The value of random testing
DeCODE’s model stands in sharp contrast to that of the U.S. and most countries in Europe, where only those who show clear signs of infection have been tested for the coronavirus. “If you don’t have symptoms, you don’t need a test,†Vice President Mike Pence said in a press conference on Sunday. Similar advice comes from the Centers for Disease Control and Prevention, whose website notes, “[N]ot everyone needs to be tested. Most people have mild illness and are able to recover at home.â€
Stefánsson, 70, who was a professor of neurology at Harvard University before returning to his homeland to launch his company in 1996, rejects that strategy. He believes it leaves governments unable to understand how to control the spread of the coronavirus, since they have too little data to track its origins.
Until they do random testing, he says, “they do not have the faintest idea of how and why it is spreading in the society,†he says. “It is as simple as that.â€
Stefánsson says that when Iceland began testing people in February, it expected to find infections among those who had returned from skiing trips to the Alps during the winter vacation, because an outbreak was then beginning in Italy and France’s Alpine region. Indeed, public health authorities did find infected vacationers. But Iceland also found a cluster of infections among people who had returned from England, as well as one from the U.S.—each of which presented with a separate mutation of the coronavirus. “As of yesterday, we have sequences for about 380 viruses,†Stefánsson says. The company plans to release the data on those mutations in the form of public databases this week.
Amid the fraught debate over self-quarantining, Iceland has remained curiously calm. It has no lockdown laws in place, simply urging people to remain at home if possible. Elementary schools remain open.
Rather than stress self-distancing above all, the focus has been on testing. “All countries should listen to the World Health Organization and follow the example of Iceland when it comes to the mantra ‘Test, test, test,’†former Prime Minister David Gunnlaugsson wrote in Britain’s The Spectator on Tuesday. He called the country’s testing strategy “virtually unparalleled anywhere in the world.â€
Of course, Iceland’s minuscule population makes it far easier to test there than in most other countries—including even South Korea, where the swift control of the coronavirus among its 50 million people is credited in large part to the government’s aggressive testing and quarantine strategy. In an email, Iceland’s Health Ministry tells Fortune the country has tested a far higher proportion of its population than South Korea has, “yielding valuable insights into the behavior of the virus.â€
DeCODE—and Iceland in general—is in an exceedingly rare position in its ability to analyze its findings on the coronavirus, and perhaps detect what makes some people more susceptible to infection and illness. That could be hugely valuable for scientists as they race to develop treatments and vaccines, and try to stave off any future coronavirus outbreak.
Since launching 24 years ago, deCODE has mapped the DNA of more than half the population of Iceland, “and we can infer data from the other half,†Stefánsson says. “We are in a reasonably good position to begin to explore if the susceptibility to the infection is in part genetically dictated,†he says. As scientists compare the DNA in deCODE’s data banks with the results of Iceland’s random coronavirus testing, the possibilities might begin to emerge.
“We are working on that, trying to generate a set of overlapping data,†Stefánsson says. “I don’t think there is another place where there is data like this.â€
https://fortune.com/2020/03/27/coron...ovid-19-tests/
Quite a contrasting approach when compared to Japan's
https://www.vox.com/covid-19-coronav...ths-quarantineBut experts saythe true number of cases in the country almost certainly exceeds 1,400. The government has been criticized for its strict testing criteria, which requires patients to have had a fever of greater than 37.5 Celsius (99.5 F) for more than four days, unless the patients are elderly, have other underlying health conditions, or are connected to a previously confirmed case. Some people who meet the criteria have been denied tests.Even the United States’ badly flawed and belated testing effort eclipses Japan’s minuscule effort — as of March 20, the US had conducted 313 tests per million people compared to Japan’s 118 tests per million people. Japan is using just 15 percent of its supposed testing capacity of 7,500 tests per day. South Korea, widely praised for its drive-through testing measures, is conducting more than 6,000 tests per million people.
The Japanese National Institute of Infectious Diseases has argued that the strict testing criteria are in place to preserve limited medical resources for those in need of urgent care. “Just because you have capacity, it doesn’t mean that we need to use that capacity fully,†health ministry official Yasuyuki Sahara told the press in a briefing last week. “It isn’t necessary to carry out tests on people who are simply worried.â€
Abe’s governmentis going directly against the WHO’s firm recommendation to “test, test, test,†leading many to conclude that the coronavirus may be far more widespread in Japan than the numbers indicate.