HHS Ups Testing in States Where COVID-19 Is Spiking

Alicia Ault

July 01, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

The federal government is assisting Florida, Louisiana, and Texas determine how to vastly and quickly increase COVID-19 diagnostic testing to get a handle on a spiking number of cases in those states.

Admiral Brett P. Giroir, MD, assistant secretary for health at the Department of Health and Human Services (HHS) and federal leader on COVID-19 diagnostics, told reporters at a media briefing that the agency is in discussion with those three states and several others on how the federal government can best support a surge in testing.

That would mean doing a month's worth of testing in a few days, with a goal of identifying many of the asymptomatic persons younger than 35 who are thought to be behind the current rise in COVID-19 cases in some areas, he explained.

"It's very clear that the positives are being driven by the under-35-year-olds, and we presume that most of them are asymptomatic or only very mildly symptomatic," he said.

It's harder to conduct contact tracing with asymptomatic patients, which is why surge testing might be helpful, Giroir added.

Although this younger age group may feel semi-invincible, "you're not," he said, noting that some have been hospitalized. Young adults are part of the disease dynamic and can still transmit to vulnerable people, he continued. He said that health officials are urging them — especially ahead of a holiday weekend — to "please, please, please, avoid mass gatherings, use face coverings, and use hygiene.

"If we don't have the personal discipline and do the kinds of things that are known public health measures, we cannot test our way out of this," he added.

More Tests — and Pooling — Soon

States are projecting that they will perform 13.5 to 13.7 million tests in July, and although he does not have figures for June yet, Giroir said the nation is currently performing about 500,000 to 600,000 tests a day, exceeding the goal set by many states in April.

The COVID Tracking Project, a research unit of The Atlantic, estimates that a total of 32.2 million tests have been performed in the United States. Its data show that almost 600,000 tests were performed daily in late June.

HHS has invested heavily in rapid point-of-care tests, which will avoid lab backups and give results more quickly; some five million additional rapid point-of-care tests will be available in July, bringing the total to 10 million, Giroir explained.

Half of the tests will be molecular based and half will be antigen based. The tests have some limitations in that they are not as sensitive as would be desired, but they still meet US Food and Drug Administration criteria. Approximately 20 million rapid point-of-care tests should be available in September, according to Giroir.

He and other federal officials have also said they are considering increasing testing throughput by pooling results — a process in which samples from a group of individuals are combined and tested as a single sample. If the result is negative, the question is resolved. If the result is positive, the individuals are referred for further testing.

Pooling five to 10 individual samples together is likely to be proven to be a valid way to conduct tests, Giroir said.

He expects that pooling will be useful to colleges and universities, and he said that by late August and early September, "pooling is going to be very mature." Such institutions will then have a way to rapidly assess large numbers of students.

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