COVID-19: AMA asks HHS to reconsider testing priorities

By John McKenna
Published August 19, 2020

Key Takeaways

The AMA, along with other public health organizations, asked Health and Human Services (HHS) Secretary Alex Azar to make changes to Covid-19 testing prioritization guidelines to ensure that testing supplies are reserved for those who need them.

"In light of surging demand for non-medically indicated tests, updating prioritization guidelines would ensure testing capacity for those with Covid symptoms, known exposures, and those in need of pre-procedure testing," the AMA wrote in a press release, citing strain on the supply chain for testing supplies, lack of access to PPE, ongoing staffing issues, and an ever growing number of incoming patients seeking Covid-19 testing.

"As the country continues to struggle to provide laboratories with a consistent supply of reagents, viral transport media, plastics (such as a pipette tips), and other items essential to providing both Covid-19 and non-Covid-19 testing, we recommend that the Administration consider updating testing prioritization guidelines to ensure that the limited testing resources available are directed at those with a medically-indicated need for tests and those identified by well-defined public health surveillance efforts," the AMA wrote in its letter to Secretary Azar. "Updated guidelines are critical to manage the ever-increasing demand for Covid-19 testing, as it has been made clear that, despite the best efforts of many, no additional manufacturing capacity for many testing supplies is likely to be available through the remainder of this year. Updated guidelines will also allow physicians and laboratories to better manage the surging demand for non-medically indicated tests, as the current capacity will not be able to meet all demands.

The AMA put particular emphasis on a growing number of asymptomatic individuals seeking testing, such as employees hoping to return to work, students returning to colleges, and individuals engaging in non-essential travel.

"Without improvement in available supplies, we simply do not have the resources to meet the huge demand for testing by asymptomatic individuals without exposure to Covid-19," the AMA wrote. "Therefore, we recommend that the Administration consider updating its testing prioritization guidelines to ensure that those with a medically-indicated need for Covid-19 diagnostic testing, such as those with Covid-19 symptoms, those with known exposures to Covid-19, and those in need of pre-procedure testing can have ready access to testing services and timely return of test results."

The AMA also suggested that any changes to the guidelines include a "well-designed surveillance strategy" that can achieve current surveillance goals while also managing testing resources — the organization also pointed to rapid screening tests designed for at-home or at-point-of-care administration can help reduce the strain on health care facilities and help in re-opening efforts.

"During critical public health emergencies, where a rapidly spreading novel pathogen presents a significant risk to the health and wellbeing of those infected, limited testing resources must first be directed towards those who need them most—those at immediate risk of infection and serious illness," the AMA wrote. "Outside of necessary public health surveillance strategies, limited resources should not be utilized by those with no symptoms or known exposure and whose needs could be equally served by following quarantine measures. Without adequate testing capacity to rapidly serve those with a medically indicated need for testing, we risk continued widespread transmission of this disease. We also threaten the ability of healthcare facilities to continue to offer critical medical services to those in need of care."

The AMA was joined in signing the letter by 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, and the Infectious Diseases Society of America.

This article first appeared on BreakingMED.

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