tetano
Editor, Senior Moderator
Health Aff (Millwood)
. 2020 Dec 2;101377hlthaff202001409.
doi: 10.1377/hlthaff.2020.01409. Online ahead of print.
Increased Intensity Of PCR Testing Reduced COVID-19 Transmission Within Countries During The First Pandemic Wave
Ravindra Prasan Rannan-Eliya[SUP] 1 [/SUP], Nilmini Wijemunige[SUP] 2 [/SUP], Jrna Gunawardana[SUP] 3 [/SUP], Sarasi N Amarasinghe[SUP] 4 [/SUP], Ishwari Sivagnanam[SUP] 5 [/SUP], Sachini Fonseka[SUP] 6 [/SUP], Yasodhara Kapuge[SUP] 7 [/SUP], Chathurani P Sigera[SUP] 8 [/SUP]
Affiliations
Abstract
Experts agree that reverse transcription-polymerase chain reaction (PCR) testing is critical in controlling coronavirus disease 2019 (COVID-19), but decision-makers disagree on how much testing is optimal. Controlling for interventions and ecological factors, we used linear regression to quantify testing's impact on COVID-19's average reproduction number, representing transmissibility, in 173 countries and territories, accounting for 99% of the world's COVID-19 cases, during March to June 2020. Amongst interventions, PCR testing had the greatest influence-a ten-fold increase in the ratio of tests to new cases reported reduced the average reproduction number by 9% across a range of testing levels. Our results imply that mobility reductions (e.g., shelter-in-place orders) were less effective in developing countries than in developed countries. Our results help explain how some nations achieved near-elimination of COVID-19 and the failure of lockdowns to slow COVID-19 in others. Our findings suggest that World Health Organization and other testing benchmarks are insufficient for COVID-19 control. Increased testing and isolation may represent the most effective, least costly alternative in terms of money, economic growth and human life for controlling COVID-19. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript. The final edited version will appear in an upcoming issue of Health Affairs
. 2020 Dec 2;101377hlthaff202001409.
doi: 10.1377/hlthaff.2020.01409. Online ahead of print.
Increased Intensity Of PCR Testing Reduced COVID-19 Transmission Within Countries During The First Pandemic Wave
Ravindra Prasan Rannan-Eliya[SUP] 1 [/SUP], Nilmini Wijemunige[SUP] 2 [/SUP], Jrna Gunawardana[SUP] 3 [/SUP], Sarasi N Amarasinghe[SUP] 4 [/SUP], Ishwari Sivagnanam[SUP] 5 [/SUP], Sachini Fonseka[SUP] 6 [/SUP], Yasodhara Kapuge[SUP] 7 [/SUP], Chathurani P Sigera[SUP] 8 [/SUP]
Affiliations
- PMID: 33264048
- DOI: 10.1377/hlthaff.2020.01409
Abstract
Experts agree that reverse transcription-polymerase chain reaction (PCR) testing is critical in controlling coronavirus disease 2019 (COVID-19), but decision-makers disagree on how much testing is optimal. Controlling for interventions and ecological factors, we used linear regression to quantify testing's impact on COVID-19's average reproduction number, representing transmissibility, in 173 countries and territories, accounting for 99% of the world's COVID-19 cases, during March to June 2020. Amongst interventions, PCR testing had the greatest influence-a ten-fold increase in the ratio of tests to new cases reported reduced the average reproduction number by 9% across a range of testing levels. Our results imply that mobility reductions (e.g., shelter-in-place orders) were less effective in developing countries than in developed countries. Our results help explain how some nations achieved near-elimination of COVID-19 and the failure of lockdowns to slow COVID-19 in others. Our findings suggest that World Health Organization and other testing benchmarks are insufficient for COVID-19 control. Increased testing and isolation may represent the most effective, least costly alternative in terms of money, economic growth and human life for controlling COVID-19. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript. The final edited version will appear in an upcoming issue of Health Affairs