The University of Illinois implemented an aggressive testing campaign to reign in the spread of COVID-19. The operation involves testing the entire student body and faculty twice per week—around fifteen thousand tests each day. Students tested positive are alerted and quarantined while the school grants building and facilities access to those who test negative. This testing regime illustrates how to conduct a nationwide testing campaign to overcome the COVID-19 pandemic.
The saliva based tests used by the school were developed by a university research team. Tests are free and are available at 17 on campus testing centers. Students are typically alerted of their test results within five hours of administration. Tests are being processed 24 hours a day on weekdays and nearly all day on weekends.
If a student or faculty member tests positive, they receive an alert immediately and must quarantine immediately. Additionally, the University allows students to enable bluetooth settings to track if they have been in close contact with a recently confirmed positive case. Those students are alerted and required to test immediately. A University app tied to student IDs moderates the whole process. This app also acts as a key to give negative students access to campus buildings and resources.
How are these advances applicable to a nationwide project? It first shows that wide scale testing protocols are possible and effective. In a recent CNN article, I wrote about a testing plan to contain COVID-19. This plan includes testing the entire US population every three days, or about one hundred million tests per day. Simulations of this plan suggest eighty percent cuts in transmission.
The University of Illinois is seeing similar results in its reduction of transmission. After students returned to campus, positivity rates peaked at 2.86 percent due to off campus parties and ignored isolation guidelines. After a week of testing and enforced isolation guidelines, the University reduced the positivity rate to one percent and officials anticipate a rate of .5 percent in the coming weeks. That is a 65 to 85 percent reduction in positivity over a couple weeks. With a national testing regime, there could be a similar reduction seen.
Second, these campus tests utilize saliva samples rather than nasal swabs. Citing a Yale study from April, campus researchers concluded that saliva samples are more sensitive and more quickly administered, without the help of a healthcare worker. Saliva based tests are essential to a national testing regime. Tests must be home based and self administered to ensure ease of use.
Third, the University is able to deliver results on the same day. A nationwide testing protocol would hinge on rapid antigen testing and results in minutes. The slowdown at the University of Illinois is lab processing, which takes a few hours. Even with the hurdle of running tests through a lab, students and faculty still typically receive their results in about five hours. Breakthroughs in antigen testing by Abbott Laboratories and others are putting twenty minute tests into production at this moment. Same day results are encouraging, but same hour results are necessary.
A lacking aspect of the University plan that is essential to a successful nationwide effort is assisted isolation. Individuals and families forced into quarantine due to a positive COVID-19 test do not stop having bills, stop having to pay rent, or stop buying food for their children. Isolation must be economically feasible for this strategy to succeed. The government would need to guarantee food, medical supplies, and shelter if necessary.
The current positivity rate in the United States hovers around five percent. Reducing that by a simulated eighty percent would bring that down to one percent. That rate could optimistically go down to .5 percent if The University of Illinois is a valid preview of what could be. There must be aggressive action taken nationwide as we have seen at this university. The health of millions are at stake.