Dr. Birx Calls For Mandatory COVID Testing and ‘Sentinel Surveillance’

Washington, District of Columbia

By Kate Michael

Dr. Deborah Birx, response coordinator for the White House Coronavirus Task Force, made an appearance at the National Association of Counties’ Virtual Policy Summit to explain her current prioritization of developing a critical understanding of virus spread on a community level. 

Dr. Birx
White House Coronavirus Response Coordinator Ambassador Debbie Birx speaks on the coronavirus COVID-19 pandemic with members of the Coronavirus Task Force March 26, 2020 at the White House in Washington, D.C. (Yuri Gripas/Abaca Press/TNS)

“It always struck me that we’re always responding to the last issue we had,” Birx said, determined instead to use lessons and observations to scale response and get consistency across the country. 

Now in the nation’s third cycle — Birx identified March and April as “the large metropolitan epidemic” in the U.S. and a “summer surge across the South driven by early silent spread from individuals that were asymptomatic” as predecessors — the doctor claims she is learning most from communities of college students about where to focus our national energies next.

She’s concentrating on testing “because we know what mitigations work,” and setting up an alert system.

“If you’re seeing cases, you have asymptomatic spread in your community,” Birx said. And college campuses have served as a great testing ground to prove her theory.

Colleges that allowed students to return to campus were divided largely between two groups: those that perform symptomatic testing and contact tracing, and those that mandate a test for all students once a week, if not more often. 

“When you compare the two, those that just had symptomatic testing had over 10% infected,” Birx claimed, “while those that made testing mandatory and were pulling out the asymptomatic cases tested positive at less than 1%.” 

She cited the asymptomatic level for individuals under 30 as 75 – 80%. 

“If you’re only finding that one in seven [case] because they’re asymptomatic, you’re missing that early spread. This is a lesson to all of us that we need to realign testing… and incentivize testing among those asymptomatic.” 

To do this, Birx calls for “sentinel surveillance for the community” which she described as asking certain key community individuals, like nurses, police officers, or teachers, to step forward and test weekly. 

“Every county needs to understand what individuals could be routinely tested so we could find that silent spread. If you stop asymptomatic spread, you stop the infection of the community.” 

What’s more, Birx believes that individuals will change their behaviors if they know they will be tested, and she claims mandatory college testing has proven this to be the case. 

“Students knew what was risky in their communities and altered their behaviors so they could return to campus. Also, no student wants to put their friends into quarantine,” she said. 

She suggested that a huge motivator would be finding something important to a community at a hyper-local level, like attending high school sporting events in West Virginia, and linking its availability to testing and reduced virus spread.

Says Birx: “I’ve found that people around the world are very responsible if they have the information to make clear choices.” 

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