Legislative and Regulatory Steps for a National COVID-19 Testing Strategy

The Duke-Margolis Center for Health Policy has released a new report, “Legislative and Regulatory Steps for a National COVID-19 Testing Strategy,” that outlines legislative actions and federal appropriation targets that Duke-Margolis and its collaborating experts believe are needed to get a robust, diversified testing strategy in place for the nation by fall 2020.

“The country needs a national testing strategy to start testing smarter, and the resources and policies to implement it rapidly,” state authors Mark McClellan, MD, PhD, director of the Duke-Margolis, Caitlin Rivers, PhD, an epidemiologist and assistant professor at the Johns Hopkins Center for Health Security, and Christina Silcox, PhD, a managing associate at Duke-Margolis.

The report lays out a comprehensive approach to testing that separates diagnostic testing from routine screening tests to alleviate strain on the laboratory testing capacity that has suffered regional breakdowns in the past several months. This approach includes $75 billion in funding to allow rapid, less costly point-of-care (POC)/at-home testing and more effective contact tracing, isolation, and containment enabled by:

• Developing smarter testing: direct additional $300 million in research and development to accelerate and expand access to rapid, accurate point-of-care testing and easy sample collection
• Increasing testing capacity: provide $45 billion to create a robust national testing capacity
• Widening the supply chain: direct HHS to address critical testing supply chain shortages, with $6 billion to fund advance purchase contracts or support use of the Defense Production Act (DPA) for testing equipment, infrastructure, and related supplies.
• Tracing and isolating: provide $24 billion to support state and local governments to implement additional contact tracing, provide local isolation for those who cannot do so at home, and support infected workers who lose pay in isolation
• Reporting: standardize and publish key information on testing and community risk by state and region stratified by age, sex, race and ethnicity, so that local epidemic response decisions can respond effectively to shifts in the pandemic
• Communicating: initiate a cohesive public communications strategy at the Federal level to keep all Americans informed about testing opportunities, turn-around times for results, contact tracing, and support for preventing spread.

“Timely Congressional action would enable a successful national testing strategy to address the ongoing COVID-19 pandemic,” state the authors. “Smart testing, effective tracing, and support for isolation of potentially infectious individuals implemented can enable all Americans to participate in a more successful re-opening and path forward in the COVID-19 pandemic.”