“The claim was that (mass testing) would stop the pandemic in its tracks… and it hasn’t.”

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COPENHAGEN/LONDON — For many people around the world, sticking cotton swabs up the nose or throat to test for COVID-19 has become a routine and familiar nuisance.

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But two years into the pandemic, health officials in some countries are questioning the merits of repeated mass testing when it comes to containing infections, particularly considering the billions it costs.

Chief among them is Denmark, which from the start championed one of the most prolific COVID-testing regimes in the world. Lawmakers are now demanding a detailed study of whether that policy was effective.

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“We have tested much more than other countries, so we may have overdone it,” said Jens Lundgren, professor of infectious diseases at Rigshospitalet, University of Copenhagen, and a member of the government’s COVID advisory group.

Japan avoided large-scale testing and yet weathered the pandemic relatively well, based on infection and death rates. Other countries, including Britain and Spain, have scaled back testing.

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Yet repeated testing of entire cities remains a central part of the “COVID zero” plan in China, where leaders have threatened to crack down on critics.

“We need to learn, and nobody did it perfectly,” said Dale Fisher, president of the World Health Organization’s Global Outbreak Alert and Response Network.

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The WHO urged countries to “test, test, test” all suspected cases after the coronavirus was first identified. Global surveillance helped scientists understand the risk of serious illness or death, as well as the risk of transmission.

Now, with the prevalence of the relatively milder Omicron variant and the availability of more effective vaccines and treatments, governments should consider more strategic policies such as population sampling, experts said.

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However, backtracking too drastically could leave the world blind to a virus that is still changing, some officials said.

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Workers in protective suits guard a street during a lockdown in Shanghai on April 16.
Workers in protective suits guard a street during a lockdown in Shanghai on April 16. Photo by ALY SONG /REUTERS

WHO guidelines have never recommended mass screening of asymptomatic people, as is currently the case in China, due to the costs involved and a lack of data on its effectiveness.

Denmark ultimately recorded case numbers and death rates similar to other countries with less widespread testing. This has prompted most parties in parliament to call for an investigation into the strategy.

In the last two years, the 5.8 million inhabitants of Denmark registered more than 127 million rapid tests and PCR, all free of charge. In all, Denmark spent more than 16 billion kronor ($2.36 billion) on testing, according to the Danish Critical Supplies Agency.

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Neighboring Norway, with a similar population size, only conducted 11 million PCR tests, while Sweden, home to almost twice as many people, completed around 18 million, according to Our World in Data.

Christine Stabell Benn, a professor of global health at the University of Southern Denmark, said Denmark’s strategy was costly and the results “undocumented.”

“The mass testing approach took the focus off testing where it really matters: among the vulnerable.”

Other experts, and the Danish government, said widespread testing reduced the rate of transmission and helped people re-enter society, boosting the economy and their own mental health. The economy took a relatively smaller hit than other European countries, according to a government report released in September.

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“There is no doubt that the human and economic costs of, for example, an extensive lockdown, as we have seen in many other countries, would be higher,” Justice Minister Nick Haekkerup told Reuters in an email.


A woman receives a free COVID-19 rapid test kit in London, England.
A woman receives a free COVID-19 rapid test kit in London, England. Photo by Tolga Akmen/AFP via Getty Images/File

A Danish study published last year found that the testing program and subsequent isolation of confirmed cases helped reduce transmission by up to 25%.

Other disease experts question such estimates. A review published in Medical Virology in late March on the use of rapid tests for people without symptoms in mass screening initiatives found “uncertainty” about their impact.

“The claim was that (mass testing) would stop the pandemic in its tracks and reduce transmission by 90%. And it hasn’t been,” said Angela Raffle, a senior lecturer at the University of Bristol Medical School, who has worked with the UK’s National Screening Committee.

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There are several possible explanations for why the tests did not generate a higher profit, including an overly ambitious goal and the fact that the tests were imperfect. In addition, many people did not isolate or were unable to isolate after testing positive: a review in the British Medical Journal, predating Omicron, found that only 42.5% of those cases stayed at home for the entire period of isolation.

In England, free COVID tests are now only available to government health workers, those with certain health conditions, and people admitted to hospital. Others, even with symptoms, have to pay for tests or are simply advised to stay home until they feel better.

Some global health experts say such a pushback goes too far.

“In some settings, because politicians have decided to ‘go ahead’ and dismantle all of public health, testing has been deliberately reduced or made more difficult to access,” said Madhu Pai, professor of global health at the University McGill in Canada.

“This will be disastrous, because we will be taken completely by surprise if a more dangerous variant emerges.” (Reporting by Nikolaj Skydsgaard and Jennifer Rigby; Additional reporting by Rocky Swift in Tokyo; Editing by Michele Gershberg and Nick Macfie)



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