COVID-19 cases associated with testing policies in 34 highly democratic countries, 2020-2022

Abstract

COVID-19 testing policies varied in time from testing only the symptomatic, testing the symptomatic and persons at higher risk of severe disease, on-demand testing for people who wanted one, and two periods of government-imposed mass testing in Slovakia. Using Poisson regression, this study examines the associations of COVID-19 cases during the times that the noted policies were in effect in 34 countries rated highest on democracy scores. Statistically corrected for other risk factors, increases in negative tests were associated with subsequent surges in cases when on-demand testing was promoted, particularly when coupled with poor contact tracing. Mass testing in Slovakia was associated with reduced spread of the virus for short periods but was deemed unsustainable. The data support the hypothesis that on-demand testing resulted in the unanticipated consequence of increased travel and increased exposure of travelers to the virus.