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Targeted COVID-19 more effective than random testing

Tuesday September 29th 2020

A focused COVID-19 strategy that tests groups that are most at risk of having and passing on the disease should be introduced, scientists have urged.

The testing strategy, which concentrates resources on specific groups rather than the general population at random, is proposed by researchers at the University of Oxford, UK.

Co-author Dr Daniel Susskind, fellow of economics at Balliol College, said: “Governments around the world are looking for a testing strategy for COVID-19. This strategy will inevitably be constrained by our testing capacity: in short, every person in the world cannot be tested every day.

“Given these constraints, which still bind us many months into this crisis, we need to focus again on a testing strategy that is workable, efficient and affordable for the government.”

The strategy, published in the latest edition of Oxford Review of Economic Policy, says individual’s likelihood of infecting others largely depends on their occupation, geography, and other behaviours when not isolated.

Dr Susskind said: “We have seen over the course of the pandemic that certain groups, such as health care and social care workers that are in frequent close contact with others, are more likely to pass on COVID-19 than other groups, for example those working from home.

“Focusing testing on groups who are at particular risk of spreading COVID-19 at regular intervals is a far better use of scarce testing resources than testing the entire population at random, as has recently been discussed globally.”

As well as healthcare and social care workers, the study authors say that transport workers and delivery drivers, who travel to different locations regularly, as well as coming into contact with a wide variety of people could also be considered a priority.

Members of large religious congregations, or those who regularly attend other types of big gatherings, could also be an identified sub-set of the population included in a testing programme. Subsets also located in large cities could be prioritised further.

Dr Susskind and colleagues said testing done at regular intervals with identified “risk” groups was more efficient and effective than random testing and it would enable the healthcare system to save money.

He said that while highly accurate and sophisticated testing is needed for clinical reasons when treating someone, cheaper diagnostic tests can identify who should be isolating. There are fewer concerns about false negatives with a regular testing programme because any individual who has received a false negative will be tested again shortly afterwards.

A targeted testing programme for those most likely to spread the virus, rolled out at the same time as antibody testing for the entire population, would be the most efficient way to suppress the virus, he said.

“The COVID-19 pandemic has created both a medical crisis and an economic crisis. As others have noted, we face challenges just as big as those in the Spanish Flu Pandemic and the Great Depression -- all at once. The task facing policymakers are extraordinary. The hope is that our work will shape the discussion about how to test for COVID-19 and contribute to bringing these crises under control,” added Dr Susskind.

Cleevely M, Susskind D, Vines D et al. A workable strategy for COVID-19 testing: stratified periodic testing rather than universal random testing. Oxford Review of Economic Policy 29 September 2020

https://doi.org/10.1093/oxrep/graa029

Tags: Flu & Viruses | UK News

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