The association between early country‐level COVID‐19 testing capacity and later COVID‐19 mortality outcomes

Abstract

Background The COVID‐19 pandemic has overrun hospital systems while exacerbating economic hardship and food insecurity on a global scale. In an effort to understand how early action to find and control the virus is associated with cumulative outcomes, we explored how country‐level testing capacity affects later COVID‐19 mortality. Methods We used the Our World in Data database to explore testing and mortality records in 27 countries from December 31, 2019, to September 30, 2020; we applied Cox proportional hazards regression to determine the relationship between early COVID‐19 testing capacity (cumulative tests per case) and later COVID‐19 mortality (time to specified mortality thresholds), adjusting for country‐level confounders, including median age, GDP, hospital bed capacity, population density, and nonpharmaceutical interventions. Results Higher early testing implementation, as indicated by more cumulative tests per case when mortality was still low, was associated with a lower risk for higher per capita deaths. A sample finding indicated that a higher cumulative number of tests administered per case at the time of six deaths per million persons was associated with a lower risk of reaching 15 deaths per million persons, after adjustment for all confounders (HR = 0.909; P = 0.0001). Conclusions Countries that developed stronger COVID‐19 testing capacity at early timepoints, as measured by tests administered per case identified, experienced a slower increase of deaths per capita. Thus, this study operationalizes the value of testing and provides empirical evidence that stronger testing capacity at early timepoints is associated with reduced mortality and improved pandemic control.

Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities

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A method for intelligent allocation of diagnostic testing by leveraging data from commercial wearable devices: a case study on COVID-19

“…Such circumstances lead to underreporting of COVID-19 incidence and may lead to a premature sense of security and unwarranted changes in public health measures 14 . Thus, there is an unprecedented need to improve our current and future methods for mass COVID-19 surveillance testing, especially as stronger testing capacity has been associated with reduced mortality and greater pandemic control 16 .…”

COVID-19 excess death rate in Eastern European countries associated with weaker regulation implementation and lower vaccination coverage

“…COVID-19 incidence and confirmed death rate are the most widely used epidemiological parameters to describe differences between countries in the level of risk and health outcomes in the pandemic (1). Both outcomes might be highly affected by countries' testing and data collection capacities (2). Excess death rate is a more complex indicator but it may show the true impact of the pandemic across a population, especially in the long term (3).…”