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Routine, Rather Than Incidental, COVID-19 Testing May be Key to Keeping Society Open

By MolGen

Replacing symptom-based SARS-CoV-2 testing with routine monitoring may improve detection and provide better insight as to disease dynamics in undertested communities, according to recent research. However, implementing routine testing will require lifting barriers to access, making tests less invasive, and convincing the public to participate, said Niels Kruize, chief commercial officer of Dutch life sciences firm MolGen.

SARS-CoV-2 tests are generally administered to individuals who are exhibiting symptoms of COVID-19 or those who have been exposed to the virus. But this testing paradigm misses asymptomatic cases and transmission among undertested groups.

In September 2021, researchers from the University of Nebraska and the Omaha Public School District found that weekly saliva polymerase chain reaction (PCR) testing in three schools in Omaha over five weeks in the fall of 2020 improved detection as compared to symptom-based strategies. Cases detected at the participating schools exceeded those reported at the county level, illustrating how the symptom-based testing paradigm misses cases and how routine testing may help public health officials address outbreaks more effectively.

A rack of test tubes containing MolGen PurePrep Buffers
MolGen monitoring workflow solutions 01.

The emergence of new, more transmissible variants that cause fewer symptomatic cases, such as the Omicron variant, increases the need for more regular monitoring, according to Kruize. “In diagnostics, scientists have long been aware that we need to move from incidental and individual diagnostic testing to regular interval testing for monitoring on a much larger scale,” he said.

To keep society open, Kruize said, individuals may need to be regularly tested — as often as twice per week. This testing will increase the chance of detecting a new infection before the individual becomes infectious and spreads the virus. Isolating the individual temporarily will then slow the spread of the virus.

However, there are several challenges to implementing regular interval testing at larger scales, said Kruize. Improving the public’s motivation to test regularly will be critical, he said. There are several barriers to public participation: nasopharyngeal and throat swabs are invasive and uncomfortable; testing can require an appointment at a testing center; some individuals have privacy concerns with how their test results are reported; and regular testing can be expensive.

For this to work, we will have to lift the barriers to mass PCR testing, make collecting a sample non-invasive, and make the costs to governments, employers, and individuals far more affordable,” he said.

To lift these barriers, Kruize recommends replacing invasive nasal and throat swabs with non-invasive saliva-based tests; making sample collection available at home, work, and other locations; using an anonymous mobile app to report test results to patients without the risk of data leaking; and industrializing PCR testing to reduce costs.

A laboratory technician operating MolGen equipment.
MolGen monitoring workflow solutions 02.

MoIGen’s MegaPrep workflow can address all of these four barriers, according to Kruize. MolGen’s Saliva Collection Kit mixes saliva with a stabilization lysis transport buffer. This tube can be either collected in a dropbox or can be sent in a safety bag to a lab where the PCR testing is performed. The barcode on the tube combined with a video recording of the sample collection in the MegaPrep app allows for non-invasive, safe, and anonymous sample collection. The MegaPrep workflow uses the same principles as any other COVID-19 extraction and PCR detection workflow but is implemented on an industrial scale. A combination of smart innovations in automation and massive parallel PCR can handle much larger amounts of samples in a shorter timeframe, and at lower costs, said Kruize.

“By making non-invasive testing available every three to four days, we are far more likely to detect an infected person before they become infectious,” said Kruize. Accommodating routine testing at the workplace, at the gym, and in schools can create what Kruize calls “green bubbles.” He said monitoring using large-scale PCR testing is the safest way to create and maintain these safe bubbles. “I’m excited about all the possibilities created by MegaPrep,” he said. “With non-invasive, cost-effective, and sensitive testing, MegaPrep will forge the future of testing and will be a key to unlocking our world.”

Find out more about MolGen here.

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This sponsored content is provided by an advertiser and published in collaboration with the GW Custom Solutions Group, a division of GenomeWeb. The content was not produced by the editors or reporters of GenomeWeb, 360Dx, or Precision Oncology News, and does not represent the views of these publications or GenomeWeb's parent company, Crain Communications Inc.