First It Was Masks; Now Some Refuse Testing for Coronavirus

SARS-CoV-2 Testing Hesitancy Could Hamper Mitigation Efforts This Medical News feature examines the problem of people refusing to be tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). JAMA_current

At a September webinar entitled, “Until We Have a COVID-19 Vaccine,” epidemiologist Michael Osterholm, PhD, MPH, expressed concerns about insufficient testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the US.

The problem has morphed from inadequate testing capacity to inadequate numbers of people agreeing to be tested, said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

In the pandemic’s early weeks, when a shortage of tests meant that mainly hospitalized patients were being tested, the demand was greater than the supply. Months later, laboratories have greater testing capacity, but in some states, testing rates have dropped as cases have increased.

Test avoidance appears to be a growing problem, at least anecdotally. Many of the same people who dismiss the need to test feel the same way about wearing a mask, in part because they think no one has the right to tell them to do either.

“There are challenges with the messaging, from the top to the bottom,” said Charity Menefee, MA, director of communicable and environmental disease and emergency preparedness at the Knox County Health Department in Tennessee. “The [pandemic] fatigue has set in; the politics have gotten more intense.”

Testing is a key component of contact tracing, and only testing can reveal whether flulike symptoms are due to influenza or to the much more contagious and deadly SARS-CoV-2.

But most states aren’t performing enough tests, as evidenced by their 7-day average positivity rates, according to the Johns Hopkins Testing Tracker. As of October 23, only 16 states and the District of Columbia had a positivity rate of 5% or lower, which the World Health Organization has said jurisdictions should achieve for at least 14 days before reopening. ...