Testing Strategy

Labs to HHS: Since We Can’t COVID-19 Test Everyone, Let Us Prioritize the Symptomatic

Labs continue to lack the resources necessary to meet the demands for timely COVID-19 testing. In July, industry groups called on the White House to take control and resolve, or at least allay the reagent shortages and supply chain bottlenecks that have dogged testing efforts since the crisis began (See NIR, July 20, 2020). But now that seems to be off the table with labs being told not to expect any relief on the supplies front for at least the remainder of the year. So, the industry is moving to Plan B: figuring out how to prioritize the testing resources it does have available until the supplies challenges are resolved. And they’re once more asking the Administration for help.

Labs to HHS: Help Us Prioritize Testing Services

On Aug. 11, seven healthcare organizations sent a letter to the US Department of Health and Human Services (HHS) asking the agency to update COVID-19 testing prioritization guidelines. “We are increasingly concerned about the serious strains being placed on testing services for COVID-19, the impact those strains have on our ability to provide timely medical care to our patients, and ultimately on our ability to contain the spread of this dangerous virus,” the letter begins.

“Without improvement in available supplies, we simply do not have the resources to meet the huge demand for testing.” Accordingly—and in bold face—the letter calls on the Administration to update its testing prioritization guidelines.

Prioritize the Sick Over the Asymptomatic

Specifically, the organizations want clarification that for as long as there aren’t enough supplies to test everyone, prioritization should be placed on those with medically indicated need for COVID-19 testing, including persons who are symptomatic, have known exposures to the virus and/or in need of pre-procedure testing.

While acknowledging society’s need for broad testing for performing medical surveillance and ensuring safe reopening, the letter recommends that testing of asymptomatic individuals without exposure to COVID-19 be assigned a lower priority. “During critical public health emergencies. . . limited testing resources must first be directed towards those who need them most—those at immediate risk of infection and serious illness,” urges the letter.


And, so it’s come to this. After months of warnings, finger points and political claims, the clinical leaders of the lab industry are making it plain that they don’t have the supplies to test everyone who wants to be tested and that the problems will continue until at least through the end of the year. Having failed to resolve the supplies shortage, it’s now up to the powers that be to clarify who should get tested so that physicians and labs know how to make the right “Sophie’s Choice” testing decisions they face in the months ahead. 

The 7 Signatories

The signatories to the HHS letter requesting COVID-19 test prioritization guidance was signed by seven of the most powerful and respected medical and lab organizations in the US, including:

  • The American Medical Association
  • The American College of Medical Genetics and Genomics
  • The American Society for Clinical Pathology
  • The Association for Molecular Pathology
  • The Association of Pathology Chairs
  • The College of American Pathologists
  • The Infectious Diseases Society of America



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