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BioCommunique Article

We compare the three main types of COVID-19 tests currently available and provide insight to help companies determine their ideal testing strategy.

Return to Work Webinar Series: COVID-19 Testing Foundations that We all Need to Know Recap

  • 2020-07-28T19:00:00.000+0000
  • California
  • Author: Harry Chang


Biocom recently announced a new partnership with One Medical to provide our members with exceptional 24/7 primary care and convenient COVID-19 testing. In Biocom’s Testing Solutions addendum to The Path Forward: Biocom’s Return to Work Guide for California’s Life Science Industry, we compare a number of reliable testing options available to make it easy for life science companies to decide on the best solution for them, but first, it’s important to understand the different types of tests available.

In Biocom's Return to Work Webinar Series, we held a discussion about COVID-19 testing foundations so that all individuals have a clear understanding of the three main test types. The webinar, moderated by Laura Furmanski, Managing Director and Partner, Boston Consulting Group, featured three expert panelists at the forefront of research: Kristian G. Andersen, Professor, Scripps Research, Director of Infectious Disease Genomics, SRTI, Vice President, Viral Hemorrhagic Fever Consortium; Raj Behal, MD, Chief Quality Officer, One Medical; and Gene Yeo, Co-Director, Bioinformatics and Systems Biology Graduate Program UCSD.

Read on for some of the key takeaways from the presentation or rewatch the webinar via our archived webinars.

Types of Testing

To navigate the planning process, it’s important to establish a baseline understanding of the testing options available under current FDA Emergency Use Authorization (EUA). This webinar focused on first exploring three common testing subjects:

  • PCR Tests
    • Can be used to look for active infection
    • Have the ability to test for Viral RNA
  • Antigen Tests
    • Can be used to look for active infection
    • Have the ability to test for Antigens or anything that induces an immune response like certain viral proteins
  • Antibody test for N protein and/or S protein
    • Can be used to look for prior exposure to the virus
    • Have the ability to test for Antibodies (IgM, IgG, or total)

Panelists explained that antibody testing can be valuable to understanding one’s prior exposure to the virus, however, its use is for public health understanding to discover the percent of a population that has been exposed.

Moreover, while high sensitivity tests taken at the doctor’s office produce a sample taken to a testing facility, point-of-care tests using a machine to test samples are faster, but are still costly and test only one sample at a time.

Going forward, rapid diagnostic tests like lateral flow assays, which offer single test kits, will be a transformative option for employers as they are faster and don’t require a machine. These tests will have the ability to be scalable for screening, however, are not yet widely available.

Temperature Tests

In addition, taking employees’ temperature upon entry to a workplace has seen varying opinions on effectiveness. Temperature checks alone are highly susceptible to false negatives and positives and are prone to missing individuals at risk of spreading COVID-19. In general, however, panelists agreed temperature checks can offer many protections. While employers won’t capture everyone with a fever symptom, they will be able to capture some. Any one person with symptoms you can sequester from spreading the virus in the workplace is a win, and temperature tests are a scalable way of catching fever symptoms. In addition, regardless of whether someone has COVID-19, preventing fever patients from entering a workplace is a best practice guideline.

One thing panelists noted is that guidance states that the temperature scanner must have PPE and that a queue of employees waiting for a temperature check should abide by social distancing and not gather closely upon entry while waiting for a test.

The Purpose of Office Testing

An important question to ask before seeking testing, is why does the individual want a test? The most common reason is to see if a person who feels they may be infected is positive or negative. With COVID-19, testing is a bit different. When an employee enters a building, it becomes about whether they might spread the virus or not, rather than whether they themselves might need treatment. Ideally, employers should test individuals they assume are not infected while employees who show symptoms should not have their test done at the office at all, rather they should get the best test they can at a doctor’s office.

Moreover, the kinds of nasopharyngeal cotton swab tests that many have seen in the news, as a modality, while accurate, don’t suit office screening. Realistically, diagnostic tests like these are not scalable to the workplace and panelists also noted that the jury is still out on whether nasopharyngeal or saliva tests are most accurate.

Panelists noted that it’s also important to know that when screening rather than attempting to diagnose, detecting the virus higher up in the airways is key, which less invasive and lower barrier-to-entry tests can do.

The Bottom Line

Importantly, office testing’s role is as a component of a risk reduction strategy but not the entire strategy. A helpful risk management strategy might look like these six steps:

  1. Plan for medically vulnerable employees
  2. Phased, cohort-based reentry
  3. Baseline and repeat testing
  4. Daily symptom screening
  5. Workplace infection prevention
  6. Exposure management

Panelists stressed it cannot be overstated that a range of actions are needed to create a safe workplace. Testing can identify population risks, however social distancing and PPE will remain of utmost importance no matter how the curve or rate of infection rises or falls, and even after scalable single tests are available.

Hand sanitizer serves as a preventative measure both by eliminating germs but reminding employees to be safe and wearing a face mask indoors is also a proven method of slowing the spread of transmission, even when practicing social distancing or working at a desk away from others. Panelists urged face mask usage is the most important thing anyone can do and is also the easiest and cheapest prevention method.

Biocom takes a global approach in all that we do. As a representative of over 1,300 organizations connected to California’s life science industry, we strive to provide information that could benefit this community and their pursuit of innovation. These resources are not to be taken as medical advice but as a means to stay informed and updated.