To date, no national testing strategy has been articulated for coronavirus. New research from Massachusetts General Hospital suggests that low-cost and recurrent screening of asymptomatic individuals at an expense of approximately $3 or less per test every two weeks would decreases expanding infections and mortalities. When Covid-19 pandemic is slowing, and while cases are surging, frequent screening can be cost-effective, even if the tests used are costly. These research findings were published in Clinical Infectious Diseases.
— MassGeneral News (@MassGeneralNews) September 21, 2020
So far, Covid-19 testing has been done extensively to diagnose the confirm cases. Covid-19 testing is referred to test those people who have been showing infectious symptoms, yet Covid-19 screening is referred when people do not show symptoms. Screening is done to identify the silent carries who are spreading the infectious unknowingly. Therefore, expanding frequent Covid-19 screening in addition of Covid-19 testing could significantly reduce the hospitalizations and mortalities. Moreover, it would be cost-effective, allowing for safe recommencement of economic and social activities.
The research team analysed a clinical and economic impact of alternative testing strategies on Cobid-19 incidence as well as its mortality in Massachusetts using a microsimulation model. Four testing strategies were compared:
1) Hospitalized: PCR testing only patients with severe/critical symptoms warranting hospitalization;
2) Symptomatic: PCR for any COVID-19-consistent symptoms, with self-isolation if positive;
3) Symptomatic + asymptomatic – once: Symptomatic and one-time PCR for the entire population; and
4) Symptomatic + asymptomatic – monthly: Symptomatic with monthly re-testing for the entire population,” quoted from the study. Researchers used data on Covid-19 progression and mortality along with transmission, PCR testing, and costs.
Results revealed that individuals from Symptomatic + asymptomatic-monthly vs. Hospitalized showed 64% reduction in Covid-19 infections and 46% reduction in mortalities, yet over 66-fold more PCR tests per day. When the when test cost was less than $3, testing every 14th day was cost-effective for all re-examined.
The co-senior author Andrea Ciaranello, MD, MPH, investigator in the Division of Infectious Diseases at MGH says in press release, “Based on the prices that most laboratories are now charging for the PCR test, with our current levels of new COVID-19 cases in Massachusetts, the most cost-effective strategy remains testing only people with symptoms of COVID-19. Importantly, for Massachusetts as of now, this includes testing all people with symptoms, and not only people whose symptoms are severe.”
“However, in locations where cases are rising, regular screening of the entire population, while expensive, will actually be of very good value. This is true even at current testing costs around $50 and will be truer if test costs can be brought down substantially. There are creative ways to bring tests costs down; for example, using emerging techniques such as less expensive reagents, pooling of specimens in the lab, or carefully allocating unused testing capacity across cities or regions,” she explains further.
Therefore, it is implicated in the study that low cost as low as ≤$5 and recurrent Covid-19 screening people who do not show symptoms would considerably reduce infections and associated mortalities and it would be cost-effective when pandemic is slowing. Even if the Covid-19 testing costs are more than $50, it would be economic to expand frequent screening of Covid-19.