johnson132_Sakis MITROLIDIS  AFP) (Photo by SAKIS MITROLIDISAFP via Getty Images_covid testing Sakis Mitrolidis/AFP via Getty Images

After the Vaccine

For some childhood diseases, the development of a vaccine was by itself decisive. But this may not be true of COVID-19, because adoption will be slow, effectiveness will wane over time, or both, implying that the need for testing will be ongoing.

WASHINGTON, DC – There is a growing consensus that one or more COVID-19 vaccines will become available at some point in early 2021. Within a year, many people in the United States, and some other countries, will be vaccinated. For some childhood diseases, the development of a vaccine was by itself decisive. But this may not be true of COVID-19, because adoption could be slow or effectiveness wane over time – or both.

In that case, the need to test people both for individual safety and to prevent outbreaks will be ongoing. The long-term problem with testing is already evident: the cost per test is high. In health-care systems where scarce medical resources are allocated on a fee-for-service basis, such as in the US, this means that many people cannot afford to get tested. In addition to progress toward a vaccine, we need to make virus testing at scale much cheaper, so that it becomes available to everyone, whatever their income level.

Currently, the untested in the US include most children attending public primary and secondary schools, as well as the teachers and others who work in those schools. They also include millions of older people, including those living in low-income housing (known as Section 202 housing). This lack of access to testing is a major economic and moral issue that will not go away.

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