The first case of novel Coronavirus was detected on December 31, 2019 in Wuhan, China. Since then the respiratory disease causing virus has spread rapidly across the globe and was officially declared a pandemic on March 11, 2020 by the World Health Organization (WHO). According to Johns Hopkins Coronavirus Resource Center, there are now almost 838,061 confirmed cases in 180 countries.
Coronavirus, which causes COVID-19, poses an extreme risk for health infrastructure globally. A spike in cases in several countries has threatened to overwhelm the capacity of health systems with the need for more ventilators, staff, personal protective equipment (PPE) and ICU hospital beds. National governments have approached the crisis differently with differing levels of success; however, at the root of the most effective responses is the widespread availability of testing. Testing is of paramount importance since there is strong evidence that suggests that people can spread COVID-19 when they are mildly sick or presymptomatic. Testing is the only way to identify these cases and isolate them before they spread.
South Korea, in particular, has been held up as one of the most successful examples of disease containment as new cases begin to slow. This is especially impressive in light of the fact that they have not had to take extreme measures such as ‘shelter-in-place’ mandates or orders for complete lockdowns like so many other countries dealing with the pandemic. Testing aggressively was central to South Korea’s effectiveness as health officials were able to detect cases early, isolate them, and employ contact tracing to prevent further spread. They have also employed creative solutions to safely and rapidly test large volumes of people such as drive-through and phone booth testing facilities. These methodologies reportedly deployed double the number of tests per hour as indoor clinics. In Germany, currently the 5th most affected country globally, a lower than average fatality rate has also been attributed to extensive testing availability.
Premise Global Impact Study on Testing Option and Best Practices
On March 15th, Premise launched a task surveying ‘Testing Options and Best Practices’ across 83 countries and has since received 91,517 responses. Globally only 40% of respondents were certain that testing was available in their area, but of that, 78% of respondents claimed that they knew where exactly to get tested. 84% reported that they were Likely or Extremely Likely to get tested if they started exhibiting symptoms of Coronavirus, yet the United States, currently the global leader in terms of confirmed cases, had a much lower response rate to this question at 78%.
For those who did not respond with an affirmative likelihood of testing, when asked ‘What is the primary reason you may not get tested for Coronavirus?’ the most common response related to intent to self-quarantine. However, the second most popular response was ‘I’m concerned about government agencies having access to my health information.’ This indicates mistrust of the government and the health system which will definitely pose a challenge with a pandemic that requires such a strong public health response.
When looking at available testing locations the majority were reported to be located in typical health care settings such as hospitals, health departments and clinics. Reports of more non-traditional testing facilities such as drive-through testing and temporary testing locations were reported at 15% and 13% respectively. This could indicate that some areas are beginning to take a more inventive and scaled approach to testing that has shown positive results in South Korea. Worldwide around 45% of respondents reported that testing was increasing in their community, while just under 38% said they were unsure.
The United States currently has the most confirmed cases globally with over 177,452 and 3,440 deaths. For this survey, there were 3,936 respondents from across all 50 states and the District of Columbia. 36% of respondents knew for sure if testing was available in their city and of those respondents 69% knew exactly where they could go to get tested. As mentioned previously, 78% of respondents said they would get tested if they exhibited symptoms. Of those who would not get tested 36% reported that they would just self-quarantine instead. 42% of respondents from the U.S. also reported the availability of drive-through testing in their area which could point to more rapid and widespread testing capabilities on the horizon.
Case Study on Vietnam
An interesting comparison to the United States is the data we received from Vietnam. Sharing a border with China one might expect a high number of cases, but currently, Vietnam only has 207 confirmed cases and no deaths due to Coronavirus. Unlike wealthier Asian countries, Vietnam does not have the resources for a mass testing campaign yet they have been successful in containing COVID-19 through swift action, easy access to public health information, and strategic dissemination of testing. According to our survey 52% of respondents know for certain if testing is available and 87% know exactly where to go to receive testing. 86% of are Likely or Extremely Likely to get tested if they exhibit symptoms and 66% of respondents reported an increase in testing in their area.
The U.S. has become the global epicenter of the pandemic as it surpassed both China and Italy for most confirmed cases. While the total number of tests distributed is higher in the United States than South Korea, proportional to the population we’ve only given one test for every 786 people compared to a 1:142 ratio across the Pacific. While the number of tests distributed is increasing, it is clear that a top priority globally should be the rapid proliferation and strategic deployment of testing so we can truly understand the reality of what we are dealing with and respond accordingly.
Premise will continue to follow trends in perception, knowledge and attitudes towards testing so check back soon for continued updates. You can track our work on COVID-19 here: www.premise.com/COVID-19