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Editorial: Expand testing to meet demand

Workplace requirements for vaccinations or weekly negative COVID-19 tests have caused an explosive demand for testing among unvaccinated employees who need to comply. Some major private employers have announced similar policies, adding to the rush.

So far, those lining up for free, sponsored tests have experienced hours-long waits.

That’s not good enough. The testing regimen must expand to properly fulfill its function: identifying infections and isolating them as much as possible. Dr. Anthony Fauci, the Biden administration’s chief medical adviser, recommends more testing — including among those who are vaccinated.

It is a frustrating challenge, given the high cost and slower turnaround time of the best tests, and the limited accuracy of the cheaper, faster ones.

A program of free tests for Oahu residents, sponsored by the Kidney Foundation of Hawaii, has been running for weeks since the delta variant first sparked a rapid increase in infections in mid-July. Already being extended week by week, the foundation has committed to offering them at least through Saturday. These are the nose-swab type called polymerase chain reaction (PCR) tests, long considered the gold standard for accuracy.

The problem? Under the best of circumstances, the delay in delivering results is about six hours, a period that surely will get longer if the case counts continue to rise, as most experts believe they will for some weeks to come. And the longer the wait for the result, the likelier it is that someone else will be exposed to the virus in the interim, while the individual is the most infectious.

Speeding up this process would require a lot more test kits, and crews to manage them. And although the free tests may continue for some time, the money won’t last forever. The cost for each of them will then fall to those being tested, a bill in the $100-$150 range. And that’s a weekly tab.

Scientists at the National Institutes of Health on Monday announced that a faster, cheaper test has been developed. It also inactivates the virus, making the test safer to handle. It’s not on the market yet, though.

Available now are antigen tests, already being deployed. Health Department spokesman Brooks Baehr said at the Aloha Stadium site, 736 were given out on Saturday and 791 on Sunday; the Monday count was pending.

That is encouraging. Antigen tests can return results in about 15 minutes, and in drugstores a kit of two sells for about $25.

Their limitations: They are best at detecting high viral loads, so if someone’s infection has not yet produced a sufficiently high count, the test-taker could receive a false negative result. In addition, if taken at home, user error could produce a false positive.

Clear guidance on their use is essential — how to administer the tests correctly, and the protocols for reporting the results and quarantining if necessary.

Still, meeting a growing demand for tests will be difficult without a cheaper alternative to the gold standard. And some advocate rapid testing for other reasons: These kits can identify people when they are most infectious. That’s important, because the delta variant can infect vaccinated people, leaving many of them carrying a high viral load without symptoms.

Moreover, as Max Nisen, a biotech columnist for Bloomberg Opinion, noted, buying in bulk can save money: “That makes rapid tests easier to do repeatedly, which can boost accuracy.”

However the state refines a robust testing plan to cast the widest net possible, it needs to be done. Hawaii is going to be dealing with the coronavirus pandemic, unfortunately, for a long time to come.

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