Testing for Respiratory Infections: Beyond the COVID-19 Public Health Emergency

Issue Brief Cover Image featuring patients getting tested

White Paper

Testing for Respiratory Infections: Beyond the COVID-19 Public Health Emergency

Executive Summary

Recent progress in diagnostic testing for respiratory infections has created a powerful and effective tool to prevent the spread of the COVID-19 virus and protect the most vulnerable, by enabling everyone to take common-sense measures to avoid infecting others and helping those who need treatment to access it in a timely manner. Requirements for broad insurance coverage, along with continued federal and state purchases and distribution of tests, have supported access to testing throughout much of the Public Health Emergency (PHE), but are tied to the emergency declaration.

The end of the PHE on May 11, 2023 will impact Americans’ free access to tests and diminish the national and state ability to access early testing and prevent infectious disease spread. COVID-19 testing with no cost-sharing for any American will no longer be guaranteed. The cost of COVID-19 tests, even if low, will decrease demand for available testing, even for people at high risk, and will result in continued reduced manufacturing, positioning the United States once again to face any new surges without enough tests.

Innovative approaches to diagnostic testing for respiratory infections have provided new ways for Americans to protect themselves and their communities from potential COVID-19 surges and severe health complications from other serious respiratory infections. In early 2023, COVID-19 continued to account for nearly 4,000 Americans being hospitalized with COVID-19 every day, and more than 3,700 dying every week. Moreover, COVID-19 only accounted for just over half of the hospitalizations for common identifiable viral respiratory infections in fall and early winter 2022. Flu and respiratory syncytial virus (RSV), which can be detected using similar diagnostic tests, accounted for the rest. This report sets out policy steps to support practical information, availability, and affordability for innovative and convenient testing capabilities to empower Americans to protect themselves from a broad array of respiratory infections and other health risks, especially people with high risks of complications or from vulnerable communities, without substantial restrictions, extraordinary measures, or very large new government appropriations.

Read the full paper here.

Duke-Margolis Affiliated Authors


Christina Silcox, PhD

Research Director, Digital Health
Adjunct Assistant Professor
Senior Team Member
Margolis Core Faculty

Thomas Roades Photo

Thomas Roades, MPP

Senior Policy Analyst

Mark McClellan

Mark McClellan, MD, PhD

Director of the Duke-Margolis Institute for Health Policy
Robert J. Margolis, MD, Professor of Business, Medicine and Policy
Margolis Executive Core Faculty