CEO SUMMARY: After 15 months of the pandemic, the nation’s clinical laboratories are at an interesting crossroads. Is the COVID-19 outbreak diminishing and close to disappearing? Or might it intensify again, particularly when the traditional influenza season arrives next fall? There has been an 82% drop in the daily number of molecular COVID-19 tests since January. To help clinical laboratories plan for the future, The Dark Report surveys key trends in the current COVID-19 pandemic.
WILL THE COVID-19 PANDEMIC EMULATE THE CLASSIS ADAGE that “if March comes in like a lion, it will go out like a lamb?”
The pandemic certainly “came in like a lion” when it hit the United States, and the entire world, with full force in March 2020. Every aspect of clinical care and normal human activity was disrupted. Clinical laboratories played a key role in ramping up the SARS-CoV-2 testing required to respond to the pandemic.
Now, 15 months later, there is growing evidence that COVID-19 could possibly “go out like a lamb.” If true, this has many clinical, operational, and financial implications for clinical laboratories and pathology groups.
In particular, labs have the pressing need to predict what volume of COVID-19 molecular tests will be needed in their communities for the balance of the year. An accurate prediction is essential to drive planning, staffing, spending, and revenue.
As clinical lab administrators and pathologists conduct planning and develop strategies associated with the COVID-19 pandemic, a prediction of higher levels of testing will require labs to perform more tests and incur more costs. But the increased testing also will generate more revenue from COVID-19 test claims.
The opposite is true if the prediction is for less demand for COVID-19 molecular tests. Labs will need to plan for a smaller volume of these tests, resulting in lower costs associated with SARS-CoV-2 testing and less revenue because of fewer COVID-19 test claims.
In the United States, the third wave of the pandemic crested on Jan. 8, 2021, when the CDC reported a record number of 312,824 new COVID-19 cases. The number of deaths per day peaked on Jan. 7 at 4,131. Since then, the number of new cases and deaths per day in this country have continuously declined.
94% Fewer Cases Per Day
This slowdown in new cases of SARS-CoV-2 infections is reflected in recent statistics. As of May 17, the CDC reported daily new COVID-19 cases and deaths as 18,692 and 679, respectively. That is a decline of 94% and 86% in the number of daily new cases and deaths since the January peak for both statistics.
Not surprisingly, the demand for molecular COVID-19 tests collapsed in parallel with the decline in new cases. It was on Jan. 6, 2021, when the CDC reported a record daily total of 2,315,502 COVID-19 tests. As of May 18, that number had fallen to 385,860 tests for the day. This is a decline of 82% in the daily volume of COVID-19 tests over the past five months.
The timing of this decline coincides with the first release of the COVID-19 vaccines in late December and early January. Priority was given to essential workers—including healthcare workers and medical laboratory professionals—and then expanded to include elderly and those with specific chronic conditions.
As of May 20, CDC data show that 127.8 million Americans are fully vaccinated. That is 38.5% of the population. Another 10% of the population have received at least one vaccination shot. COVID-19 cases in this country now total 32.8 million, or about 10% of the population.
Epidemiologists arguing in favor of a diminishing pandemic point out that more than half the population of the United States now has some level of immunity to SARS-CoV-2.
Clinical lab executives and pathologists will want to interpret the significance of these statistics that document a decline in incidences of COVID-19 in the United States since the start of 2021.
Labs also should consider another important factor in their strategic planning—falling consumer demand for both COVID-19 tests and vaccinations. One major reason for the substantial decline in the number of daily COVID-19 tests performed by the nation’s clinical labs is simply that many Americans no longer want to be tested.
This phenomenon differs from COVID-19 testing required by an employer, university, or school for regular testing of employees, faculty, and students. These organizations may require rapid COVID-19 tests for months into the future simply to reduce their liability. They are concerned about being named as a defendant in potential lawsuits, for example, if an employee, customer, or student becomes infected and files a lawsuit claiming to have been exposed to SARS-CoV-2 while working, studying, or shopping at the organization.
Serology Testing for COVID
The facts presented here deal with molecular COVID-19 testing. Separately, clinical labs will need to watch the development of accurate serology tests for SARS-CoV-2. In the early months of the pandemic, many experts believed serology testing would play a greater role in helping physicians and public health officials track outbreaks and identify individuals with existing antibodies to COVID-19. As of this date, that has not happened.
There are two other factors to consider. One: that new variants may emerge which are more infectious and/or cause a more severe form of the disease. Two: it has yet to be determined how long current vaccines will protect the individual from infection. If protection is not long-lasting, there may be the need for serology testing of vaccinated individuals to determine when and if they need a booster shot. The charts below will help clinical labs and pathology groups with their strategic planning.
CDC’s Current Predictions of COVID-19 Cases Show Steady Decline in Weekly Numbers
CLINICAL LAB ADMINISTRATORS AND PATHOLOGISTS TASKED WITH PREDICTING the uncertain future of the COVID-19 outbreak in the United States will find a useful tool on the website of the Centers for Disease Control and Prevention (CDC).
The CDC tracks the predictive models of 28 different entities. It publishes updates that show the number of weekly new COVID-19 cases in past weeks and what the 28 models predict will be the number of new cases in the coming four weeks.
• This chart was posted on the CDC website as of May 21, 2021. It shows “ensemble forecasts of new reported COVID-19 cases over the next four weeks, included are forecasts from 28 modeling groups, each of which contributed a forecast for at least one jurisdiction.”
• This week’s national ensemble predicts that the number of newly reported COVID-19 cases will likely decrease over the next four weeks, with 60,000 to 268,000 new cases likely reported in the week ending June 12, 2021.
• It is significant that only three of the 28 different models predict an increase in the number of weekly new COVID-19 cases in the coming four weeks.
CDC Statistics Demonstrate the Steady Decline of the SARS-CoV-2 Outbreak in the United States