Wednesday, March 29, 2023

Pandemic becomes harder to track as COVID testing

Testing for COVID-19 has plummeted around the world, making it much harder for scientists to track the course of the pandemic and the emergence and spread of new, worrying viral mutants.

Experts say there has been a 70 to 90% drop in worldwide testing from the first to second quarter of this year – contrary to what they say will be with new Omron variants on the rise in places like the United States and South Africa. needed.

“We are not testing anywhere where we might need it,” said Dr Krishna Udayakumar, who directs the Duke Global Health Innovation Center at Duke University. “We need the ability to accelerate testing as we see the emergence of new waves or surges to see what is happening” and respond.

Reported daily cases in the US, for example, have averaged 73,633, more than 40% over the past two weeks, according to data compiled by Johns Hopkins University. But this is a huge low because of the drop in testing and fact tests are being done at home and are not reported to health departments. An influential modeling group from the University of Washington in Seattle estimates that only 13% of cases are being reported to health officials in the US – meaning there will be more than half a million new infections every day.

The decline in testing is global but the overall rates in developing countries are particularly inadequate, Udayakumar said. According to FIND, a Geneva-based public health nonprofit, the number of tests per 1,000 people in high-income countries is about 96 times higher than in low-income countries.,

What’s driving the drop? Experts point to COVID fatigue, a lull in cases after the first omicron wave, and a feeling among some residents of low-income countries that there is no reason to get tested because they lack access to antiviral drugs.

In a recent press briefing by the World Health Organization, FIND CEO Dr Bill Rodriguez called the test “the first loss of the global decision to let down our guard” and added that “we are blind to what is happening with the virus.” are happening.”

Delving into testing, genomic sequencing and case spikes can lead to the discovery of new variants. New York State Health Officials Found BA.2.12.1 Version Super Infectious After examining the higher-than-average case rates in the central part of the state.

“Going forward, we will not allow new variants to emerge the way we saw previous variants emerge,” Rodriquez told the Associated Press.

As the infection progresses and people develop symptoms — testing increases — and it comes with a lull in new cases. With the recent boom, testing is increasing again in the US.

But experts are concerned about the size of the fall after the first Omicron surge, low overall levels of testing globally and the inability to track cases reliably. While home tests are convenient, only tests sent to laboratories can be used to detect variants. If fewer tests are being done, and fewer of those tests are processed in laboratories, there are fewer positive samples available for sequencing.

In addition, home test results are largely invisible to tracking systems.

Mara Espinol, managing director of an Arizona-based consulting company that tracks COVID-19 testing trends, said there is at least four times more at-home testing than PCR testing, and “we need more at-home testing than mandated”. Currently getting zero data.”

This is because there is no uniform mechanism for people to report results to under-staffed local health departments. The CDC strongly encourages people to tell their doctors, who must report a COVID-19 diagnosis to public health officials in most places.

Generally, however, the results of home tests fall under the radar.

Reva Seville, a 36-year-old parent from Los Angeles, got herself tested at home this week after she started experiencing symptoms such as a sore throat, cough and congestion. After the result came back positive, she took two more tests to be sure. But her symptoms were mild, so she didn’t plan on going to the doctor or telling anyone about her results.

Beth Barton of Washington, Missouri, who works in construction, said she took about 10 home tests before visiting her parents or when she had symptoms that she thought could be COVID-19. Is. All came negative. She shared the results with those around her, but didn’t know how to report them.

“There has to be a whole system for this,” said Barton, 42. “We don’t know where we are as a society.”

Aspinol said one possible solution would be to use technology such as scanning a QR code to report the confidentiality of home test results.

Another way to better track the pandemic, experts said, is to strengthen other forms of surveillance, such as monitoring wastewater and collecting hospitalization data. But they have their drawbacks. Wastewater monitoring is a patchwork that does not cover all areas, and trends in hospitalization lag behind cases.

Udayakumar said scientists around the world should use all tracking methods at their disposal to avoid the virus, and would need to do so for months or even years.

Also, he said, steps should be taken to promote testing in low-income countries. The demand for tests will increase if antiviral access improves in these places, he said. And one of the best ways to increase testing is to integrate it into existing health services, said Wadzanai Muchenje, who leads the Health and Strategic Partnerships in Africa for The Rockefeller Foundation.

Georges Benjamin, executive director of the American Public Health Association, said a time would come when the world would stop widespread testing for COVID-19 – but that day is not here yet.

With the pandemic and the virus still unpredictable, “it is not acceptable for us to be concerned only about individual health,” he said. “We need to worry about the population.”


Associated Press reporter Bobby Cana Calvan in New York and Carla Kay Johnson in Seattle contributed to this story.


The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. Associated Press is solely responsible for all content.


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