Testing called critical bridge to vaccine; but capacity 'far short' of what's needed

Promising vaccine trial results have offered a glimmer of hope that the end of the Covid-19 pandemic could be approaching, but testing capacity is still “far short” of what’s required to avoid “further significant economic damage” until a vaccine is rolled out, the Massachusetts High Technology Council said Monday morning.

The council presented its latest update to the framework developed by some of the state’s top health and life sciences business leaders and first unveiled in April to propose ways for the state to fully recover from the coronavirus outbreak and begin to open its businesses. The latest update, which was presented by Executive Committee member Steve Pagliuca, focused on the ways a federal, state, and local expansion of testing capacity and usage can keep the coronavirus largely in check until a vaccine is widely available.

“Testing will be critically important to our ability to continue to move the economy forward and to mitigate the impact and size of the second Covid wave we are experiencing as we transition to a nationwide vaccination program,” Pagliuca, the Bain Capital co-chair and Boston Celtics co-owner, said.

The updated framework envisions a “systematic, expanded testing regime to surveil the asymptomatic population to mitigate and suppress the viral spread” using multiple types of testing, public-private partnerships, education campaigns and encouragement that people get tested, and a financing plan that allows all citizens access to testing. To complement the testing program, governments should also boost their contact tracing capabilities so people who test positive can be isolated.

The update that Pagliuca presented takes into account that the second surge of Covid-19 gripping Massachusetts and the rest of the country is different from the initial wave of cases that threatened hospital capacity in the spring.

“This is more cases, more rapidly, than what we had seen before,” White House coronavirus response coordinator Dr. Deborah Birx said last week. The High Tech Council cited a presentation Birx made last week in which she said testing would need to be increased tenfold to be able to test and monitor both symptomatic and asymptomatic cases.

In Massachusetts, the number of molecular tests performed each day over the last few weeks has ranged roughly from about 85,000 to 105,000 each weekday and about 30,000 to 40,000 each weekend day, according to Department of Public Health data.

Using a low-end estimate that may not have accounted for the recent increases in holiday-related testing demand, Pagliuca’s presentation pegged the time to test the entire Massachusetts population once at 86 days – far higher than academic estimates required to suppress the virus.

Pagliuca also presented information on testing regimens used in Singapore after the 2002 SARS outbreak and more recently to curb coronavirus activity in Qingdao and Wuhan, China.

When Pagliuca first presented the High Tech Council’s reopening framework in the spring, it placed a great emphasis on the Rt for the coronavirus in Massachusetts – a measure of a virus’s average transmission rate at a given point in time – and the need to keep that metric as low as possible. On Monday, he said that a robust testing and tracing program can work independently of workplace mitigation measures to keep the coronavirus in check in the workplace.

Using a hypothetical Rt value of 2.5, the High Tech Council said the combination of mask-wearing, distancing, self-diagnosis, screening, ventilation, cleaning and “other” could reduce the rate to about 0.5. A testing and tracing program like the one Pagliuca outlined could “independently significantly reduce Rt” to about 0.5, the High Tech Council said.

“Good morning. We need more testing. MUCH more testing. Free is best and equitable but as inexpensive as possible is critical. We need more and better contact tracing,” Massachusetts Medical Society President Dr. David Rosman tweeted Friday. “We are in trouble. There is a way out. TEST! Test us all. Regularly. We would be normal again.”