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Pooled Testing for COVID-19: Africa Leads!

By Shlomo Maital

One of my favorite quotes is by former Curitiba, Brazil mayor Jaime Levin: “if you want real creativity, known a few zero’s off your budget”.

   COVID-19 testing is very expensive, and African countries have very limited budgets. Solution? Pooling. Pool the samples, say 10 at a time. See if the coronavirus is present. If so, go back and check which sample was positive.   The logic: Infection rates are, say, 1%, 3%, 5% …and in very very hot spots, 25-30%. At worst, 1 in 3. So, in low-infection-rate countries, checking every sample means searching for a 1-in-100 needle in the haystack. Time consuming (and time is of the essence), and very expensive.

     This idea — pooling —  is currently NOT widely used in the US. Even though the top expert, Dr. Fauci, now advocates it, and as US numbers reach record levels, 60,000 cases a day, and as tests are again becoming in short supply:

   “Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently announced that health officials are considering pooled testing for COVID-19 in response to the recent surge.”

   Dr. Fauci:   Ghana is way ahead of you. America can learn from Ghana:

   “When the first batch of specimens came for testing, in early March, the Noguchi Memorial Institute for Medical Research (NMIMR) was the only facility capable of testing for COVID-19 in Ghana. Moreover, it had a very limited supply of test kits.   Faced with the harsh reality, scientists decided to exploit a standard testing methodology in which individual specimens are combined into pools and tested. When a pool tests positive, then each individual specimen of that particular pool is tested. The NMIMR started with a pool size of fives, which was later increased to ten as the testing needs and the understanding of test sensitivity parameters improved.”

   So let’s be clear. Ghana has been doing pooling of tests since early March.  Rwanda, too.  The US is now considering it.

   America – open your windows. There are very clever people, outside your borders.  Maybe, the Trump administration should stop trying to keep foreigners out, or kick them out if they’re in, and listen to their ideas…..  and President Trump?  What was that profanity you used, to describe African nations?  Shxxxholes? 

How to Emerge from Lockdown: Speed is Vital!

By Shlomo Maital

   Question: how does coronavirus resemble standup comedy?

   Answer: For both, timing is crucial.

As countries begin to emerge from lockdown (Denmark has opened its kindergartens, because 90% of families with children have both parents working), fears arise whether this is wise. One answer is, yes, but…   The diagram above shows how emergence can best be done. And everything, EVERYthing, depends on timing and speed —

  • test for virus among those with symptoms, and some who are asymptomatic,
  • get the results super-fast, within hours (this is possible with some tests),
  • track those in contact with persons testing positive,
  • lock down those with the virus, and
  • do this again and again.


     All this depends on revising current testing procedures (some results have been lost, some take 6-8 days for results, far too long to be useful). Timing and speed are crucial. Why? Because, in the 6 days it takes now for results to be provided, the person potentially infected can infect many many other people, even unknowingly.

       Does your country have test results within minutes or even hours? There are such tests. We need millions of them.

Blog entries written by Prof. Shlomo Maital

Shlomo Maital