Arguments against universal or mass testing for COVID-19 before the economy can reopen

This page captures the main arguments that have been advanced to oppose the argument that everyone must be tested for COVID-19 before the economy can reopen. These arguments come from a variety of sources, including public officials, journalists, think tanks, economists, scientists, and other stakeholders. We encourage you to share the debates happening in your local community to editor@ballotpedia.org.

There are seven main types of arguments against universal or mass testing:

• Universal testing is not necessary
• Universal testing is not possible
• Universal testing would divert and waste resources
• Universal testing might be dangerous
• Massive testing is too expensive
• Universal testing results are unreliable
• Universal testing is too slow to protect public health

Click here to read about arguments in favor of universal or mass testing before reopening the economy.

Argument: universal testing is not necessary

Claim: representative samples of a population can provide sufficient information

• David E. Bloom and David Canning wrote in the Boston Globe on April 15, 2020, that “universal testing is not necessary. There is a scientifically sound, far less costly approach at our disposal: conducting COVID-19 tests on a representative sample of the population. Massachusetts has a population of nearly 7 million, but a random sample of 5,000 residents is large enough to determine the prevalence of COVID-19 infection within a margin of error of 1.5 percentage points. The information yielded by testing such a sample would contribute decisively to our epidemiological projections and related policies to prevent and control the spread of this too-often deadly virus.”

• Ken Bissun, M.D., wrote in the Greensburg Daily News that “testing healthy individuals with the best Covid-19 tests we have is worthless (or worse). Getting a negative test result means nothing when you are feeling well — tomorrow you may be ill and have a virus level high enough to possibly give a positive result. Many of today’s demands for universal testing seem to be politically motivated attacks — not based on scientific reality.”

• Avik Roy, president of the Foundation for Research on Equal Opportunity, wrote in The Wall Street Journal on April 24, 2020, that the United States should move away from using public health milestones to determine when to reopen. Instead, reopening strategies should focus on which demographic groups are most susceptible to the coronavirus. Roy said businesses should reopen with healthy, non-elderly employees returning to work.

Argument: universal testing is not possible

Claim: though testing might be desirable, supplying the tests will be challenging

• Dan Mangan reported for CNBC on April 16, 2020, that “there will ultimately need to be 200 million to 300 million tests each week to have the economy functioning as it was before the outbreak began. That level of testing assumes multiple rescreenings of individual Americans in the absence of a Covid-19 vaccine.”

• In the same CNBC piece, former director of the Centers for Disease Control and Prevention Thomas Frieden, said that “We need an army of 300,000 people” to do contact tracing nationwide.”

• The Association of American Medical Colleges wrote a letter on April 13, 2020, warning that "Widespread but uneven shortages in one or more of the essential components for testing have resulted in a situation where few labs are able to maximize the testing capacity of any one machine, platform, or test."

Claim: social and political resistance is too great for successful universal testing

• A report released by the Safra Center for Ethics at Harvard University on April 20, 2020, said: "Roadmap to Pandemic Resilience: Massive Scale Testing, Tracing, and Supported Isolation (TTSI) as the Path to Pandemic Resilience for a Free Society" April 20, 2020, "The [mass testing for coronavirus] roadmap, as outlined, could likely work. However, assuming that the real and substantial technical difficulties in ramping up that much daily testing can be overcome, the ongoing economic distress makes it unlikely that the public would endure the implementation of such a careful plan. And even if the public did remain patient, it's doubtful that the bureaucrats and politicians in Washington, including our chaotic president, have the competence to pull it off."

Claim: Certain surveillance and contact tracing programs violate privacy

• Albert Fox Cahn and Melissa Giddings (Daily Beast): "Hawaii’s case is likely the most extreme to date, but it’s far from unique. In Washington State, civil rights watchdogs expressed alarm that the state was implementing manual contact-tracing requirements without adequate safeguards. Under the state’s effort, not only would 1,400 contact tracers be hired, but businesses would be required to keep a log of every customer they contacted. Across the country, New York City’s top civil rights watchdog expressed similar alarm at the lack of safeguards for data collected by the city and state’s combined contract tracing program, which may hire as many as 18,000 tracers. And at the same time, Silicon Valley’s effort to get into the COVID-19 tracking business has seen sharp pushback from civil rights and immigrant justice groups, including our own." - "COVID-19 Has Turned Paradise Into a Privacy Nightmare," May 25, 2020.

Argument: universal testing would divert and waste resources

Claim: targeted testing is the most effective use of resources

• Scott Becker, CEO of the Association of Public Health Laboratories, told The Pew Charitable Trust on August 14, 2020, "We need to use our statewide testing resources wisely and only test people who have appropriate reasons to be tested."

• Dr. Tina Tan, a member of the board of directors for the Infectious Diseases Society of America, told The Hill on July 26, 2020: "I think what we're starting to recognize is that it really is not going to be feasible in probably most areas of the U.S. to try to put together some type of testing strategy where you're testing multiple times, especially if the results don't come back for a while. I don't think it really gives you a lot of information, and you're using critical resources that could be better spent in other places."

• Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Vox on July 31, 2020, that targeting groups for testing instead of deploying testing comprehensively “is where we’re going to get the most bang for the buck.' This strategy “would cut down on a lot of unnecessary tests,” he says, “so we could do more with the tests that we currently have, which would speed things up — less volume and more high-impact outcomes.”

• Gary Procop, medical director of clinical virology at Cleveland Clinic, told Vox on July 31, 2020: "Individuals visiting friends or going on vacation should not use precious testing resources and deny these to individuals in need. They need to mask, respect social distancing as much as possible, and wash their hands frequently."

Argument: universal testing might be dangerous

Claim: false negatives might give false sense of security

• Dr. Tom Moore is an infectious disease specialist in Wichita, Kansas. He advocated for large-scale testing for COVID-19. Moore also stated in a CNBC article on April 16, 2020, that there is a risk "of false negatives, in which rapid tests show someone does not have the virus when they actually are infected.”

• Dr. Brian Gannon, professor of pediatrics at the University of Alabama, told AL.com on August 8, 2020, "(Universal testing) gives you a false sense of security that these people are safe to come to school,' he said, noting that someone could get a test, go to the grocery store, and pick up COVID-19 later that day."

• Dr. Michael Hochman, from the University of Southern California, told ProPublica on September 1, 2020, that "a false negative could give patients a misguided sense of security and prompt contacts to leave quarantine before they’re supposed to.”

Argument: universal testing is too expensive

Claim: testing might not be affordable for all

• Dr. Tom Moore, an advocate of large-scale testing for COVID-19, stated in a CNBC article on April 16, 2020 that “one potential major hurdle to ensuring widespread testing is the out-of-pocket cost of a screening to individuals. “The test has to be affordable,” ... “Otherwise, you will have people who won’t come in to do it.”

• Dr. Michael Saag, infectious disease professor at the University of Alabama at Birmingham, told AL.com on August 8, 2020, that he "believes universal testing in all schools would be impossibly expensive for Alabama at $50 a test. Hundreds of thousands of tests would be needed. 'You start doing the math and it becomes pretty overwhelming in terms of the lift that has to be made.'”

• David Lubarsky, CEO of UC Davis Health, and Brad Pollock, UC Davis School of Medicine, wrote in a press release on May 29, 2020: "Testing everyone in all locations every day would clearly identify cases to be isolated, quarantined, and medically cared for, and it would improve forecasting to better direct resources for continued containment and mitigation. However, this extreme scenario is obviously impractical and unpleasant. Testing 330 million Americans at the current $70/test that delivers great accuracy would cost about $23 billion for the first wave of testing the U.S. population. How often will we spend another $23 billion for a follow-up test – every week? That is $1.2 trillion in a year. More importantly, who knows if once a week, twice a week, or more is even useful. . .Smarter testing, not just more testing, will improve health resources utilization and result in better tactics to control the future of this pandemic and allow us to safely reopen the economy."

Claim: universal testing is infeasible, and less effective than strategies to limit exposure, promote masks, and social distancing

• The Center for American Progress published a study on August 6, 2020, that said: "The insufficient public health infrastructure and the recent degree of community spread in much of the United States, however, means that the United States cannot currently manage the virus through testing and tracing alone. Many state and local officials have no choice but to close and monitor high-risk venues, including indoor dining and bars, if they want to contain infections. Indeed, even more aggressive measures may need to be taken to drive transmission down to a level where this strategy would work. The goal of business closures is not to suppress economic activity. On the contrary, it is the only way to solve the public health crisis that is blocking the U.S. economy’s path to recovery."

Argument: universal testing results are unreliable

Claim: false positive and false negatives from mass testing create dangerous impacts

• Howard Kunreuther and Harvey Rubin, University of Pennsylvania, and Paul Slovic, University of Oregon, published an op-ed in the The Philadelphia Inquirer on September 2, 2020. They wrote: "Extensive testing is seen as an important tool to identify and contain COVID-19 infection. But because no test is perfect, there will be widespread misunderstanding by the general public and key decision-makers regarding the likelihood of false positive or false negative results, as behavioral studies have clearly demonstrated. In areas with low prevalence of the virus, positive test readings are likely to be wrong, resulting in unnecessary and costly consequences to individuals and the community. Therefore, it will be important to have independent second tests before imposing quarantines and contact tracing."

• Dr. Michael Hochman, from the University of Southern California, told ProPublica on September 1, 2020: “The value of testing contacts without symptoms is ‘modest’ and would rather make them stay home for 14 days instead of come into a clinic for a test, ‘which is bringing them together with other people, the opposite of what you want.’ He worries that a false negative could give patients a misguided sense of security and prompt contacts to leave quarantine before they’re supposed to.”

Argument: universal testing is too slow to protect public health

Claim: the time delay between taking a COVID-19 test and receiving results has dangerous implications

• Dr. Francis Collins, Director of National Institutes of Health, said on NBC's "Meet the Press" on July 19, 2020, that "[t]he average test delay is too long. And that really undercuts the value of the testing, because you do the testing to find out who's carrying the virus and then quickly get them isolated so they don't spread it around. . .We need to do things that are more on the spot. There's a number of new technologies that are coming along that look very promising in that space. We need to invest a lot of money, and the government is willing to do so, in scaling those up."

• The Pittsburgh Post-Gazette Editorial Board wrote on July 29, 2020: "Health experts have said from the start of the pandemic testing and contact tracing are keys in controlling the virus, but the delays in obtaining test results make tracing all the more difficult or too late to be effective. Officials estimate if turnaround times extend beyond several days, the results can be useless because the person tested may have already infected scores of people in the interim."

See also

• Arguments in favor of universal or mass testing for COVID-19 before the economy can reopen
• Taxonomy of arguments about universal or mass testing for COVID-19 before the economy can reopen