Can we test our way back to business?
Although we cannot test food safety into food, we can detect and prevent issues by conducting regular environmental monitoring/testing and implementing controls. Can a similar testing practice work for COVID-19 – can we test our way back to business?
There are, of course, a number of differences between the two and a number of improvements that need to be made in COVID-19 testing, the greatest of which are the availability, speed, and accuracy of tests.
All of these have gradually evolved in food testing through the years, such that food facilities (and the regulatory agencies) can get as many test kits and swabs as they want, with many such as ATP and allergen tests providing accurate results in minutes. Anyone who has followed any news of the coronavirus knows that is not the case with tests for the virus. There is currently a lack of availability of tests, as well as a lack of validated accuracy of the rapid tests that are starting to be developed. Regarding serological testing, a recent WHO Scientific Brief “applauds the efforts of test developers to innovate and respond to the needs of the population” but “recommends the use of these new point-of-care immunodiagnostic tests only in research settings.”
But just as food testing has evolved, so too will coronavirus testing. So what will further testing look like and what needs to be considered?
The first point I’d make is on wellness screenings. Since early March, TAG has been recommending that businesses conduct employee wellness screening and we expect that to continue to be the key factor in both employee protection and business continuity – not for the next four to six weeks, but the next four to six months, at least. In fact, it could very well become a standard practice to help prevent the spread of any illness and disease (i.e., norovirus). Currently that screening is based on employee questions along with temperature and symptom monitoring.
So, the second point, as the rapid COVID-19 tests evolve and become validated, could these be added to screening in some form or fashion? Perhaps; but with a number of considerations, one of the primary being whether discussing a COVID-19 diagnostic test to determine if the person has the virus, or an antibody test of whether the person had the virus and recovered (e.g., asymptomatically or simply not diagnosed) – and if it is proven that exposure leads to immunity.
In relation to the antibody test, as stated in a CIDRAP article on the topic, “it’s complicated.” If it were to be scientifically proven that a certain level of antibody does confer immunity to further infection, the article states, “then that can be used to determine maybe who can go back to work, or who is less likely to be able to transmit the virus."
In relation to a COVID-19 diagnostic test, it also needs to be remembered that a negative test today does not mean the person is negative tomorrow, as they could have been exposed to the virus anytime in between, or within the last two weeks but not yet tested positive. According to a WHO document, data suggests that some people can test positive for COVID-19 from 1-3 days before they develop symptoms. But how far before that might they still test negative?
Just as wellness screening can help to keep ill persons from coming to work and spreading the virus to others, testing can be a proactive form of preventing the spread of the virus and getting back to business – if, and only if, availability, speed, and validation improve; tests are widely and equably conducted; and additional steps are taken to further mitigate the risk as we continue to not only flatten, but reduce and eliminate the curve.
Current diagnostic testing capacity in the US is at about 150,000 tests per day and has been at that level for the past two weeks. A recent analysis from the Harvard Global Health Institute determined that the US needs at least 500,000 tests per day (about 152 tests per 100,000 people) to more safely start to reopen society. This level of testing is needed so that we have enough capacity to rapidly test and isolate people that may be sick with COVID-19 to reduce the risk of community transmission. Testing at lower levels means that we’ll likely miss infected people and community transmission can continue.
Because each food facility, restaurant, and grocery store is part of a community, increasing testing is integral to operating a business safely until a vaccine can be developed.
About The Acheson Group (TAG)
Led by former FDA Associate Commissioner for Foods Dr. David Acheson, TAG is a food safety and public health consulting group that provides guidance and expertise worldwide for companies throughout the food supply chain. With the advent of the COVID-19 pandemic, TAG’s public health and infectious disease expertise has been brought to the forefront to assist food businesses weather the increased challenges of employee protection, food safety, and business continuity. With in-depth industry knowledge combined with real-world experience and advanced virtual technologies, TAG’s team of experts helps companies assess their unique situation, address gaps, and deploy best practices to more effectively mitigate risks, improve operational efficiencies, and protect their brand. www.AchesonGroup.com