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A national testing strategy to safely reopen America

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Coronavirus testing center located at Barcroft Community Center in the Arlington, Virginia.

In the past few weeks, in varying degrees, virtually every state in the country has begun to reopen. Retail stores, office buildings, and even restaurants are opening their doors for the first time in months.  ur national daily volume of testing is increasing while our daily infection rate and death tolls appear to be declining, somewhat. But, at best, progress is tenuous.

As the country reopens, a plan for national testing, contact tracing, in addition to isolating those who are sick has never been more crucial. Without it, as people begin interacting again, the chance that the virus will spread undetected goes up exponentially. 

Knowing who is infected is key to containing the virus and tied directly to the success of efforts to reopen, as we’ve already seen in countries like Germany. We have already seen circumstances like those in the auto industry where manufacturing plants had to close after reopening as a result of escalating cases of coronavirus detected by onsite testing.

In short, we need a bipartisan national testing strategy to safely return to normalcy. Indeed, a Pew Research Center survey taken this month reported that over 60 percent of Americans believe that adequate testing and tracing is primarily the federal government’s responsibility. While Congress was able to reach bipartisan agreement on $25 billion for testing as part of the Paycheck Protection Program and Health Care Enhancement Act, health experts agree more is needed. 

Last month, the House passed the Heroes Act, providing an additional $75 billion for a national testing and contact tracing plan. Over the Memorial Day weekend, the administration released a “COVID-19 Strategic Testing Plan,” offering support for the testing and contact tracing efforts of state and local governments. And, this week, House Republicans released the first part of a series of recommendations for the potential next wave of COVID-19, focusing on testing and surveillance, particularly among the most vulnerable individuals. 

Only, now is the time to push for a more comprehensive plan. One that incorporates many of the components of a proposal Sen. Patty Murray (D-Wash.) led in the Senate and that aligns with principles on which there can be bipartisan agreement. 

A detailed strategic plan 

The strategy must start with intense federal planning.  A national testing and tracing effort require a carefully considered blueprint for the creation of a pipeline for the development and manufacturing of tests and testing supplies. 

It is essential that tests be efficiently and comprehensively administered, and that the health and safety of the entire population be prioritized. Testing must inform policy decisions and ensure universal equity. But a blueprint for planning must also rely on robust public health infrastructure and workforce to ensure that the plan can be successfully implemented. 

Adequate funding for testing and contact tracing

No strategy, regardless of how comprehensively it is written, can be effectively implemented without adequate funding. This must be recognized as one of the highest national priorities and federal responsibility.  

It is essential that federal resources be made available for at least four major components of the national effort: ongoing diagnostic testing to determine whether symptomatic individuals are positive for COVID-19; surveillance and occupational testing to track and monitor the spread of the virus in communities and work settings; contact tracing to determine who has been exposed in order to effectively mitigate further spread; and an ample number of broadly-located facilities for proper isolation of sick patients who are unable to self-isolate on their own. 

Both private insurers and the government have taken responsibility for funding diagnostic testing. However, population-based testing (i.e., surveillance and occupational) and contact tracing is far broader in scope, requiring several million tests a day to effectively control the virus’s spread. These efforts must be considered a public health responsibility and fully publicly funded. While varying estimates predict billions of dollars are needed to fund a national testing plan, it doesn’t compare to the now over 100,000 lives lost, and the ripple effects the virus is having on our economy.

 A test development and supply pipeline

The country is slowly expanding upon the testing capacity it had at the outset of the pandemic. But, to meet our demand, a highly functioning, transparent supply chain is a necessity. Mechanisms should incentivize the domestic manufacturing of testing supplies and the sharing of intellectual property to expand our capacity. HHS and FEMA must compile and share information of testing inventories and their distribution. The federal government should ensure the development of a variety of testing methods. 

Our strategy should recognize the importance of innovation to effectively scale testing. Testing should be offered in non-traditional sites such as pharmacies, community health centers and mobile vans to reach both urban and remote rural communities. Private retailers as well have truly stepped up in this regard, offering to test in parking lots and drive-thrus across the country.

And, accuracy is imperative. Testing with false negatives undermines both the trust in and efficacy of our national efforts.

Enhancing public health infrastructure

Effective administration of a national strategy begins with establishing sufficient public health and medical personnel. Over the past decade, public health has experienced dramatic budgetary cuts. The result is a fragmented and fragile infrastructure. A rapid expansion of public health providers is essential. 

In addition, the strategy must recognize the importance of modernizing public health data. In some states, it is reported that existing data is more than a half-century old. Improving our capacity with data management should include a recognition of the need to strengthen the electronic reporting of results and patient outcomes. And, perhaps most importantly, it is critical that the federal government expand the nation’s disease surveillance systems to collect data on rates of infection and immunity while protecting personal privacy.

Scaling and optimizing testing administration 

With adequate funding and public health infrastructure, it is also quite essential to recognize the importance of deploying tests and medical supplies to communities where they are most urgently needed. Care should be given to ensure that health disparities are addressed with effective policies and adequate resources. Access to testing should be guaranteed.  

Ensure transparency and accountability

Finally, strong transparency requirements are required in creating a national strategy. Regular reporting, access to testing supply and distribution information, and program accountability should be prioritized. It should include a prohibition on political interference. And the independent analysis on the effectiveness of all the components of testing and contact tracing should be established and fully reported.

Dwight Eisenhower once commented that “plans are worthless, but planning is everything.” Let us hope that well before we celebrate our independence on July 4th, the Congress will again unify to recognize that our nation’s health and economic independence is inextricably linked to planning a federal strategy for testing and tracing. 

The future of American freedom depends on it.

Sen. Tom Daschle is a former U.S. Senator Majority Leader from South Dakota; founder and CEO of The Daschle Group. Governor Tommy Thompson is a former Governor of Wisconsin, former Secretary of the Department of Health and Human Services, and Founder and CEO of Thompson Holdings.

Tags Academic disciplines Patty Murray Public health Sanitation

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