“The testing we are doing today is mostly just keeping score for the virus,” says William Hanage, an epidemiology professor at Harvard. Even that grim framing gives the U.S. system too much credit. The Centers for Disease Control and Prevention’s sampling of Americans with SARS-CoV-2 antibodies shows that the true number of infections is as many as seven times higher than the official count.
Over time, though, the problem of testing has attracted new focus, new thinking, and new money. Experimental viral screening technologies have taken big steps forward, and researchers have found ways to retool existing procedures. Some of that work isn’t likely to pay off in time to change the course of the pandemic, but some of it already has. And the outbreak’s global scale has spurred epidemiologists and policymakers to seek better answers to fundamental questions about the management of a modern plague: not only how to test but whom to test, and why.
Those debates are particularly vital now. The number of new U.S. Covid cases, which peaked this summer before dropping significantly, is climbing again—the CDC’s seven-day moving average rose from 34,371 on Sept. 12 to 44,307 on Sept. 26. Colder weather and classroom reopenings threaten an explosion of cases at a time when the public has tired of social distancing’s heavy costs. And we’re still, at the earliest, months away from a working, widely available vaccine.
Until then, testing can help close the gap between normalcy and where we are. If Americans want to safely send kids to school, eat in a cafe, go to a basketball game, or get on a plane, the U.S. needs to test a lot more people a lot faster. Faster, cheaper testing may not flag every new case of Covid, but that shouldn’t mean settling for the current level of blindness, with its torturous drip of preventable deaths. Even world-class testing won’t rid us of the virus, but it can allow us to live our lives in the meanwhile.