Retrospective look at rapid Covid testing

To be clear, I still favor rapid Covid tests, and I believe we were intolerably slow to get these underway.  The benefits far exceed the costs, and did earlier on in the pandemic as well.

That said, with a number of pandemic retrospectives underway, here is part of mine.  I don’t think the strong case for those tests came close to panning out.

I had raised some initial doubts in my podcasts with Paul Romer and also with Glen Weyl, mostly about the risk of an inadequate demand to take such tests.  I believe that such doubts have been validated.

Ideally what you want asymptomatic people in high-risk positions taking the tests on a frequent basis, and, if they become Covid-positive, learning they are infectious before symptoms set in (remember when the FDA basically shut down Curative for giving tests to the asymptomatic?  Criminal).  And then isolating themselves.  We had some of that.  But far more often I witnessed:

1. People with symptoms taking the tests to confirm they had Covid.  Nothing wrong with that, but it leads to a minimal gain, since in so many cases it was pretty clear without the test.

2. Various institutions requiring tests for meet-ups and the like.  These tests would catch some but not all cases, and the event still would turn into a spreader event, albeit at a probably lower level than otherwise would have been the case.

3. Nervous Nellies taking the test in low-risk situations mainly to reassure themselves and others.  Again, no problems there but not the highest value use either.

So the prospects for mass rapid testing — done in the most efficacious manner — were I think overrated.

I recall the summer of 2022 in Ireland, which by the way is when I caught Covid (I was fine, though decided to spend an extra week in Ireland rather than risk infecting my plane mates).  Rapid tests were available everywhere, and at much lower prices than in the United States.  Better than not!  But what really seemed to make the difference was vaccines.  The availability of all those tests did not do so much to prevent Covid from spreading like a wildfire during that Irish summer.  Fortunately, deaths rose but did not skyrocket.

The well-known Society for Healthcare Epidemiology just recommended that hospitals stop testing asymptomatic patients for Covid.  You may or may not agree, but that is a sign of how much status testing has lost.

Some commentators argue there are more false negatives on the rapid tests with Omicron than with earlier strains.  I haven’t seen proof of this claim, but it is itself noteworthy that we still are not sure how good the tests are currently.  That too reflects a lower status for testing.

Again, on a cost-benefit basis I’m all for such testing!  But I’ve been lowering my estimate of its efficacy.