Random testing key to a safe exit from COVID-19 lockdown

By Angela Betsaida B. Laguipo, BSNApr 16 2020

The coronavirus disease (COVID019) global pandemic has placed many countries and regions in lockdown. There are thousands of cases reported daily, with the global infection toll topping 2.15 million. How can nations shift from lockdown back to normal daily routines while ensuring there won’t be a second wave of viral infection?

A new study highlights the importance of random testing for a safe exit from lockdown, noting that polling the fraction of infected people in the population is the key to managing the pandemic. Random testing measures the key variable controlled by restrictive measures and forestalls the load on the healthcare system through the disease progression.

Study: Using random testing to manage a safe exit from the COVID-19 lockdown. Image Credit: Horth Rasur / Shutterstock

Safe exit from lockdown

Governments around the works are currently unable to gauge the extent and nature of undetected (asymptomatic) cases of COVID-19 in the community. Having this data is vital for governments to fully understand the drivers of community transmission and then deal with the possibility of a second wave of outbreaks.

Why random testing?

Random testing will help improve the predictability of the course of the current pandemic, allow informed decisions on how to modify restrictions in countries affected, and enable real-time assessment of the effectiveness of measures used to reduce transmission of the virus. The measures that can help reduce transmission rates may include wearing of face masks when people are going out and extensive tracing using the mobile telephone network.

The researchers from Switzerland suggest that frequent random testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will help provide more reliable and accurate data about the situation. Knowing more about how many are infected in the area can contribute to better monitoring and surveillance. This way, governments will have an idea of when to shift from restrictive measures to more lenient policies.

In the study, published in a preprint server for health sciences, medRxiv, the research team showed that independent of the total size of the population with frequent interactions among constituents, about 15,000 tests with randomly selected people per day are needed in Switzerland to obtain valuable data on the current infections spreading in the community.

The researchers estimate to suppress the COVID-19 pandemic by widespread testing for infections entirely, there needs to be the capacity to test millions of people per day in Switzerland. This should be compared to the present number of 7,000 tests per day currently undertaken.

“With random testing in place, the risk of a second wave can be kept to a minimum. Random testing would allow us to follow the course of the pandemics almost in real-time, without substantial time delays, and without the danger of increasing the number of infected people by more than a factor of two, if our intervention strategy is followed,” the researchers wrote.

Currently, countries are testing those who are displaying symptoms in particular subpopulations. Random testing or mass testing will allow close to a real-time assessment of the overall efficacy of restrictive measures, such as social distancing and community quarantine measures.

Countries must boost testing to a certain number of tests per day. With a higher testing capacity, countries will be able to detect the geographical differences in spreading rates, helping formulate efficient and optimal strategies in shifting from lockdowns to a normal way of life. It can also help reboot the economy more efficiently.

“These predictions are obtained from examining a feedback and control model of the pandemic where the feedback is derived from random testing. Besides, we describe simulation strategies for decision support concerning testing, local quarantine regimes, and the safety of a reboot,” the researchers wrote on the paper.

“At some point, one might consider the option to start releasing different sets of restrictions in different regions, to learn faster about their respective effects and thus to optimize response strategies in subsequent steps,” the team concluded.

COVID-19 global situation

The COVID-19 has placed many countries in lockdown, with people staying in their homes. Lockdowns have left many people unemployed and businesses on the brink of collapse. Social distancing measures are important to prevent the rapid spread of the virus so hospitals and health workers will not be overwhelmed.

With lockdowns in place, many countries have started random testing or mass testing to determine the extent of the virus spread. This way, effective isolation and quarantine measures will be in place.

Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.