Image caption: A CU Boulder student provides a saliva sample for a rapid COVID-19 test. CU is among several institutions developing new tests which can provide faster-turnaround results.   

每周对一半的人进行廉价的测试, rapid-turnaround COVID-19 tests would drive the virus toward elimination within weeks—even if those tests are significantly less sensitive than gold-standard clinical tests, according to a new study published 11月ember 23 by CU Boulder and Harvard University researchers.

Such a strategy could lead to “personalized stay-at-home orders” without shutting down restaurants, 酒吧, 零售店和学校, 作者说.

“博彩平台推荐的重大发现是, 当涉及到公共卫生时, it’s better to have a less sensitive test with results today than a more sensitive one with results tomorrow,首席作者丹尼尔·拉雷莫尔说, 他是博彩平台推荐计算机科学助理教授. “Rather than telling everyone to stay home so you can be sure that one person who is sick doesn’t spread it, we could give only the contagious people stay-at-home orders so everyone else can go about their lives.”

这项研究发表在杂志上 科学的进步, Larremore teamed up with collaborators at CU’s BioFrontiers Institute and the Harvard T.H. 陈氏公共卫生学院探讨是否检测敏感性, 频率, 周转时间对于遏制COVID-19的传播至关重要.

的 researchers scoured available literature on how viral load climbs and falls inside the body during an infection, 当人们出现症状时, 当它们具有传染性时.

的y then used mathematical modeling to forecast the impact of screening with different kinds of tests on three hypothetical scenarios: in 10,000 individuals; in a university-type setting of 20,000 people; and in a city of 8.400万年.

在遏制传播方面, they found that 频率 and turnaround time are much more important than test sensitivity.

传染性降低80%

例如, 在一个大城市的场景中, widespread twice-weekly testing with a rapid but less sensitive test reduced the degree of infectiousness, 或者R₀ (“R零”)，病毒的80%. 但 twice-weekly testing with a more sensitive PCR (polymerase chain reaction) test, 这需要48小时才能得到结果, 传染性只降低了58%. 在其他情况下, 当测试量相同时, 快速检测总是比慢速检测更能降低传染性, 更灵敏PCR试验.

That’s because about two-thirds of infected people have no symptoms and as they await their results, 他们继续传播病毒.

“This paper is one of the first to show we should worry less about test sensitivity and, 当涉及到公共卫生时, 优先考虑频率和周转,资深合著者罗伊·帕克说, director of the BioFrontiers Institute and a Howard Hughes Medical Institute investigator.

的 study also demonstrates the power of frequent testing in shortening the pandemic and saving lives.

在一个场景中, 其中一个城市4%的人已经被感染, rapid testing three out of four people every three days reduced the number ultimately infected by 88% and was “sufficient to drive the epidemic toward extinction within six weeks.”

的 study comes as companies and academic research centers are developing low-cost, rapid turnaround tests that could be deployed in large public settings or commercialized for do-it-yourself use.

敏感程度差别很大. 抗原测试需要相对较高的病毒载量——大约1,与检测感染的聚合酶链反应(PCR)测试相比，多出了000倍的病毒. 另一个测试叫做 RT-lamp (逆转录环介导的等温扩增), 能检测出比PCR多100倍的病毒吗. 的 benchmark PCR test typically provided by medical professionals requires as little as 5,000 to 10,每毫升样本有000个病毒RNA拷贝, 这意味着它可以很早或很晚感染病毒.

在过去, federal regulators and the public have been reluctant to embrace rapid tests out of concern that they may miss cases 感染早期. 但, 在现实中, 一个被感染的人可以从5,在18到24小时内，000个颗粒变成100万个病毒RNA拷贝, 说帕克.

“窗口期很短, 感染早期, in which the PCR will detect the virus but something like an antigen or LAMP test won’t,帕克说.  

他说，在这段时间里，这个人通常不会传染. 的 authors recently used these findings to call for a shift in the way we think about test sensitivity in 的 新英格兰医学杂志.

“这些快速测试是传染性测试，”资深合著者Dr. 迈克尔·米纳(Michael Mina)是哈佛大学流行病学助理教授.H. 公共卫生学院陈教授在接受采访时表示 今天的科罗拉多大学. “的y are extremely effective in detecting COVID-19 when people are contagious.”

他补充说，他们也负担得起. 这种快速检测每次只需花费1美元，15分钟内就能得出结果. 一些PCR检测可能需要几天时间.

每个家庭都可以做便宜的DIY测试

米娜设想有一天政府会派简单的, 廉价的DIY测试在美国的每一个家庭. Even if half of Americans tested themselves weekly and self-isolated if positive, 结果将是深远的, 他说.

“Within a few weeks we could see this outbreak going from huge numbers of cases to very manageable levels,米娜说。.

Rapid testing could also be the key to breathing life back into former superspreader threats like football stadiums, 音乐会场地和机场, with patrons testing themselves on the way in and still wearing masks as a precautionary measure, Larremore说.

“不到 .1% of the current cost of this virus would enable frequent testing for the whole of the U.S. ”米娜说，她指的是一项人口普查 近期经济分析 由国家经济研究局发布.

的 authors say they are heartened to see that several countries have already begun testing all of their citizens, 并希望新的美国.S. 政府已将快速检测列为优先事项. On Tuesday, the Food and Drug 政府 approved the first at-home rapid test.

“It’s time to shift the mentality around testing from thinking of a COVID test as something you get when you think you are sick to thinking of it as a vital tool to break transmission chains and keep the economy open,拉雷莫尔说.