It's time for the CDC to pivot on COVID testing
Quarantining and testing for COVID should be limited to those who are around high-risk individuals
{{#rendered}} {{/rendered}}For many high-risk Americans, it’s hard to get a COVID test. Meanwhile, millions of tests are being used on the lowest-risk population on earth—immunized, young, healthy students.
At Princeton University, students get tested twice a week – three times if they play a sport. The hyper-testing isn’t just in the Ivy League. It’s rampant at many of the more than 1,000 U.S. colleges where vaccination is mandatory. This excessive consumption doesn’t just make it harder for others to find a test. It drives a secondary market where price gouging is common.
{{#rendered}} {{/rendered}}The risk of being hospitalized for all fully vaccinated Americans is 1 in 26,000 for the week ending in Nov. 27. And that risk is much, much lower for young students. One analysis of breakthrough infections by age found that the average age of a vaccinated person being hospitalized is 72 years. So why are using so many tests on the lowest risk segment of our population?
The CDC has not helped with the dilemma caused by a shortage of tests. It’s now caught up in a public deliberation about whether you need one or two negative antigen tests or one negative PCR test in order to come out of quarantine. But someone should ask: Why are we even quarantining immune people who are around other immune people? Quarantining and testing should be limited to those who are around high-risk individuals, such as nursing home staff.
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{{#rendered}} {{/rendered}}For the vast majority of Americans, the overly complex CDC guidance should be replaced with a simple message of common sense: If you’ve been exposed, keep your distance. If you’re near anyone vulnerable, be careful, and if you’re sick, stay home. We are dealing with a far less dangerous omicron variant and growing population immunity is helping to protect against severe illness. Not everyone needs to get tested.
The failure of public health officials to acknowledge that we are rationing a limited testing supply is nothing new. In fact, government officials have been extremely uncomfortable with rationing. We’ve seen that again and again during the pandemic, beginning with the vaccine rollout.
Many of us pleaded with public health officials to delay the second vaccine doses so more people could get their initial dose, as the U.K. successfully did, which saves more lives. After all, why would you give two life preservers to one person when many were dying with none? I also urged public health leaders to allocate the limited supply of vaccines (early in the vaccine rollout) to those without natural immunity from prior infection, but to no avail.
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Our testing shortage is a manufactured crisis—a self-inflicted wound. But even with a scarce testing supply, public health officials continue recommending widespread testing as if tests are unlimited. They need to pivot and put forth recommendations for selective testing.
Because the CDC has not acted, some states have delivered this guidance. Last week, Florida released a selective testing strategy that acknowledges a limited supply we are currently rationing. The Florida guidance discourages testing people who have been exposed to COVID but have no symptoms.
{{#rendered}} {{/rendered}}We need a new approach to COVID, one based on risk, common sense and what we know works best.