Lack Of COVID-19 Testing Raises Concerns Of Symptomless Spread

Published: Thursday, April 23, 2020 - 5:47pm
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David Engelthaler, co-director of TGen's Pathogen and Microbiome Division (TGen North) in Flagstaff.

Nearly 150 people at a Boston homeless shelter; 29 of 33 women admitted to give birth at New York-Presbyterian Allen Hospital and Columbia University Irving Medical Center; more than half of those who tested positive on the quarantined Diamond Princess cruise ship and the U.S.S. Theodore Roosevelt aircraft carrier.

All had COVID-19, but none had symptoms.

Such reports underline the dangers of reopening communities when so many questions remain — and when testing data is so lacking.

With the limited available tests being focused on the sick, little data exists on how many people without symptoms may carry, and pass on, coronavirus.

David Engelthaler, co-director of TGen North, home to TGen's Pathogen and Microbiome Division, said we don't know enough about this new disease to make such estimates.

"We have to continue to do lots of testing and really gain that actionable intelligence," he said.

But Engelthaler added antibody testing would not settle the question of if or when people can return to work because we don't truly know whether testing positive means they cannot get sick again.

It's also likely the vast majority of people will have no antibodies by the time they return to work.

"We're going to have to continue to track the amount of antibody, the amount of immunity, in our community, but it cannot be a deciding factor on whether or not people can work," said Engelthaler.

More comprehensive testing will be necessary to give researchers and policymakers the information they need to monitor infected populations and protect those most at risk.

"We can't necessarily say, 'Well, we're not going to make any new public policy decisions or let people go back to work until we figure all this out,' because we won't figure it all out — at least not for the next 12 or 18 months," said Engelthaler.

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