A quick thought on our pandemic response

Here is something I’ve been wondering about since the start of this pandemic: Why aren’t we testing more? Vaccines are definitely a crucial component of overcoming the pandemic. The problem with vaccines, however, is that they are complicated.

Yes, we have managed to produce several different vaccines by now, with more likely on their way. But having them is but the first step, assuming there won’t be mutations that make them ineffective. The next step, which is at least as complex as the first, is distributing those vaccines. The logistical challenges are monumental.

This is what brings me back to testing. Why aren’t we testing more? In theory, I imagine tests are easier to produce, store, and distribute, as well as significantly cheaper than vaccines. To my mind, tests that are simple to administer and produce reliable results in a short timeframe could help us transition back to normality, while also significantly easing the burden on vaccine rollout.

People could get tested in transit, at malls, even when moving from one part of a country, state, or city to another. This way, infections could be traced and isolated quickly and affected individuals treated, while Covid-free safe zones could be gradually expanded.

Of course, the cornerstone of this is having those tests. They need to be easy to do and produce reliable results quickly. It needs to be possible to administer them essentially anywhere, like a breathalyzer test.

I imagine there are good reasons why we are not currently doing this, but I wonder if the reason is that we just focused too much on other measures, if efforts to invent an adequate test have simply not been successful, or if it’s something entirely different. But still, I am left with the question: Why aren’t we testing more?

36 thoughts on “A quick thought on our pandemic response

  1. I don’t know why countries have become lenient now. I have a friend who traveled with Covid and he got isolated upon arrival. I was shocked when I heard him say that he’s traveled with Covid. How was he allowed by his country!?!

    Saudi Arabia spent a huge chunk of their budget for pandemic response. There are several drive thru testing centers, free of charge open 24/7 I believe. They’ve also started administering vaccine to frontliners and the elderly for some time now.

    They have an app that is in sync with our government details. We can request testing @ any time and there are several slots that could accommodate everyone. It was fast. The results are fast as well. Contact tracing is available but can get tricky due to some vulnerabilities i.e. not being tech savvy enough or the main issue on governmental forms — language barrier — for people like me who aren’t fluent in Arabic. There was a time when I accidentally placed myself on Home Quarantine status (14 days countdown), the phone had my live location and pinged my phone. I was playing with the app while at the office and marked that I was doing the quarantine in my office address labeled as HOME. There was no way to undo it! I could not find any button in English that says back or cancel. I was so worried that I’d get caught and will be asked to pay the fine of 10,000 SAR (128,121.41 php) for breaking the accidental quarantine.

    You are right, the government can get people tested in transit, at malls, or at the boundaries… They should press on its necessity.

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    1. Seems like SA is trying to use all the tools at its disposal. Especially the free testing sounds great. Here, you can only get tested after showing symptoms – which is pretty much when it’s already too late to stop yourself from infecting others, and it won’t stop asymptomatic cases from spreading the infection either. Were you able to solve the situation with the app?

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      1. No, I wasn’t able to resolve it. The app seemed to be more advanced as of date because the request for vaccination is already in both the English & Arabic languages — using it was a breeze. I mean my dad was able to create an appointment on his own… it must have been super user friendly.

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          1. I guess our data is compromised at one point or another… we too can get so distrustful, however, when mandatory, we are left with no choice but comply..

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  2. Well well you ask an important question but if I was to speak from a totally different continent…at least you have hope of the vaccine getting to you it’s not the case our end.

    We know prevention is the most we can go now.
    Our Government monetised our tests which not many can afford only the privileged so you can imagine why the hope is not even in the vaccine when it comes it will be a whole lot of politics so we are all living it out as best as we can.

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    1. Yes, it is a massive problem. There is a chance that once more and more countries have successfully vaccinated their population, they will increasingly start supporting vaccination efforts elsewhere. But that hoping for this chance is even necessary to begin with is tragic in itself.

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  3. There seems to be a limit to the tests available in our public health sector. In our private healthcare system, this is not a consideration because people have to pay for the test. Maybe it’s as simple as a lack of funds in less developed countries. In first world countries, there does seem to be a lot of testing happening. I know one blogger in the USA who has been tested three times in the last few months. Perhaps the problem is that like most viruses, this one is contagious before people have any symptoms and consider getting tested. Also, a lot of people have no symptoms at all so why would they get tested?

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    1. You make a good point about tests actually being done in some parts of the world. But asymptomatic cases is exactly why I was wondering if testing even more couldn’t make a big difference. When everyone in an area gets tested, and then everyone entering that area gets tested, too, then you can be confident that nobody in that area has Covid, symptomatic or not. But this always stands and falls with how effective and viable the tests are.

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  4. I have no idea. I have also heard that there are many false-positive tests and many false-negative tests and there is so much contradictory information on websites everywhere that it feels impossible to know what to believe!

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  5. It’s a good question, Markus. On the testing front it does come down to what you point out – being easy to do, reliable and expedient. Our testing rates have been extremely high and people are now only encouraged to test if they have flu like symptoms. When there is an outbreak in Australia, the response is immediate. Yes, there is some whining that goes on about how effective we are, but when it is all said and done, a number of big outbreaks have been brought to heel.

    In terms of contact tracing, because we can move freely around in Western Australia, most of us have downloaded the SafeWA app – which recognises a QR code. Places deemed a risk must have a QR code in place. It works brilliantly – so simple and easy and you can add others to your list for each venue visited. It’s almost second nature now. So, you can go out to dinner, go to the movies, eat ice cream, get your hair done and so on (with the appropriate hygiene and social distancing place).

    With the vaccines, the interesting point is that, yes they will be ineffectual as different strains develop. However, as I have been reading of late, the COVID vaccines being developed are designed in such a way that they do not have to be redeveloped from scratch every time there is a new strain (as it is done at the genetic level). The turn around time is, as a result, very short. Vaccines for other diseases are now being developed in the same way.

    The roll out in Australia starts mid February, with 5M doses available for frontline health workers, other key personnel and the aged – with the second dose provided four weeks later (sounds like the name of a movie 😜). The rest of us will have the opportunity later in the year.

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    1. Thank you for your detailed comment, Sean! Always appreciate your thoughtful responses.

      I have observed the Australian response with some envy, to be honest. We also have an app in Germany, but due to privacy concerns, way too few people downloaded it. I’m not sure if this is due to Germans’ intrinsic anxiety over these matters or if the government could have done a better communication job. It also seems like the features of your app are extremely well-tailored to fit real-life needs, which is definitely not the case for ours.

      The mRNA method seems like a wild card in the best possible sense. Due to covid, the method was able to get thoroughly tested, so to speak, and the proof of concept was successful. More than having a shorter turnaround time for new strains and variants, I recently heard that Biontech is now working on trying to treat HIV with the same method. Perhaps just having tested the mRNA method in the pandemic will lead to good things in the future.

      We have officially started rollout in Germany, with priority given to the elderly and frontline workers. What worries me a bit is the talk about postponing a second vaccine dose that is required for immunization, in favor of giving one dose to more people. Maybe vaccine rollout may not be as expedient as initially hoped, and I would assume that half-assed immunization just increases the probability of more mutations by the virus. But perhaps this latter point is not as grave as I thought thanks to the theoretically quick turnaround time of mRNA vaccines.

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  6. Ah, but there’s always the human element to consider. Whether it’s testing for the virus or vaccinating against it, there will always be those (a significant number) who won’t test/vaccinate, or with testing, will ignore the positive result and continue about their ways, oblivious to the danger they pose to others.

    I suspect that’s why more effort has been put into developing vaccinations than rapid tests.

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    1. Yes, this is why for any successful testing regime, tests would need to be simple and reliable to administer by a scarcely trained third party. Say, a 30-second test for everyone who tried to enter a mall, administered by volunteers who got training or something. That’s why I was wondering if we could have achieved better results on our path back to “normality” by now if we focussed some more of our resources on improving testing instead of putting everything on vaccines. But I’m also just stabbing in the dark, of course.

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  7. It’s a really good question. Here in Ontario, Canada, we are testing more than we were in the early days but it’s still not easy to get a test. I think the testing has its downfalls too because there are a lot of false positives. I honestly don’t know what the answer is.

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    1. Ha, I don’t think anyone really knows what the answer is. Right now, everyone just hopes that vaccines will solve it, but whether or not they will (and if yes, when) remains to be seen. False positives are probably preferable over false negatives, but any inaccuracy is a problem, of course. This is part of what I’m wondering about, though: Could we have had cheap and accurate tests by now if we had focussed some more of our time and resources on it, instead of putting everything on vaccines? I’m not saying it would definitely be better eve if we could have, but just like everyone else I’m wondering what we could learn from our response so far and how we could improve on things for the future.

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      1. You raise a good point. I hope when this is all over that all parties step back and look at what could have been done better. Different countries, even different provinces here in Canada, took different approaches. It’s too soon to tell which approach worked better but this could be helpful information for similar health crises in the future

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  8. Unless there is universal testing using the same methods it could be very difficult to regulate! One country’s test vs another, one city vs another! Which variant would be tested?

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    1. That’s an important dimension of the challenge. I would imagine the WHO could serve as a coordinator, which is in line with its purpose – especially now that the US isn’t leaving anymore. With variants, it’s more tricky. I don’t know if some tests could only provide results for one variant but not another. Should that be the case, it would certainly complicate things.

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  9. From what I’ve read, the perspective seems to be that there are many false test results, tests take more manpower, people do not properly isolate and/or can test neg but turn poss hours later, and it’s now easier and more logical to vaccinate everyone – regardless of test results. There are many vaccine doses in a vial and they require only a standard needle (and some need special storage). Tests require kits, special handling, processing equip, and people able to interpret/process the results.

    But again, that’s my understanding, not necessarily correct.

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    1. You make good points, and I appreciate your intellectual honesty. I hope you’re right about vaccine-rollout being the most efficient solution by now – I would certainly prefer being immunized over the alternatives. Even here there are ‘ifs’, though. While more than enough vaccine doses seem to have been ordered, having them delivered and administered in time is a different question again. Just hearing about supply shortages in Canada, for example. But yes, I don’t think anyone’s understanding is complete right now. The situation is complex and constantly evolving – as is the virus.

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      1. Yes, we have supply shortages in Canada, although the suppliers are saying it’s because they are slowing down for a production upgrade so we don’t really know what that means. Even before the supply shortages, I wasn’t due to be vaccinated until August or September. When I heard about the shortages, my first thought was “there go what few plans I had for the rest of 2021”.

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      2. Yes. Guidelines keep changing here because vaccine rollout is not a nationally coordinated activity and virtually every state and site has said they have no visibility to how many vaccine doses they will receive each week – sometimes more than projected but quite often less.

        My projected vaccine timeframe has been upgraded from Apr/May to March. But my neighbor, who qualifies as a frontline worker (but isn’t) starts his vaccine shots today even though he was already infected. Since he also rants that covid is NBD, I personally feel he should be at the END of the line, not the start!!

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        1. Challenges wait at every turn, too. The qualification issue is ripe with them as well – how things look on paper is not always how they do in real life, so it’s never easy to make large-scale decisions that actually represent reality well.

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          1. tRump had no federal rollout plan and didn’t participate in WHO. Biden has already rejoined WHO and ordered a national vaccine rollout. As the world “leader” in covid deaths (nearing 500,000), I hope that help here!!

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            1. Yes, I hope Biden will be successful. It’s staggering that the previous administration’s response turned out to be even more of a failure than even the most cynical observers had suspected.

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  10. I think it would cost way more to test if they were doing tests on entry at malls and such. Plus the tests would need to be done by medical personnel who are currently focusing on saving lives in the hospitals. Not sure what the solution is here, but I know it isn’t simple

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    1. It certainly isn’t simple. How tests would be administered is a big ‘if’, because should they be simple enough, perhaps medical professionals wouldn’t be required. Also the cost: Does it cost more to provide and conduct the tests, or to shut down public life and/or risk mass-infection instead? For example, I’ve heard of a figure saying it costs 5 billion euros per week to maintain the lockdown in Germany alone.

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