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August 23, 2021 OTHER VOICES

When change is constant, leaders should make access to accurate COVID-19 testing consistent

Cloe Poisson | CT Mirror A health care worker inserts a nasal swab to test Pamela Waterman, of Hartford, for COVID-19 at Hartford HealthCare’s mobile testing site at Phillips Health Care in Hartford’s North End in May 2020.

As Connecticut businesses, municipal leaders and families prepare for a long-awaited return to work and the classroom, the sense of optimism we felt in the early summer has been derailed by the rapid spread of the delta and now evidence of the lambda variant and a steady stream of disappointing statistics and COVID information.

It’s easy to see how this confusion and disappointment has developed.

Earlier this year a Rand Corp. and Mathematica report commissioned by the Rockefeller Foundation advised, “Weekly testing of all students, teachers, and staff can reduce in-school infections by an estimated 50 percent.”

Additional studies have reported similar findings for businesses.

Then, because advisories from the Centers for Disease Control and Prevention are based on vaccination and infection rates, which are fluid (and were incompletely understood at the time), the focus on testing shifted and the agency advised fully vaccinated people did not need to be tested after exposure to the virus unless they were experiencing symptoms.

Then, in late July, the CDC changed its stance.

“Our updated guidance recommends vaccinated people get tested upon exposure regardless of symptoms,” Dr. Rochelle P. Walensky, the agency’s director, said in The New York Times. “Testing is widely available.”

Yes, while testing is available, unfortunately, not all tests are equal. At the peak, more than 350 COVID-19 tests and sample collection devices were authorized by the Food and Drug Administration under emergency-use authorizations.

Today, over 200 COVID-19 tests are on the FDA’s removal lists while other tests remain on the market but have been flagged by the FDA for potential inaccurate results.

This is happening because the majority of tests target viral sequences especially in the “Spike” protein that are rapidly mutating (E-gene, ORF1a, Orf 1b and RdRP).

Tests that target this region typically generate what are called “false negatives.” The virus is present but is not being detected. This could be as high as 30%, according to our preliminary research.

Of more concern is the current focus on rapid tests and antigen or antibody tests and the false sense of security related to these approaches. Such tests unfortunately have low sensitivities for detecting the virus especially at low viral loads, and overall accuracy rates below 50% are common.

They are being used because people perceive they are cheaper and easier to use. A test that is no better than a coin toss puts individuals, schools, workplaces and communities at risk.

The CDC now recommends confirming negative rapid test results using a gold-standard PCR test. Using a PCR test is the prudent option for accuracy and cost-effectiveness.

Business, community and school leaders should lead by example.

As we revisit and revise our plans and prepare to bring together colleagues and classmates, let’s start with two simple actions: 1) Support and normalize frequent, accurate (gold-standard PCR) testing in businesses, schools and communities for unvaccinated people, which will suppress the localized spread of new variants, and 2) know the test validity and demand fast, accurate and reliable tests and results.

Not losing another year of school and the long-term safety of our communities (vaccinated or not) depends on it.

Mark Kidd is the scientific and laboratory director of Wren Laboratories, a genomics biotech company in Branford that was the first U.S. lab to receive emergency-use authorization by the FDA for a saliva-based PCR diagnostic test.

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