Volunteers wait for patients at a walk-up COVID-19 testing site set up by the health department in Richmond. (Ned Oliver/Virginia Mercury)

By Anna Jeng

The federal government has pushed for reopening nationwide as COVID-19 cases continue rising in many parts of the country. In Virginia, with anticipated decreased death tolls and reduced spread, Gov. Ralph Northam has set May 15 for gradually reopening businesses with enhanced safety measures in place. Such decisions may be ahead of what the science advises to be feasible.

With uncertainties and the huge stake in human lives, it’s wise to be clear-eyed about the risks we’re all taking on. As states reopen and mitigation measures relax, a surge of cases is likely inevitable. We can’t underestimate Americans’ anxiety about the virus and unknown challenges we face in navigating uncharted territories without factual information and clear guidance.  

To guide the path to reopen our economy and to maintain a semblance of normalcy, COVID-19 testing must continue and should be widespread. Ideally, there will be mass testing at work and in churches plus self-administered home tests. 

The federal government needs to play a bigger role in testing production, availability and coordination. A majority of Americans agree that sufficient pandemic leadership and coordination at the national level is seriously lacking. With limited resources and capacity, it’s unrealistic for individual states to fully address limitations and challenges surrounding testing factors.  

The testing process for COVID-19 in the U.S. has been troubled from the start. Due to shortages of testing and inaccuracies with CDC’s initial testing kits, the virus silently circulated in our communities for more than two months. While many have recovered, the virus has continued to infect and kill exposed people and to drain our medical and economic resources. 

Our national leadership’s slow and inefficient response to the pandemic has revealed the weakness of our defunded public health systems. In the pandemic’s early phases, there was an urgency to expedite the production processes to make testing quickly available.

But independent evaluations are needed to ensure accuracy and effectiveness of testing. Twelve manufacturers have received emergency use authorization from the U.S. Food and Drug Administration to produce and deploy test kits, only with company self-evaluation and a lesser amount of supportive evidence as required in the typical approval process. 

Consequently, there is inconsistency in the manufacturers’ claims. In the past three months, diagnostic and serologic testing with many scientific unknowns and technological limitations has suffered from limited precision and accuracy. Follow-up independent evaluations have confirmed underlying glitches and concerns of inadequate testing results that could hinder and misdirect public health efforts.

 The largest diagnostic companies are estimated to produce 30 million COVID-19 tests. Although those estimates may be enough for clinical settings, they fall short on meeting broad employer screening needs and for the public being engaged in personal protection practices as they gradually resume their activities and return to work.

Researchers from Harvard’s Global Health Institute estimated that the U.S. should administer more than 900,000 tests per day with 16,664 tests per day being done in Virginia. The estimated number should serve as starting points for bare minimums. They need to increase testing based on progress and the changing status of the pandemic. Despite recent increased testing, Virginia is among one the slower states in terms of testing rates. More efforts are needed to shore up the deficiency.

With increased testing capacity, the real-time reporting system is critical. Within 12-24 hours after the testing, individuals should be notified to prevent infection among an individual’s friends, family members or co-workers. The system should flag health records to medical providers and public health professionals for contact tracing and disease treatment and prevention, while protecting personal privacy. Currently, testing conducted in state, private and hospital labs in Virginia hasn’t been utilized for such real-time protocols to maximize the use of available tests for contact tracing and other efforts. 

Sufficient and reliable testing is the urgent first step for beginning to reopen. While it won’t contain an outbreak by itself, increased testing needs to be part of board strategies and plans for Virginia to respond to the pandemic successfully. 

Anna Jeng is a member of the Virginia State Board of Health member and a professor in community and environmental health at Old Dominion University. She has a master’s degree and a doctorate in public health from Tulane University.