Biden admin steps up efforts to test Covid as Delta variant spreads

Now, midway into the second year of the pandemic, the Biden administration has shaken the leadership of the federal testing response. Michael Iademarco, who has led the HHS Covid-19 Testing and Diagnosis Working Group for the past seven months, is back at the CDC. Dean Winslow, a Stanford University professor of medicine specializing in infectious diseases, supports the task force, which was instrumental in planning Biden’s school testing efforts.

Jay Butler, CDC deputy director of infectious diseases, has been deployed to the office of the HHS deputy secretary for preparedness and response to help plan the government’s Covid-19 testing strategy as the pandemic evolves.

“This is a sign of how seriously we are taking testing issues now and also to think ahead and build the infrastructure we need for testing to prepare for the next pandemic,” said the head of HHS. “Fortunately, at the moment it looks like our vaccine is very effective against the variants, but we don’t know what will happen in the future. So we will need a very robust testing strategy and the execution of that strategy until the end of this pandemic. “

The federal government is exploring ways to ensure that the public-private partnerships that have been developed during the pandemic do not end when the current crisis does.

“In terms of financial arrangements, we are exploring what the industry needs to be prepared, much more prepared, for infectious disease emergencies before the next pandemic,” the HHS official said. “Much of the experience gained over the past year has created a program to expand the industrial base. “

Maintaining a stock of testing supplies – such as swabs, reagents, or tubes for transporting patient samples – appears to be an area of ​​interest.

“We are reviewing and discussing with the industry how best to prepare the industry as soon as possible” at the start of a future pandemic, the HHS official said.

The government is also trying to get companies to develop home diagnostic tests that can simultaneously test multiple respiratory viruses, including Covid-19. While the United States saw virtually no cases of influenza during the 2020-21 influenza season, public health laboratories are already preparing for the potential re-emergence of influenza this fall and winter alongside regional epidemics of Covid-19, Becker said. This could be tricky for doctors, as the early symptoms of both diseases can be similar.

NIH leads federal charge to support development new and better Covid-19 tests thanks to its rapid diagnostic acceleration program. It is expected to distribute an additional $ 100 million to support the commercialization of new test technologies before the end of 2021, said Bruce Tromberg, the NIH scientist leading the initiative.

“We have several manufacturers that we are working with as part of RADx to try to stimulate more approaches that can quickly assess variants,” he said. “You do a swab, you get it in your device, it could search for 27 interesting concern variants at the same time, without having to [genetic] sequencing.

Tromberg hopes the government will fund another round of RADx projects aimed at developing tests that can determine the durability of vaccine protection.

“If we are able to continue the program next year, it will be a significant expansion,” said Tromberg. “And we will find out in the next few months if we can continue. “

In the long term, a multi-year effort on Capitol Hill to develop an overhaul of how the United States regulates medical testing may shape the country’s ability to avoid the early pitfalls of the Covid-19 response. This includes confusion over how the FDA regulates different types of tests, such as those intended for use in a single lab versus those created for wider use. The legislation, called the VALID Act, would create a single regulatory framework for these two types of tests. It would also codify the ability of test manufacturers to market tests that meet basic precision standards in an emergency. while the FDA is doing a formal review.

An industry source said that one of the takeaways from the Covid-19 pandemic is that there is a public health benefit when the performance and availability of critical diagnostic tests are publicly shared, this which they said was a unique aspect of the Covid-19 pandemic.

“The real story is that transparency on existing tests, it turns out it matters a lot,” the industry source said. “The Covid tests were unusual in that we actually looked to understand which tests were actually available. “

But the current pandemic is not over. NIH’s Tromberg warned that even if cases of Covid-19 in the United States were brought under control, infections in other countries could give rise to potentially dangerous new variants – and testing will have to keep pace.

“We know the variants change over time,” Tromberg said. “And until we get the pandemic under control on a global scale, these variants that cook in other parts of the world are going to come back and bite us. “

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