Strategic testing approaches for targeted disease monitoring can be used to inform pandemic decision-making

PLoS Biol. 2021 Jun 17;19(6):e3001307. doi: 10.1371/journal.pbio.3001307. eCollection 2021 Jun.

Abstract

More than 1.6 million Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) tests were administered daily in the United States at the peak of the epidemic, with a significant focus on individual treatment. Here, we show that objective-driven, strategic sampling designs and analyses can maximize information gain at the population level, which is necessary to increase situational awareness and predict, prepare for, and respond to a pandemic, while also continuing to inform individual treatment. By focusing on specific objectives such as individual treatment or disease prediction and control (e.g., via the collection of population-level statistics to inform lockdown measures or vaccine rollout) and drawing from the literature on capture-recapture methods to deal with nonrandom sampling and testing errors, we illustrate how public health objectives can be achieved even with limited test availability when testing programs are designed a priori to meet those objectives.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control
  • COVID-19 Testing
  • Epidemiological Monitoring*
  • Humans
  • Pandemics* / prevention & control
  • Public Health
  • Resource Allocation
  • SARS-CoV-2 / isolation & purification
  • Sentinel Surveillance
  • United States / epidemiology

Grants and funding

The authors acknowledge support from the National Science Foundation (NSF) Ecology and Evolution of Infectious Diseases (EEID) program award Division of Environmental Biology (DEB) 1911962; Biotechnology and Biological Sciences Research Council (BBSRC) BB/T004312/1, and National Science Foundation (NSF) Division of Environmental Biology (DEB) COVID-19 RAPID awards number 2028301 and 2037885, the Huck Institutes for the Life Sciences at The Pennsylvania State University, the National Institutes of Health, the U.S. Department of Agriculture, Animal and Plant Health Inspection Service, and the U.S. Geological Survey. WJMP is funded by the Li Ka Shing Foundation. JRCP is supported by the Department of Science and Innovation and the National Research Foundation (NRF). Any opinion, finding, and conclusion or recommendation expressed in this material is that of the authors and the NRF does not accept any liability in this regard. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.