of Commerce
Meet the Author

James J O'Day

State Representative, Massachusetts House
Before we can get back to our pre-pandemic activities, a yet undefined critical mass of the population needs to be vaccinated, and we don’t know how long that will take. Even after herd immunity is reached, testing will be necessary for preventing setbacks and maintaining the hard-earned return to normalcy.

Tim Murray is the president and CEO of the Worcester Regional Chamber of Commerce and the former former lieutenant governor of Massachusetts. Jim O’Day is a Massachusetts state representative from Worcester.