@joel_c_miller raising a good Q here about using high-capacity testing to reduce transmission among university students. As part of a group aiming to do exactly this, I'll make 2 comments that may not be broadly known:
1) due to billing difficulties, our testing lab has been unable to cover costs to test everyone needed in our community. We've recently been able help more key pops through fundraising efforts (inc. a health provider that serves 46K people including many undocumented farmworkers)
But this is obviously limited to funds that have been donated. Costs for current testing are ~$35-40/test. Much lower than commercial tests (>$100), but still costly if you want to test 1000s/day. University admin contributed substantial funds early to get lab running, ...
but are hemorrhaging $$ due to lost dorm fees, etc., so couldn't foot bill for testing 1000s of people w/out any way to pay for tests.
(Note: if billing issue could be addressed problem would go away)
(Note: if billing issue could be addressed problem would go away)
Pooled testing, which we're validating now, will likely cut costs ~3-5x or more which will help a bunch & make fundraised $$ go further. But it'd be nice to have more reliable funding for testing (I seem to recall a pile of $$ for testing being held up somewhere).
(Note: the two faculty on our team (not me) that designed testing protocol were very wise & use only re-agents NOT used by commercial platforms (Quest, etc.), so we are not slowing them down nor are we affected by their use.)
2) Frequent testing of the students that will be on campus can be done because there is a source of $$ for testing.
If more $$ could be made available for testing in community we'd do more of that. As new sources of $$ arise we have expanded coverage.
If more $$ could be made available for testing in community we'd do more of that. As new sources of $$ arise we have expanded coverage.
(Note: pop on our campus will be mostly UG students in dorms + faculty, staff, researchers; only 2% of students will have in-person classes for courses that can't be done online - hands on field & lab courses).
So, in summary, agree that @joel_c_miller is raising good Q. Answer, as usual, is slightly complicated.
More broadly, universities could contribute more & substantially to testing issues but are hampered by regulations (CLIA cert delayed us by 2+mo) & now billing issues.
More broadly, universities could contribute more & substantially to testing issues but are hampered by regulations (CLIA cert delayed us by 2+mo) & now billing issues.
Some great partnerships exist to try to get around these issues & many universities are making important contributions to local & broader communities (including us), but key obstacles remain.
My 2 cents on how to address testing issues:
1) diversify from major companies - tests aren't that technically difficult. Many ways to do this: alternate re-agents, new methods, pooling
2) only pay if results can be returned in <48hr. Quest has no current incentive to speed up.
1) diversify from major companies - tests aren't that technically difficult. Many ways to do this: alternate re-agents, new methods, pooling
2) only pay if results can be returned in <48hr. Quest has no current incentive to speed up.
New tests should be embraced to meet needs. @michaelmina_lab has been tirelessly promoting cheaper but less sensitive tests for non-healthcare settings. I couldn't agree more.
Finally, I have to promote fantastic paper by @DanLarremore @michaelmina_lab that illustrates how high freq testing can reduce transmission even if test is less sensitive.
medrxiv.org/content/10.110…
medrxiv.org/content/10.110…
