AS VACCINES ROLL OUT, WHAT ABOUT TESTING?
Public health experts say it remains an important tool in tracking, controlling the spread of the virus
As more San Diegans roll up their sleeves for a coronavirus vaccine, fewer are bracing themselves for a swab up the nose or down the throat.
Coronavirus testing has dropped, and public health experts say that’s not necessarily a bad thing. Current vaccines are effective at keeping you from getting sick with COVID-19 — especially at keeping you out of the hospital. And there’s growing evidence that vaccines reduce your chances of spreading the virus to others.
But with most San Diegans not yet fully vaccinated, researchers stress that testing still plays an important role in tracking the scope and severity of the pandemic. That’s especially true in communities that continue to be hit hard by COVID-19.
Test makers expect demand for their products to continue through 2021 and beyond as workplaces, entertainment venues and schools look to avoid outbreaks.
It’s an outlook that reflects a simple truth: While COVID-19 won’t be a global public health crisis forever, the coronavirus is likely here to stay.
“There will always be testing,” said Dr. Robert “Chip” Schooley, an infectious disease specialist at the University of California San Diego. “We’re still going to have people who haven’t been vaccinated and come down ill, and we’ll need to know if they have COVID.”
Slowing the spread
During the post-holiday surge, there were days in January when more than 15 percent of coronavirus tests administered in the county came back positive. Things have changed drastically since then, with current positivity closer to 1.9 percent.
But a community testing effort led by San Diego State University shows the situation isn’t as rosy in the county’s lower-income areas, where people are less likely to have jobs they can do from home. At a testing site in Encanto, 7.4 percent of tests collected in early April came back positive — nearly four times the current countywide rate. During the December and January surge, the site’s positivity rates neared 23 percent.
It’s a clear sign that the coronavirus is still spreading more rapidly in communities of color, says Susan Kiene, a global health expert at SDSU. Testing can help slow that spread by identifying the infected and their close contacts before they can transmit the virus to others.
In October, Kiene and her team were awarded a $5 million grant from the National Institutes of Health to bring rapid coronavirus testing to underserved communities. The test, developed by San Diego diagnostic company Quidel, returns results within 15 minutes after detecting pieces of the coronavirus from a nose swab.
“Early on in the pandemic, people were waiting like a week to get test results. And it was just ridiculous. So we wanted to really change that,” Kiene said. “For people who can’t necessarily isolate at home while they wait for test results, (rapid testing) is a tremendous benefit.”
The SDSU team worked with community leaders to place testing sites across Escondido, Chula Vista, Encanto and El Cajon, among other locations. At least four of those sites have been at churches.
“Service to the community is what we do,” said Robert Pope, pastor of the Encanto Southern Baptist Church, which serves as a testing site. “We have a genuine concern for the complete person — not only the spiritual, but the physical.”
It’s a strategy that has worked well, Kiene says, and one that will continue long after the state fully reopens on June 15.
County-run testing sites aren’t going away any time soon either, according to Nathan Fletcher, chair of the county Board of Supervisors.
“We think it’s important to maintain a robust and accessible testing network,” Fletcher said during the county’s weekly coronavirus update.
“There could be modest adjustments to hours or, perhaps, locations. But we’re very committed to ensuring that a COVID test is available, is accessible and is distributed throughout San Diego County.”
A shift in demand
Few companies have benefited from the testing boom as much as San Diego diagnostics company Quidel. Before
the pandemic, the company brought in $152 million in revenue during the fourth quarter of 2019. A year later, revenue reached $809 million during that same period, largely driven by the sale of COVID-19 products like the company’s coronavirus antigen test.
The company expects demand for those products to last throughout 2021, according to public documents filed in December. The source of that demand, however, is already changing.
“It really, truly has shifted from testing people who suspect they’ve been in contact or were potentially infected with something and they present to an urgent care or emergency room and now actively going out and saying, ‘I’m going to test all my employees,’ ” said Quidel CEO Douglas Bryant.
The company is working to set up testing for schools and employers across the country. Quidel’s antigen test isn’t quite as sensitive as standard molecular tests, but studies show there’s a simple workaround: test more often.
The San Diego Padres are
one of its customers. Fans who get a negative test result within 72 hours of a home game can sit in special sections of Petco Park reserved for those who’ve been vaccinated or tested. People in those areas can pack in at 67 percent, compared with the overall 33 percent capacity limit set on the stadium.
There may soon be demand for rapid testing at indoor entertainment and meeting venues, too. In the county’s current reopening tier, a concert hall with a capacity of 2,000 can seat 200 people, but that jumps to 700 people if guests can show proof of testing or vaccination. Similar rules govern capacity at private events, such as conferences and wedding receptions.
Eventually, though, demand will drop as the vaccine rollout and public health measures slow the spread of the virus. According to Quidel’s internal projections, the decline could happen shortly after the first half of 2022.
Guidelines around who needs to be tested are already changing. The Centers for Disease Control and Prevention
have said that fully vaccinated people who were in close contact with someone who has COVID-19 don’t need to quarantine or get tested if they don’t feel sick. The agency has also said that those who’ve been vaccinated don’t need to get tested before or after domestic travel and can travel internationally without a test unless it’s required by their destination country.
“There’s no point in doing a lot of testing on people who are fully vaccinated,” said UC San Diego’s Schooley. “Their infection rate is low and the amount of virus that they do shed if they happen to be infected is lower.”
He added that UC San Diego has been testing students and staff who live on or come to campus each week. The university will soon restrict its surveillance testing to those who haven’t been immunized.
But as coronavirus testing winds down, Schooley sees valuable lessons for dealing with future disease outbreaks. He expects that universities and other labs will be able to quickly jump in to fill testing gaps without having to navigate complex regulations. And he doubts the U.S. will ever again rely on a single test maker after a blunder in which a test distributed by the CDC produced a positive result on samples known not to contain the coronavirus — calling into question the validity of any positive. That misstep set back testing efforts by months.
“I hope we’ve learned from that this time around,” he said. “We should not be our own worst enemies.”