COVID-19 testing needs a rethink

The line “Insanity is doing the same thing over and over again and expecting different results,” usually attributed to Albert Einstein, comes to mind in Public Health's approach to COVID-19 management. Here we are with more lockdowns where health providers benefit from relief but the outcome simply defers morbidity and death until the next wave, with the added result of further economic hardship and ruination of entrepreneurial aspiration.

Until an effective vaccine is approved there may be many further waves. What will be left if the lockdown approach is continually repeated? Central to public health management is testing. Canada, like other countries, has been largely reliant on the PCR assay for COVID-19. The PCR test provides the best diagnostic accuracy, but it arguably takes too long to allow for best managing of contact tracing. Further, it requires those who may have COVID-19 to travel to test locations, raising the risk of transmission.

Researchers at Harvard Medical School published in the Journal of Infectious Diseases in September an analysis comparing COVID-19 test approaches. Their paper makes the argument that widespread and repeated use of rapid, low-cost diagnostic tests, similar to at-home pregnancy tests — costing about $3 a test (as opposed to PCR costs that range from about $50 to $2,000 a test) would not only be more cost-effective but, importantly, would lead to a reduction in infections and 46-per-cent reduction in deaths — this despite the lower diagnostic accuracy these cheaper assays have that will allow some people with low levels of infection to miss detection.

It appears that Health Canada and our public health experts prefer to stick with the current test regime that will likely result in further lockdowns. One has to ask if maybe the Harvard researchers might be onto a better approach.

Russ Redshaw, Carp