Washington, May 11 (BUS): Testing for COVID-19 has plummeted worldwide, making it difficult for scientists to trace the course of the pandemic and detect alarming viral mutations as they emerge and spread.
Experts say testing is down 70-90% worldwide from the first quarter to the second quarter of this year — contrary to what they say should happen with new omicron variants on the rise in places like the US and South Africa.
“We’re not testing anywhere close to where we might need to,” said Dr. Krishna Udiakumar, director of the Duke Global Center for Health Innovation at Duke University. “We need the ability to ramp up testing because we’re seeing new waves or storms emerge to keep track of what’s going on” and the response.
The average daily reported cases in the United States, for example, are 73,633, an increase of more than 40% over the past two weeks, according to data compiled by Johns Hopkins University, the AP reports.
But that is a much smaller number due to the decline in testing and the fact that tests are done at home and are not reported to health departments. An influential modeling group at the University of Washington in Seattle estimates that only 13% of cases are reported to US health authorities – which means more than half a million new infections every day.
Odyakumar said the decline in testing is global but overall rates are particularly insufficient in the developing world. The number of tests per 1,000 people in high-income countries is about 96 times higher than in low-income countries, according to the Geneva-based nonprofit public health organization.
What is driving the decline? Experts point to COVID stress, a lull in cases after the first Omicron wave and a feeling among some residents of low-income countries that there is no reason to get tested because they lack access to antiviral drugs.
At a recent WHO press conference, FIND CEO Dr. Bill Rodriguez called the test “the first casualty of a global decision to throw us off our guard” and said “we’ve become blind to what’s going on with the virus.”
Testing, genetic sequencing, and delving into the condition’s mutations can lead to the discovery of new variants. New York state health officials found the highly contagious BA.2.12.1 variant after investigating higher-than-average case rates in the central part of the state.
Going forward, “we won’t see the new variants emerge the way we saw the previous ones,” Rodriquez told The Associated Press.
Testing increases as infection increases and people develop symptoms — and decreases with remissions in new cases. Testing is rising again in the US along with the recent rally.
But experts are concerned about the scale of the decline after the first wave of Omicron, the overall low levels of testing globally, and the inability to reliably track cases. While home tests are convenient, only tests sent to labs can be used to detect variants. If fewer tests are performed, and fewer of those tests are processed in laboratories, there will be fewer positive samples available for sequencing.
Also, home test results are largely invisible to tracking systems.
There’s at least four times as many home testing than PCR testing, and “we’re getting zero data from testing that happens at home,” said Mara Aspinal, managing director of an Arizona-based consulting firm that tracks COVID-19 testing trends.
This is because there is no standardized mechanism for people to report findings to understaffed local health departments. The CDC strongly encourages people to tell their doctors, who in most places must report COVID-19 diagnoses to public health authorities.
In general, though, home test results fall under the radar.
Reva Seville, the 36-year-old mother of Los Angeles, tested herself at home this week after she started experiencing symptoms like an itchy throat, cough and congestion. After the results came back positive, I tested two more times just to be sure. But her symptoms were mild, so she wasn’t planning on going to the doctor or communicating the results to anyone.
Beth Barton of Washington, Missouri, who works in construction, said she did about 10 home tests, either before visiting her parents or when she developed symptoms she thought might be COVID-19. They are all negative. She shared the results with the people around her but didn’t know how to report them.
“There has to be a whole system for that,” said Barton, 42. “We as a society don’t know how to measure our position.”
One potential solution, Aspinall said, is to use technology such as QR code scanning to report the confidentiality of home test results.
Another way to better track the epidemic, experts said, is to strengthen other types of monitoring, such as sewage monitoring and collection of hospitalization data. But these have their own drawbacks. Wastewater monitoring remains a patchwork that does not cover all areas, and treatment trends in hospitals lag behind cases.
Udayakumar said scientists around the world should use all the tracing methods at their disposal to keep up with the virus, and would need to do so for months or even years.
At the same time, he said, steps should be taken to boost testing in low-income countries. He said the demand for tests would rise if access to antiviral drugs were improved in these places. One of the best ways to increase testing is to integrate it into existing health services, said Wadzanayi Muchenje, who leads health and strategic partnerships in Africa for the Rockefeller Foundation.
George Benjamin, executive director of the American Public Health Association, said there will come a point when the world stops doing widespread testing for COVID-19 — but that day has not yet arrived.
With the pandemic going on and the virus so unpredictable, he said, “it is unacceptable for us to only care about an individual’s health.” “We have to worry about the population.”