Letter to the Editor: Urging Wider Use of Covid-19 Testing

~ Submitted by Ann Kiessling, PhD
Editor’s note: Kiessling is a member of the Bedford Board of Health and the Director of Bedford Research Foundation.

Testing is a most valuable public health response to COVID19 — Why aren’t tests freely available? A fundamental tenet of public health response to pandemics is rapidly identifying infected people.  It is for this reason that months before mask mandates were proposed, the Food and Drug Administration implored capable, federally licensed laboratories to develop tests for SARS-CoV-2.  Thousands of U.S. laboratories responded to that request, developed a variety of tests, and the costs of even the expensive PCR-based tests were partially covered by federal and state pandemic funds.  Testing sites both large and small sprang up everywhere to enable appropriate quarantining and treatment strategies.

As soon as vaccines became freely available — and free to receive — government funds to underwrite the costs of testing began to disappear.  This is proving to be a big mistake.  Bedford’s free testing program for all residents and employees, overseen by the Bedford Fire Department, was a shining example of a municipal testing strategy for the safety of the community and schools.  The Bedford Board of Health requested the program be continued until at least this fall.  Instead, the Select Board chose to defund the program because it was “not cost-effective.”

And now here we are, more fully aware that SARS-CoV-2 is like influenza — vaccination helps avoid serious disease complications, but does not always prevent new infections.  In fact, the U.S. Centers for Disease Control (CDC) does not keep comprehensive data about the annual incidence of influenza infections, only about the incidence of hospitalizations of vaccinated folks.  So far, in fact, all the available SARS-CoV-2 vaccines appear to be more effective at preventing hospitalizations from COVID19 than does the annual flu vaccine.

A few reported outbreaks of SARS-CoV-2 infection — but not COVID19, the serious disease it can cause — among vaccinated individuals have revived “mask mandates” instead of renewed testing efforts.  This response is a step backward and is not based in sound public health strategy.  There is a reason masks have not historically been mandated to block the spread of the flu in a bad flu season — without training, masks have been repeatedly shown to not be very effective.  If you can breathe through a mask, the weave is open enough that viruses don’t even know there is a barrier there — viruses freely pass through filters that block all bacteria.

According to Mass Department of Public Health statistics, Bedford is slightly below the state average for SARS-CoV-2 infection incidence, i.e. about 1.1% of tested folks test positive.  https://datastudio.google.com/reporting/ae2d813a-b381-4c06-a101-96dc47ec451e/page/JALlB These test reports are not routine surveillance testing, they are people seeking to be tested for a reason, so the actual incidence of infection among Bedford residents and employees is undoubtedly lower.  This means that a minimum of 99 persons per 100 living in Bedford are not SARS-CoV-2 infected.

Given that low incidence, what is the likelihood of becoming infected in the Bedford Public Library?  Or a grocery store?  Or school?  Or a restaurant?

Several cluster studies have shown that ventilation systems are probably far more important than masks to prevent virus transmission.  Air exchanges are designed to not co-mingle air from multiple rooms and to incorporate substantial outside air into all air exchanges, keep the concentration of virus too low to be contagious.  Bedford facilities professionals have worked toward this goal for all Bedford facilities and schools for many months.

Far more effective than “mask mandates” is to revive Bedford’s excellent town testing program.  The testing format probably needs revision, perhaps a “co-pay” might be necessary, pooled testing strategies greatly reduce costs, can be conducted on-site, and could avoid business and school closures, such as the two-week school closure experienced by Bedford High School last year.  Many simplified PCR-testing strategies have been developed in the past year to specifically address the needs of schools and communities to move past SARS-CoV-2/COVID19 fears.  Simply knowing who is — and who is not — infected in real-time, not with a 24 to 72-hour wait for results, will empower Bedford to make safe, mentally healthy decisions for students, residents, and town employees.

There is no need to go back to mask mandates in Bedford.  We have a vaccinated community, we have learned how to control the spread of SARS-CoV-2 in indoor spaces, and successfully treat the COVID 19 disease it can cause in a very small percentage of people.  Our local Emerson Hospital currently has only two SARS-CoV-2 infected patients, and they are hospitalized for other reasons.  Bedford is fortunate to have the resources and energy to move forward with routine, rapid community and school testing options and improved building ventilation strategies where needed.

Hiding from the virus behind masks was last year, this year the virus can’t hide from us anymore.  Let’s move forward with a cost-effective, rapid community testing strategy to stay ahead of virus spread, whatever variants come along.  As a community, we can get this right, and “mask mandates” are a thing of the past.