PROVIDENCE, RI – A new Testing Playbook for Biological Emergencies released today, October 19, 2023, provides U.S. decision-makers at the federal, state, and local level, with a clear and evidence-based guide for making rapid and effective decisions regarding the development, implementation, and scale-up of diagnostic testing at every stage in an infectious disease emergency. This first-of-its-kind playbook is the work of national public health experts, and led by those at the Pandemic Center at the Brown University School of Public Health and the Association of Public Health Laboratories.
“Achieving better testing – faster – is vital to improving preparedness and response in the next biological emergency . We need to prepare because there will be another pandemic. We need a stepwise plan for a targeted, rapid response that is based on information that can only be gained through widespread testing,” said Dr. Jennifer Nuzzo, Director of the Pandemic Center at the Brown University School of Public Health.
Said Scott Becker, Chief Executive Officer of the Association of Public Health Laboratories, “While every disease outbreak will unfold differently, testing will always be at the center of response, just as it was a significant need in the COVID response. This playbook aims to significantly speed access to testing to stop the spread of infectious disease and save lives.”
Experience during previous outbreaks in the United States has shown that early access to testing is vital, and a variety of testing approaches are necessary as an outbreak evolves. This rapidly changing environment has resulted in uncertainty for decision makers, as well as the public. The Testing Playbook is explicitly designed to reduce uncertainty by illustrating the steps to be taken at each stage, while consistently enabling rapid and equitable access to testing.
The Playbook is divided into six sequential phases of a biological emergency.
- Phase One begins when a novel pathogen is first detected globally, outside the US.
- Phase Two starts with introduction of the pathogen into this country.
- Phase Three follows the rapid early spread of infections.
- Phase Four looks at the broad acceleration phase.
- Phase Five describes sustained high levels of cases nation-wide.
- Phase Six occurs when the outbreak has been brought under control, and case numbers are declining.
The Playbook says achieving effective outbreak testing requires the following steps as early as possible and throughout a disease emergency:
- Public health laboratories (PHLs), as first responders, must have access to accurate test kits and necessary reagents immediately (in a “ready state”) to quickly identify new health threats and perform testing.
- As quickly as possible, testing must be scaled in hospitals, academic medical centers, and commercial laboratories.
- Healthcare providers, their patients, and other individuals must consistently have broad access to all testing modalities, including home tests, to detect infection, stop transmission, and support treatment and recovery.
- Each of these sectors provides unique and critical capabilities to stop disease spread and save lives. National coordination of these sectors is essential to optimize capacities and contributions.
This Playbook was developed collaboratively by subject matter experts at the Pandemic Center at the Brown University School of Public Health, Arizona State University College of Health Solutions and Illumina Ventures, the Association of Public Health Laboratories, and the STAT Public Health Network at the Brown University School of Public Health, with funding from the Peterson Foundation. Importantly, 37 public health leaders were consulted to inform its creation with expertise from across federal agencies, state and local governments, commercial and hospital laboratories, academic medical centers, and diagnostic manufacturers.
The developers of the Playbook envisage that it will be updated over time as more knowledge is gained. This Playbook also can be adapted for use in state and local government as well as for employers by asking questions pertinent to individual institutions and regions. To facilitate broad access to the Playbook, and to foster edits, additions, and future versions, Brown University School of Public Health has established a website at bettertestingnow.org where the document and additional information can be accessed.