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AAMC Recommendations for COVID-19 Testing Appendix B: National Testing Strategy Proposals

Published October 22, 2020

The research conducted by several organizations provides the data to support a range of testing targets. Notably, as the nation has failed to contain the spread of the virus, later proposals are increasing in the number of recommended tests. Seminal work by these organizations should both guide and accelerate consensus.

  • The AAMC noted in June that 2.3 million tests per day would be required just to reduce the rate of positive tests to below 3% when the nation was averaging 70,000 new cases per day.1
  • In June, the Harvard Global Health Institute (HGHI) published a model for calculating state-based testing targets,2 describing how a virus mitigation strategy would require a significant increase in state-based testing and a virus suppression strategy to “quickly find and isolate new cases before they lead to a wider outbreak, with an aim of keeping new case levels at or near zero,” would require as many as 4 million tests per day nationwide.
  • An updated discussion of state and national testing targets from the HGHI and Brown University School of Public Health includes a testing target calculator and demonstrated as of Oct. 1, 2020, that all but one state were well below testing levels needed for suppression of the virus and only a handful of states demonstrated a positive test rate below the target of 3%.3 Based on these calculations, the group estimates that the United States would require 4.4 million tests a day to achieve “a basic level of proactive testing” and 14 million tests a day to achieve an ideal testing target.4
  • A report from the Rockefeller Foundation laid out the need for decisive government action and funding to deploy rapid accessible diagnostic tests for symptomatic people and their close contacts. The combination of those necessary diagnostic tests and the much larger number of needed screening tests led to the conclusion that “getting to the goal of at least 30 million weekly tests (~4.3 million tests per day), with the majority of those being screening tests, is the only way to beat back Covid-19.”5
  • A Rockefeller Foundation report provided detailed testing suggestions and protocols for K-12 schools, with the goal of  “1) helping school administrators to assess the risk of SARS-CoV-2 in their schools and 2) identifying key considerations in developing a screening program to regularly test students and staff for the virus to support schools to open in-person more safely.”6
  • A recent report issued by the Duke-Margolis Center for Health Policy concludes that 200 million tests per month (~6.7 million tests per day) would be required to test all students and staff at the nation’s primary and secondary schools and residents and staff at nursing homes alone.7

1 Association of American Medical Colleges. The Way Forward on COVID-19: A Road Map to Reset the Nation’s Approach to the Pandemic. https://www.aamc.org/covidroadmap/roadmap. Accessed October 15, 2020.

2 See https://globalepidemics.org/july-6-2020-state-testing-targets/ for a July 2020 description of the testing targets published by the HGHI and NPR.

3 Brown University School of Public Health. October 1, 2020 | State testing targets. https://globalepidemics.org/october-1-testing-targets. Accessed October 15, 2020.

4 NPR. Can the U.S. use its growing supply of rapid tests to stop the virus? https://www.npr.org/sections/health-shots/2020/10/01/915793729/can-the-u-s-use-its-growing-supply-of-rapid-tests-to-stop-the-virus. Published October 1, 2020. Accessed October 15, 2020.

5 Rockefeller Foundation. COVID-19 national testing & tracing action plan. https://www.rockefellerfoundation.org/national-covid-19-testing-and-tracing-action-plan. Accessed October 15, 2020.

6 Rockefeller Foundation. Risk Assessment and Testing Considerations for Reducing SARS-CoV-2 Transmission in K-12 Schools. https://www.rockefellerfoundation.org/report/risk-assessment-and-testing-considerations-for-reducing-sars-cov-2-transmission-in-k-12-schools. Published October 14, 2020. Accessed October 15, 2020.

7 Silcox C, Anderson D, Zavodszky A, et al. A National Decision Point: Effective Testing and Screening for Covid-19. https://healthpolicy.duke.edu/publications/national-decision-point-effective-testing-and-screening-covid-19. Published September 9, 2020. Accessed October 15, 2020.