THREAD: The government has worked to improve testing capacity, including supporting the validation of synthetic swabs that can be manufactured at scale and increasing payment to labs running high throughput tests for COVID-19. There is more we can do to increase access. 1/n
Despite these measures, most states are unlikely to experience a significant increase in testing availability over the next several weeks as we plan to reopen parts of our economy. Why? And what more can be done? 2/n
Access to PCR-based testing is still limited by supply chain constraints, like reagents, personal protective equipment for providers, and personnel to run tests. At the same time, not all lab platforms that could be running COVID-19 are testing at full capacity. 3/n
Given the limits on testing capacity, states should try to match the type of test to the patient who needs it, and strategically deploy additional testing as it comes available. States need to band together, lead the way with state and regional plans that cross state lines. 4/n
The federal government can help by requesting and making public information from manufacturers about the testing supply chain going forward, so states can plan 5/n
Manufacturers should make available more information about their plans to seek EUA for new test types, like antigen testing that can be point of care. When a new test comes online, manufacturers should disclose planned capacity, identify options for increasing capacity. 6/n
Currently, states can rely on major academic and hospital labs running PCR to test patients with severe illness, healthcare workers, and other patients. The commercial labs, where samples have to be transported for testing, provide important options for outpatient settings. 7/n
Point of care tests can be used where there’s high risk populations and known outbreaks, like nursing homes. More point of care systems should be reaching the market and may create a bigger increase in capacity by June. 8/n
We also can make sure high throughput labs are functioning at capacity; pooling resources so regional labs are serving as many patients as they can, even if it means reallocating lab supplies to increase capacity, as we’ve seen hospitals do with ventilators across state lines 9/n
States that are collaborating on reopening their economies can coordinate to make sure that they’re maximizing what testing resources are available across a region. 10/n
We need to build into this system the ability to test mild and asymptomatic individuals, who may be spreading the virus, and their known contacts, including through routine surveillance, testing made available by employers, and testing as part of regular healthcare visits. 11/n
We can build more capacity by supporting efforts of manufacturers able to control their own supply chain and provide end to end solutions. And we can invest in additional technologies that have not yet been deployed in coronavirus testing, and plan now how to scale them. 12/n
As employers think about supporting solutions, they can develop risk-based criteria for workplace testing. We can also plan now how to reallocate our current capacity as ED visits and hospitalizations decrease in certain areas and more point of care options become available 13/n
We need allow larger hospital labs to support widespread testing when current pressure on healthcare system decreases, and set how to best deploy new antigen and rapid tests (even in stepwise fashion) to test anyone who needs a covid test, and build a surveillance system. 14/14
