Covid-19 (Coronavirus)- Universal Testing for Breaking Community Transmission
Introduction
The Covid-19 (Coronavirus) is spreading in communities both urban and rural in many countries in the world. The confinement is not a sustainable option. It can help in the short-term, but it is not affordable economically and socially.
Currently, three options are the ones that can contribute effectively to break the Covid-19 transmission:
(i) Universal vaccination: It may take a minimum of 5 years for the world.
(ii) Universal testing: It may take one year if included in the global health systems.
(iii) Universal barrier methods (mask, hand washing, and social distancing): It may take one month if there is political and community engagement.
Universal Screening
The PCR test with high sensitivity and specificity is the one largely utilized by the global health systems. The PCR is not technically accessible, and it is expensive. When the Covid-19 was with travelers and few contacts, it was the preferable test. Currently, Covid-19 is spreading globally in the communities.
Moving forward to the rapid tests and serology tests may increase the access technically and financially. There are rapid and serology combo tests (antigen and antibody) tests that can detect early and chronic infection or asymptomatic carrier. The positive cases should be confirmed by the PCR. There are rapid tests that can be used by the health professionals and the ones can be used at home (community health workers or self-testing).
Universal screening both by the health professionals, community testing, and self-testing for the detection of early and chronic or asymptomatic infections have high potential (high impact) to breaking the community transmission when the universal vaccination is not yet possible.
Access to the testing
The regulatory bodies of the health laboratories (Ministries of Health, Food and Drugs Authorities, etc.) should accredit the Covid-19 tests, the official representatives of the manufacturers (storage, transport, etc.), as well as the services providers (hospitals, clinics, pharmacies, etc.). This is to ensure the quality is maintained at all levels.
As much as many tests, many distributors, and many services will be accredited, the accessibility will increase towards universal access to testing. The access to the community and self-tests will make a big move towards the breaking of the transmission.
Incentives to the testing
There is an opportunity to establish a direct linkage between the economy and social activities to the prevention. All activities should be authorized on the conditions to have all the persons concerned to be tested and use the barrier methods (mask, hand washing or sanitizing, and social distance). The risky places like the dancing clubs, cinemas, etc. should need PCR tests. For others like the open markets, etc. should need the rapid and serology tests especially the combo tests that include the antigen and antibody testing. The regulatory bodies should provide the details of how each test should be used (what, why, and how).
With the decentralization of the Covid-19 tests at the community and households’ levels and linkages between the testing and the economic and social activities, universal testing can be reached and contribute highly to breaking the transmission.
Financing the testing
By moving towards universal testing, the economy of scale should be considered for the pricing. Regulatory bodies should assess the market and standardize the prices across the tests with the same nature and costs. The insurances (travel and health especially) should include the Covid-19 tests in the benefit packages. The subsidies to low-income populations should be planned for ensuring the test will not be a catastrophic health expenditure factor.
Conclusion
The Covid-19 universal testing can allow global businesses to resume as per the past normal conditions before the universal vaccination will be possible.
Dr. Claude Sekabaraga