A modern healthcare system should invest in diagnostics and testing

As more and more COVID-19 vaccines are approved around the world, our hopes of life returning to normal are rising. At some no longer unforeseeable point, we will be able to throw away our masks and hug our nearest and dearest again. But we should stick with one custom the pandemic has bred: testing for disease like never before. That’s because the pandemic proved the value of testing. It allowed doctors to quickly detect, isolate, treat and trace those infected with the SARS-CoV-2 pathogen. Testing saved innumerable lives.

For sure, many testing and tracing systems were overwhelmed, especially at the beginning of the pandemic. But COVID-19 quickly saw the testing industry step up to the incredible challenge of increasing output in huge magnitude and in record time – many thousands more devices that can now be used to fight other infectious diseases and cancers better and quicker.

Leveraging testing capacity

Between the end of March 2020 and January of this year, the number of tests conducted for SARS-CoV-2 in the United States rose from around 100,000 to over 2 million a day. This 20-fold increase came from genetic-testing machines, from devices testing for antigens and antibodies, and next generation sequencing. So-called PCR machines, for example, took the tiniest fragment of human material and sifted for the genetic markers of SARS-CoV-2 – and can now be used to hunt for the viruses, bacteria, parasites and fungi driving common public health problems, as well as cancer mutations, genetic defects, and autoimmune diseases.

Ours would be a healthier world if we seized the chance. Modern testing has traditionally been undervalued and underestimated. While 66 percent of treatment decision-making was based on so-called in-vitro diagnostics, only 2.3 percent of US healthcare expenditure went into buying these regulated testing devices, according to a 2016 report published by the science journal PLoS ONE. After the recent scramble to upgrade testing infrastructure, testing and treatment should be able to work even more effectively together in the future.

More testing saves resources

More testing and early and targeted treatment decisions would save money that could be invested elsewhere. The National Bureau of Economic Research last fall modeled different US mass-testing scenarios for SARS-CoV-2 and found that the macro-economic benefits would outstrip the costs of the various regimens by four to fifteen times. The micro-economic potential is just as remarkable: a $200 dollar test can determine whether patient a will respond to colorectal cancer treatments that can cost up to $100,000 per cycle.

On top of that, the molecular diagnostics industry innovates constantly. Tests have become faster – analysis times have fallen from hours down to minutes – and they have become more accurate. Testing has moved out of the laboratory to the patient’s bedside – with compact portable instruments that sit in a hospital ward or doctor’s office. And getting samples has become less invasive. Spitting into a tube has joined the dreaded nasopharyngeal swabs, while cancer tests don’t only require a painful and costly tissue biopsies anymore, but can use blood to detect traces of tumors.

More prevention in the future

Testing is knowledge and knowledge is power – the power to trigger early-stage treatment that reduces usually more complicated and expensive late-stage interventions. Testing gives doctors and patients critical insights at every stage of medical care – from prevention via detection, diagnosis to treatment. As we return to some kind of normal, we should embrace testing as a key part of targeted, evidence-based and more preventative medicine that can save millions of lives and billions of dollars – and help to avert the next pandemic.