Why Testing is the Key to Getting Back to Normal

This piece was authored in collaboration with the leadership across NIH and represents a unified effort to meet the challenges presented by the COVID-19 pandemic with excellence and innovation.

One thing we know for sure — every single person can help our country control the COVID-19 pandemic. From wearing a mask to washing your hands to maintaining physical distance and avoiding large indoor gatherings, each of us can follow proven public health practices that not only reduce our own chance of getting infected by SARS-CoV-2 (the virus that causes coronavirus disease, or COVID-19), but also prevent the spread of COVID-19 to our coworkers, friends and loved ones. Another thing that will help is testing as many people as possible.

Testing for COVID-19 is so important that in April 2020, the NIH launched the Rapid Acceleration of Diagnostics (RADx) Initiative  to develop rapid, easy-to-use, accurate testing and make it available nationwide. As part of this effort, the RADx Underserved Populations (RADx-UP) program  is about finding solutions to stop the spread of COVID-19, particularly among racial and ethnic minorities, and other vulnerable populations that have been disproportionately affected by this pandemic. Previously, we reported about the launch of this project  and our plans to develop community-based approaches to study how best to implement testing and prevention strategies for populations who are disproportionately affected by, have the highest infection rates of, or are most at risk for complications or poor outcomes from COVID-19.

Scientists from the NIH and across the country are working around the clock to establish programs that will ensure access to and acceptance of rapid and reliable testing around the country. Testing can help people determine if they are infected with SARS-CoV-2 — regardless of whether they have symptoms — and whether they are at risk of spreading the infection to others. Taking measures to prevent the spread of infection will be the most effective strategy for getting us safely back to work and school.

We want to take this opportunity to articulate why widespread testing is necessary, important, and achievable.

1. 1. Testing saves lives

   Testing of all people for SARS-CoV-2, including those who have no symptoms, who show symptoms of infection such as trouble breathing, fever, sore throat or loss of the sense of smell and taste, and who may have been exposed to the virus will help prevent the spread of COVID-19 by identifying people who are in need of care in a timely fashion. A positive test early in the course of the illness enables individuals to isolate themselves — reducing the chances that they will infect others and allowing them to seek treatment earlier, likely reducing disease severity and the risk of long-term disability, or death.

   Testing of people who have been in contact with others who have a documented infection is also important. A negative test doesn’t mean you’re in the clear; you could become infectious later. Therefore, even if you test negative, you need to continue to protect yourself and others by washing your hands frequently, physically distancing, and wearing a face mask. A positive test makes it clear that you have to isolate yourself, and that others with whom you have been in contact since the time of your exposure should also get tested.

   Since it is recognized that nearly half of all SARS-CoV-2 infections are transmitted by people who are not showing any symptoms, identifying infected individuals while they are presymptomatic, as well as those who are asymptomatic, will play a major role in stopping the pandemic.

2. 2. Testing can be easy and quick

   Initially, the only test available required getting a sample from the back of a person’s throat. New developments, some of which are supported by two other NIH projects, RADx Tech  and RADx-ATP (Advanced Technology Platforms) , will provide more comfortable and equally accurate tests that obtain the sample from inside the nose. On the horizon for large-scale use are tests that will use a simple mouth swab or a saliva sample. 

   A positive test for SARS-CoV-2 alerts an individual that they have the infection. Not only can they get treated faster, but they can take steps to minimize the spread of the virus.

   This is why it is so important to get the test results quickly, ideally within a few hours or less.

   Early in the pandemic, there was not enough capacity and limited supplies to collect and process the tests, which resulted in delays. However, lab equipment has improved, capacity and supply have expanded, and results are being returned, on average, within 3-4 days. In fact, point-of-care tests will be available that provide a result in less than 15 minutes!

3. 3. Testing matters more in the communities affected the most

   Communities of color are disproportionately burdened by the COVID-19 pandemic. Some individuals in these communities are essential workers, who cannot work from home, increasing their risk of being exposed to the virus. In addition, multi-generational living situations or multi-family housing arrangements can allow the virus to spread more quickly if one household member gets infected. Comorbid conditions that worsen the health risks of COVID-19, such as heart disease, obesity and diabetes, are also more common in minority communities because of long-standing societal and environmental factors and impediments to healthcare access. Therefore, COVID-19 can spread quickly in these communities, and the impact of that spread is great. Testing, particularly of asymptomatic and pre-symptomatic individuals, is key to interrupting this spread.

Unfortunately, there still is a lot of confusion about where to get a test and who should get tested. It is becoming clear that for a person to test positive, they have to have a significant amount of the virus in their system. This means that if you have no symptoms but think or were told that you were in contact with a person with COVID-19, you should isolate yourself immediately, call your health care provider, and then get a test. If you have any questions, always call your health care provider or local county public health office. You can also contact the CDC Hotline at 800-CDC-INFO (800-232-4636).

Staying informed is essential. We encourage you to look to up-to-date, trusted sources of information about COVID-19, such as resources from the NIH website  or MedlinePlus,  the National Library of Medicine’s consumer information resource. 

Over the next few months, you’ll have opportunities, such as those listed at the NIH’s vaccine trial sites , to help scientists discover if the vaccines being evaluated now are effective. If you become ill with COVID-19, you can participate in clinical trials underway to develop and evaluate a wide range of potential treatments , as well as several possible vaccines . So that these therapies will work for everyone, it is important for people from diverse communities across the country to participate in this research. We hope that in the not too distant future, these efforts will lead to therapies that will put an end to the pandemic.

In the meantime, let’s all continue to protect ourselves and others from getting infected, and get tested if you believe you have been in contact with someone with COVID-19. 

Top Row (left to right):
Diana W. Bianchi, M.D., Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development 
Patricia Flatley Brennan, R.N., Ph.D., Director, National Library of Medicine
Gary H. Gibbons, M.D., Director, National Heart, Lung, and Blood Institute
Joshua Gordon, M.D., Ph.D., Director, National Institute of Mental Health

Middle Row (left to right):
Richard J. Hodes, M.D., Director, National Institute on Aging
Jon R. Lorsch, Ph.D., Director, National Institute of General Medical Sciences
George A. Mensah, M.D., Division Director, National Heart, Lung, and Blood Institute
Eliseo J. Pérez-Stable, M.D., Director, National Institute on Minority Health and Health Disparities

Bottom Row (left to right):
William Riley, Ph.D., Director, NIH Office of Behavioral and Social Sciences Research
Tara A. Schwetz, Ph.D., Associate Deputy Director, National Institutes of Health and Acting Director, National Institute of Nursing Research
Nora D. Volkow, M.D., Director, National Institute on Drug Abuse