High Hopes Placed on COVID-19 Testing, as Well as Vaccines

When the CDC updated masking recommendations earlier this week, the agency also updated COVID-19 testing recommendations.

With the spread of the Delta variant and the emphasis this week on masking requirements and a turn toward mandating vaccination in the United States, it could appear that another pillar of COVID-19 mitigation—testing—might have been overlooked, but it hasn’t. In fact, some medical experts think that testing just might be the best method to turn back the COVID-19 surge fueled by the highly infectious Delta variant among America’s unvaccinated.

On Tuesday, the change in masking recommendations by the Centers for Disease Control and Prevention (CDC) that caused an uproar almost overshadowed the CDC’s concurrent change in testing guidance.

CDC Director Rochelle Walensky on Tuesday said in a press conference that fully vaccinated individuals should begin wearing masks again when indoors in public settings in parts of the US with substantial to high transmission.

However, what Walensky did not say at the press conference (possibly because of all the attention on the masking guidance) was that fully vaccinated people who are exposed to COVID-19 anywhere in the US should get tested 3 to 5 days after and take additional precautions that include wearing a mask for 14 days in public indoor settings “or until they receive a negative test result.”

At the press conference, Walensky cited “new scientific data from recent outbreak investigations showing that the Delta variant behaves uniquely differently from past strains of the virus that cause COVID-19. Information on the Delta variant from several states and other countries indicate that in rare occasions, some vaccinated people infected with the Delta variant after vaccination may be contagious and spread the virus to others. This new science is worrisome and unfortunately warrants an update to our recommendations.”

Last night, President Biden announced that unvaccinated federal employees should submit to regular COVID-19 testing and adhere to other mitigation measures, such as social distancing. Biden said that every “federal government employee will be asked to attest to their vaccination status. Anyone who does not attest or is not vaccinated will be required to mask no matter where they work, test one or two times a week to see if they’ve acquired COVID, socially distance, and generally will not be allowed to travel for work. Likewise, today I’m directing my administration to take steps to apply similar standards to all federal contractors. If you want to do business with the federal government, get your workers vaccinated.”

Federal employees who do not submit to COVID-19 testing will still keep their jobs; it’s not a mandate, but Biden’s remarks do reflect a move from encouraging vaccination toward mandating vaccination. Also this week, the Department of Veterans Affairs unveiled a mandate stating that most of its health care employees who work directly with patients must get the COVID-19 vaccination within 2 months.

Where the federal government goes, private industry may follow. In fact, some businesses have already gone there. For instance, Citigroup wants unvaccinated employees to use an at-home rapid test three times a week, and wear masks in the office, while Goldman Sachs has begun regular testing for unvaccinated workers, as the New York Times reports. At-home COVID-19 tests has been called an effective strategy, as Infection Control Today® has reported.

Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, told the New York Times last month that “the most important aspect of these tests is the rapid result…. Waiting two to three days for laboratory test results isn’t ideal when you need results quickly to make decisions about going to school, work or a social gathering.”

In an article with the telling headline—“Testing Our Way Around the Delta Surge”—Axios reports this morning that “the more contagious Delta variant threatens the fuller reopening of offices and schools in the fall. But regular testing—especially with cheap and almost instantaneous tests—could help catch cases before they have a chance to spread.”

Axios: “Germany, which got off to a much slower start vaccinating its population than the U.S., has managed to largely control its COVID-19 outbreak by making frequent rapid testing a requirement for almost any kind of indoor social activity.”