I think you're right.
The high risk groups that need testing beyond healthcare workers could be a little broader depending on local testing capacity: Skilled Nursing or Long Term Care residents
Others with high levels of multi-person contact? ?Grocery checkers
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Unfortunately, under certain conditions such as the current pandemic, the social contract has to be re-negotiated. And that includes with regard to lab testing.
From a patient perspective, absolutely, it would be ideal to have universal rapid access to testing and results. From a system perspective right now, there is limited capacity of collection kits, instruments, and testing reagents. I can promise you that everyone in the lab industry, from manufacturers to clinical labs, has been working around the clock for weeks now to grow capacity and test as many and as fast as we can. But in a setting of limited capacity, you have no choice but to prioritize testing to those individuals who can benefit most. Which includes health care workers in quarantine and inpatients. That's why health systems are limiting access to testing. It's not that outpatients don't deserve testing. It's that the system has to focus its efforts right now in order to do the most good.
The more that the public tries to get access to testing in the immediate future, the more it's going to bog down our ability to produce fast results for the most critical individuals. And speed matters right now.
Please be understanding of this. BTW, my family and I are sheltering in place right now even though we have neither symptoms nor exposures, and we live in a lower-prevalence region. I hope everyone on this thread is doing likewise to the extent that your health care delivery responsibilities allow.
Brian – I completely agree.
I'm not in NY, but I totally get what you're saying. If FDA had allowed the lab industry a longer head start, diagnostic testing might be in a stronger position. I can't speak for the NYC hospitals and clinics, but I hear they're in full crisis management mode right now. Unfortunately in these types of circumstances, the marginalized get hurt even worse than everyone else.
Testing everyone and quarantining positives and contacts is the way to stop this pandemic quickly. This could have been done for a lot less than 2 trillion dollars.
Why not focus funding getting mass testing up and running? It would have stemmed the pandemic and gotten the economy up an running a lot faster.
The way to win this war is not by building the hospitals which are all downstream, but to stop people from getting infected in the first place. Test and isolate are the way to win this war.
Ted Palen, PhD, MD, MSPH
Yes – but that assumes that testing supplies are available at that level. What I'm hearing from colleagues is that the reagent manufacturers are nowhere close to being able to support mass testing. RNA extraction reagents appear to be one of the limiting factors. In the mean time hospitals are having challenges securing supplies even for the most limited testing currently going on.
Without doing the traditional public health work of testing, tracing contacts, testing, isolating as soon as we relax social distancing we're going to get another surge.
US is almost last in terms of testing per capita and some hard hit states (California) are doing even worse (5 tests per 10K people in CA, national average is between 10 and 20 per 10K).