Testing Policies Organized by Country

Weekly surveillance testing along with isolation would more effectively limit COVID-19 outbreaks than the slow and expensive (yet precise) qPCR (quantitative polymerase chain reaction) testing method that is currently employed.

Syracuse University

Northwestern University

Countries have implemented multiple control strategies for reducing the spread of COVID-19, such as closing schools and businesses to enforce social distancing.

Struggle pertaining to controlling the virus:
The epidemiology of the respiratory virus changes rapidly. Reponses have to be nimble. Given that everyone is susceptible to for which we lack effective biologic interventions, the response has required large-scale behavior change, including social distancing and public masking.

Control Strategies for COVID-19

Biomedical engineers have put in extensive time and research in testing methods and diagnostics regarding the novel coronavirus. The test results of the population have provided mathematical models to visualize the pandemic, alternatively the private sector has produced a high-volume of nasopharyngeal, throat, and nasal test kits by bioengineering front-runners including: Abbot, Xpert, Lightmix, and Genmark.

Diagnostics and Testing with Biomedical Engineering

Social and prevention policies implemented during the COVID-19 pandemic include social (physical) distancing, stay-at-home orders, limits on the maximum number of persons for group gatherings, mass testing, disinfectant protocols, the use of personal protective equipment (PPE), and international or national travel restrictions.

Social and Prevention Policies Related to the COVID-19 Pandemic

Nature Magazine. 2020. Coronavirus Research Updates: For Fast And Low-Cost COVID-19 Testing, Just Spit.     https://www.nature.com/articles/d41586-020-00502-w Accessed 26 June 2020.

Coronavirus Research Updates: For Fast And Low-Cost COVID-19 Testing, Just Spit

Physical distancing, also known as social distancing, is being used as a strategy to delay the progression of COVID-19 by reducing direct transmission of infection. The three most used methods are:
Physical Distancing,
Isolation,
Quarantine

Physical Distancing to Prevent the Spread of COVID-19

- Decreased accessibility to routine healthcare 
- Decreased usage of hospitals for emergency conditions

Consequences of Control Strategies for COVID-19

Face masks are thought to reduce or prevent transmission of the viral particles through aerosol transmission. The usage of face masks is a controversial topic whose efficacy is disputed by governments, researchers, and the public. Health officials in the early stages of the pandemic advised against the use of face masks for various reasons, although recent developments in the area of research may influence their perspectives.

Face Masks to Prevent the Spread of COVID-19

1. Washing your hands
2. Maintain distance
3. Avoid touching eyes, nose and mouth
4. follow good respiratory hygiene
5. Stay home if you feel unwell
6. Keep up to date on the latest COVID-19 hotspots
7. Disinfecting your home if someone is sick

Individual Protection Measures for Preventing the Spread of COVID-19

Testing Strategy for Controlling COVID-19 Outbreaks

- Governments around the world have responded to SARS-CoV-2 with unprecedented policies designed to slow the growth of infections.
- Many policies impose large and visible costs on society, but their benefits cannot be directly observed and are only currently understood through process-based simulations. 
- The objective of this study is to measure the direct health benefits of anti-contagion policies, specifically, how much of these policies slowed the growth rate of  infections. 

Effectiveness of Large-Scale Anti-contagion Policies

- BioRxiv
- Health Affairs 
- JAMA
- Journal of Clinical Nursing
- Nursing Education in Practice 
- The BMJ
- The Lancet
- Nature
- New York Times
- Proceedings of the National Academy of Sciences (PNAS)


References for Control Strategies of COVID-19 by Journal and News Outlets

Celum, C., Al., E., Interview with Dr. Anthony Fauci on progress made during the past four decades of the HIV/AIDS pandemic and ongoing efforts to end this threat.&nbsp;(18:44), Author AffiliationsFrom the Departments of Global Health (C.C., Interview with Dr. Anthony Fauci on progress made during the past four decades of the HIV/AIDS pandemic and ongoing efforts to end this threat. (18:44), J. H. Beigel and Others, . . . M. J. Mina and Others. (2020, May 22). Covid-19, Ebola, and HIV - Leveraging Lessons to Maximize Impact: NEJM. Retrieved October 09, 2020, from https://www.nejm.org/doi/full/10.1056/NEJMp2022269?query=featured_coronavirus

The New England Journal of Medicine 

Research on the effectiveness of COVID-19 control strategies has yielded varying results across different contexts and populations. The implementation of control strategies successfully decreased the reproduction number ($$R_t$$) in China, and stay-at-home orders were associated with decreased hospitalizations across four states in the U.S. Conversely, shelter-in-place and prevention efforts have been less effective in African American and Latino populations, and international travel restrictions demonstrated little to no effect on local epidemics. Furthermore, national surveys highlight that understanding behavioral changes and public adherence is critical to the overall success of these preventative policies.

Effectiveness of Control Strategies for COVID-19

Machine Learning models can be used to better understand the proteins and complexes that are incvolved with the novel Coronavirus. This includes producing predictions of pandemic regarding hospitalizations, patient outcomes, and simulations.

Machine Learning Analysis 

Key Features of Diagnostic Testing and Sampling

Specificity measures the ability for the test to produce a correct negative result for people who don't have a given condition.
ex) A test with a 80% sensitivity will return a correct positive result 85% of the time, but a a false negative 15% percent of the time.

Specificity in Testing

Sensitivity is a measure of how often a "true positive" result is produced. A test with a sensitivity of 85% will produce a "true positive" 85% and a false negative 15% of the time.

Sensitivity of Testing

Currently Used Methods for Diagnosis

Sample Collection Methods for Diagnosis

- Isothermal Nucleic Acid Amplification
- RPA
- CRISPR
- Cas13a Assay
- Next Generation Sequencing 
- Nanomaterials (nanotrap particles, etc.)
- Wondfo Qualitative Rapid Chromatographic Immunoassay (RCI)

Emerging Methods for Diagnosis of SARS-CoV-2

- A reduction of ADAMTS13 levels can potentially predict mortality risk for patients infected with SARS-CoV-2

Potential Diagnostic Methods for COVID-19 Mortality Prediction  

In August, the CDC officially recommended that those without COVID-19 symptoms didn't need to be tested- even if they knew they'd been exposed. This decision received a lot of backlash from public health officials pushing for more testing.  It was later revealed that that the original guidelines had been re-written by those involved with the Department of Health and Human Services and the US COVID task force.

Political Influence in CDC Virus Testing Guidelines

Disinfectant protocols

- Masks/respirators (N95, etc)
- long-sleeved gowns
- goggles 
- disposable round caps
- latex gloves 
- show covers
-ventilators

Personal Protective Equipment (PPE)

- The effect of international travel restrictions on internal spread of COVID-19
- The effect of border controls on the risk of COVID-19 reincursion from international arrivals

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