Nikolaj Skydsgaard & Jennifer Rigby

COPENHAGEN/LONDON – Many people find it annoying to have cotton swabs inserted into their nostrils or throats in order to check for COVID-19.

Two years after the outbreak, some health authorities in certain countries have begun to question the benefits of mass, repeated testing for infection control, especially when you consider the cost.

Denmark was the leader of these efforts, as it pioneered one among the best COVID testing programs in history. Now, lawmakers demand a closer examination of the effectiveness of that policy.

Jens Lundgren is a professor of infectious disease at Rigshospitalet University of Copenhagen and a member of the COVID advisory panel.

Japan avoided the need for large-scale testing but managed to survive the pandemic based upon infection and mortality rates. The testing has been reduced in other countries like Spain and Britain.

Yet, the repeated testing of entire cities is still a major part of China’s “zero-COVID” plan. China’s leaders threatened legal action against those who disagree.

Dale Fisher (chair of the World Health Organization’s Global Outbreak Alert and Response Network) stated that “We have to learn” and added, “We must all be willing to make mistakes.”

Following the identification of coronavirus in August 2001, WHO encouraged countries to conduct “tests, tests, and more testing” for all suspect cases. Scientists were able to monitor the spread of the virus and understand how it could cause severe illness.

Experts said that the Omicron variant is now the dominant Omicron variant, and there are more vaccines available and better treatments. Governments should therefore consider population sampling as a strategic policy.

Some officials warned that too much drastic action could make the world vulnerable to a virus still in development.

SIGNIFICANT COOSTS

WHO guidelines do not recommend mass screening for symptomatic patients. This is due to the high costs and lack of evidence.

Denmark ended up with similar death and case figures to those of other countries without as much testing. A majority of the parties in parliament have demanded an investigation into the policy.

    In the last two years, Denmark’s population of 5.8 million logged more than 127 million rapid and PCR tests, all provided free. According to the Danish Critical Supply Agency, Denmark has spent over 16 billion crowns (or $2.36 billion) in testing.

According to Our World in Data, the population of Norway’s neighboring country performed only 11 million PCR test, and Sweden had nearly double that number, with 18 million.

    Christine Stabell Benn, professor of global health at University of Southern Denmark, said Denmark’s strategy was expensive and results “undocumented”.

“The mass testing approach shifted the emphasis from where testing is really important: with the vulnerable.”

  Other experts – and the Danish government – said widespread testing reduced the transmission rate and helped people re-enter society, boosting the economy and their own mental health. A government report published in September showed that the economic impact was less severe than for other European nations.

In an email, Nick Haekkerup, Justice Minister, stated that “there is no doubt” about the economic and human costs associated with, for instance, an extended lockdown.

Evidence

A Danish study that was published in 2012 concluded that the isolation and testing of confirmed cases has helped to reduce transmission rates by as much as 25%.

Other disease experts question such estimates. Medical Virology published a review in March that examined the impact of mass screening programs using rapid tests to screen people who don’t have symptoms.

“Mass testing was supposed to stop pandemics in their tracks and reduce transmission by up to 90%. Angela Raffle from Bristol University Medical School is senior lecturer and worked closely with UK’s National Screening Committee.

Testing did not produce a greater benefit. There were many possible reasons, such as an unrealistic target or the imperfect tests. Also, many cases could not be isolated after positive tests were performed. An analysis in British Medical Journal (pre-Omicron) showed that 42.5% of those who had been tested for HIV stayed at home throughout the isolation period.

Free COVID testing in England is now available only to government workers and those who have certain conditions or are admitted to hospital. Other people, regardless of their symptoms, will have to pay to get tested or may be told to stay home until they feel better. 

According to some experts, such a pullback can be dangerous.

Madhu Pai is a McGill University professor of global health. She stated that testing was deliberately reduced in some cases because politicians decided to “move on” and eliminate all public health.

This will prove disastrous because it will catch us off guard in the event of a more deadly variant.