What are the testing considerations for the next steps in the pandemic?

A main focus for diagnostics will now be the ongoing monitoring of emergent strains. As discussed, this will be essential to ensure that the global rollout of vaccines is successful and to help the international community emerge from the pandemic.101Currently, as most NAATs detect several SARS-CoV-2 genetic targets, it is considered unlikely that mutations will lead to false-negative results; however, the FDA have requested that laboratorians are mindful that this may occur.103
Standardization of Ct values or fully standardized quantitative NAATs for SARS-CoV-2 will be extremely useful to assess efficacy of interventions in COVID-19 patients, to help determine when individuals are safe to leave quarantine and staff are safe to return to work.104 Development of reference material to enable standardization of these assays is recommended.
The data regarding the relationship between diagnostic parameters and infectivity is currently limited, and research is ongoing in this area to clarify exactly how these parameters correlate. Recommendations on the most appropriate diagnostic test for different utilities may change once more information is available on these points.
The use of alternative sample types to the nasal pharyngeal (NP) swab, such as saliva, and the use of new technologies, such as CRISPR-based tests, are under investigation, and these may also provide different opportunities for testing and additional considerations (e.g. those concerning school populations or mass testing of large groups).30,43,105,106 Self-sampling methods that provide increased sensitivity could broaden the capacity for mass testing prior to events or entering the workplace.27As it will take time before vaccination will be able to eradicate COVID-19, testing measures will continue to be important.