We need to prioritize testing and stop fighting blind against pandemics

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I was the chief information officer for the Department of Health and Human Services at the beginning and most intense moments thus far in the COVID-19 pandemic. My objective was to ensure national leaders had the data they needed to fight against a disease that they couldn’t not see. Insights such as hospitalization, ventilator usage and COVID case counts by zip code were the things I focused on. Collecting basic data and making it available to the best scientists in the world at HHS was and is a way to save lives.

Having the ability to walk into a grocery store and take a test is a necessity for the United States. Communities that had easy access to comfortable, safe tests used those tests and changed their behavior. The data showed that when we empowered citizens with tests, people changed their behavior. They wore masks, shopped online more and ensured they created distance in their social interactions. But, as much as 30 percent of the time, tests were getting it wrong. They had particular trouble picking up COVID-19 in the early stages, when people are often feeling no symptoms but are still highly contagious.  

Investment in testing for infectious disease has long lagged behind other prevention methods. The manufacturing base in the United States to create tests and transmit results rapidly was nearly non-existent. These days, vaccines are too frequently portrayed as our path out of the pandemic. Yet, with the threat of mutant variants looming on the horizon, testing is the key. It empowers people, communities, businesses and schools to manage risk. 

Unfortunately, when it comes to testing, we are seeing things get worse, not better. The average number of tests dropped from a peak of 2 million per day in mid-January to about 1.4 million per day last week, according to tracking done by a team at Johns Hopkins University. We are going to need a lot more testing, not less, as America empowers its citizens, reopens schools, businesses and emerges from this pandemic further building upon the values that founded this nation. 

Much of the testing done to date has been in an attempt to diagnose individuals. Our investment in manufacturing facilities to create tests has been significant but the lagging regulatory approval apparatus is squandering those efforts.

The next stage is really about trying to safely open up schools, businesses and communities by screening those entering. The need and ability to share data in real time to ensure public health officials and individuals have a transparent understanding of risk is necessary. Local communities need structures to understand disease spread and rapidly address the issues as outbreaks occur. Without this level of empowerment for our citizens and insights for officials, American communities will struggle to sustain reopenings and this crisis will continue to plague our communities.

Testing is the single most important tool to getting back to normal. We need to have American manufactured PCR quality fast tests to allow our citizens to make individual choices to stop the spread of this disease. Our country needs to publicize the data that highlights the results of tests, accuracy of tests, level of comfort and locations to take tests. Investing in the ability to share the test results and collection insights in a secure manner in real time will only enable our scientific community and invigorate public health officials to develop vaccines and improve treatment plans.

For the last year, the National Institutes of Health and the American industrial base have been heavily investing in this kind of new testing technology. There are now American-made tests that are comfortable, safe and accurate and can deliver lab-quality PCR results in less than thirty minutes. These rapid PCR tests do not rely on separate instruments and can be deployed into underserved communities where the COVID burden is highest.  

We did not have this kind of testing capability when I was working at HHS. Now that it is available, the federal government must embrace it and ensure it can securely be scaled. The federal government must ensure it prioritizes testing. It must also incentivize test manufacturers and data aggregators to establish business models that compensate citizens for sharing their data and empower them to maintain personal health records related to testing and vaccines that they can share. This approach will create a new health economy in the United States that puts the citizen first and empowers communities to make the hard risk-based decisions on reopening. No more starts and stops. As a father, I think America should use this moment to teach its kids how to plan again. 

Our country was ill prepared for this pandemic. Let’s not make this mistake again. We never again should fly blind through a public health crisis.  Let’s empower our citizens, invest in quality testing and distribution of those tests and ensure secure data sharing so we can avoid the next pandemic. Because every test result can save lives. 

Jose Arrieta is the former chief information officer and chief data officer for the U.S. Department of Health and Human Services.

Tags COVID-19 pandemic COVID-19 testing Pandemics Public Health Emergency of International Concern

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