Is "No test is better than a bad test"? Impact of diagnostic uncertainty in mass testing on the spread of Covid-19


Gray, Nicholas ORCID: 0000-0002-0930-4575, Calleja, Dominic, Wimbush, Alexander, Miralles-Dolz, Enrique, Gray, Ander ORCID: 0000-0002-1585-0900, De Angelis, Marco ORCID: 0000-0001-8851-023X, Derrer-Merk, Elfride, Oparaji, Bright Uchenna ORCID: 0000-0002-6293-0989, Stepanov, Vladimir, Clearkin, Louis ORCID: 0000-0001-8365-1770 et al (show 1 more authors) (2020) Is "No test is better than a bad test"? Impact of diagnostic uncertainty in mass testing on the spread of Covid-19. PLoS One, 15 (10). e0240775-.

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Abstract

<jats:p>Testing is viewed as a critical aspect of any strategy to tackle epidemics. Much of the dialogue around testing has concentrated on how countries can scale up capacity, but the uncertainty in testing has not received nearly as much attention beyond asking if a test is accurate enough to be used. Even for highly accurate tests, false positives and false negatives will accumulate as mass testing strategies are employed under pressure, and these misdiagnoses could have major implications on the ability of governments to suppress the virus. The present analysis uses a modified SIR model to understand the implication and magnitude of misdiagnosis in the context of ending lockdown measures. The results indicate that increased testing capacity alone will not provide a solution to lockdown measures. The progression of the epidemic and peak infections is shown to depend heavily on test characteristics, test targeting, and prevalence of the infection. Antibody based immunity passports are rejected as a solution to ending lockdown, as they can put the population at risk if poorly targeted. Similarly, mass screening for active viral infection may only be beneficial if it can be sufficiently well targeted, otherwise reliance on this approach for protection of the population can again put them at risk. A well targeted active viral test combined with a slow release rate is a viable strategy for continuous suppression of the virus.</jats:p>

Item Type: Article
Uncontrolled Keywords: Humans, Pneumonia, Viral, Coronavirus Infections, Antibodies, Viral, Diagnostic Errors, Mass Screening, Serologic Tests, Clinical Laboratory Techniques, Prevalence, Uncertainty, Sensitivity and Specificity, Reverse Transcriptase Polymerase Chain Reaction, Quarantine, Pandemics, Data Accuracy, United Kingdom, Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Testing
Depositing User: Symplectic Admin
Date Deposited: 12 Nov 2020 11:32
Last Modified: 18 Jan 2023 23:26
DOI: 10.1371/journal.pone.0240775
Open Access URL: https://journals.plos.org/plosone/article?id=10.13...
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3104989

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