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The first phase of the economic response to the COVID-19 pandemic is already under way with measures that, while costly, are relatively ‘easy’. The second phase – restarting the economy – involves the more challenging task of overcoming people’s fears of contracting the virus from a co-worker. This column describes how a combination of two currently available tests could identify people who are both free from COVID-19 and immune to it, and thus are safe to go back to work. A targeted scaling-up of procedures for both tests will help maintain vital services and accelerate the relaunch of the economy, while minimising the risk of the epidemic recurring after restrictions are lifted.
Serology, which ELISA3 tests for SARS-Cov-2 specific antibodies, allows the detection of protected individuals who have been infected by the virus and have recovered. In contrast, RT-PCR4 tests, which are based on an RNA diagnostic, detect the presence of the viral genetic material and are only valid just before and during the infection.
If easy-to-use COVID-19 antibody assays applicable via finger prick samples (e.g. Biomerica Inc.) are rapidly proven to be reliable and certified, they might be used in conjunction with FDA-approved point-of-care viral RNA testing (Xpert? Xpress SARS-CoV-2, Cepheid Inc.) to implement the suggested two-step screening on a large scale.