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Optimal allocation of scarce PCR tests during the COVID-19 pandemic

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  • Afschin Gandjour

Abstract

Background/aim: During the coronavirus disease (COVID-19) pandemic, Germany and various other countries experienced a shortage of polymerase chain reaction (PCR) laboratory tests due to the highly transmissible SARS-CoV-2 Omicron variant that drove an unprecedented surge of infections. This study developed a mathematical model that optimizes diagnostic capacity with lab-based PCR testing. Methods: A mathematical model was constructed to determine the value of PCR testing in relation to the pre-test probability of COVID-19. Furthermore, the model derives the lower and upper bounds for the threshold pre-test probability of the designated priority group. The model was applied in a German setting using the PCR test-positivity rate at the beginning of February 2022. Results: The value function of PCR testing is bell-shaped with respect to the pre-test probability, reaching a maximum at a pre-test probability of 0.5. Based on a PCR test-positivity rate of 0.3 and assuming that at least two thirds of the tested population have a pre-test probability below, lower and higher pre-test probability thresholds are ≥ 0.1 and 0.7, respectively. Therefore, individuals who have a 25% likelihood of testing positive because they exhibit symptoms should be a higher priority for PCR testing. Furthermore, a positive rapid antigen test in asymptomatic individuals with no known exposure to COVID-19 should be confirmed using PCR. Yet, symptomatic individuals with a positive RAT should be excluded from PCR testing. Conclusion: A mathematical model that allows for the optimal allocation of scarce PCR tests during the COVID-19 pandemic was developed.

Suggested Citation

  • Afschin Gandjour, 2023. "Optimal allocation of scarce PCR tests during the COVID-19 pandemic," PLOS ONE, Public Library of Science, vol. 18(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0285083
    DOI: 10.1371/journal.pone.0285083
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    References listed on IDEAS

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    1. Janet Bouttell & Neil Hawkins, 2021. "Evaluation of Triage Tests When Existing Test Capacity Is Constrained: Application to Rapid Diagnostic Testing in COVID-19," Medical Decision Making, , vol. 41(8), pages 978-987, November.
    2. Joshua S. Gans, 2022. "Test sensitivity for infection versus infectiousness of SARS‐CoV‐2," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 43(6), pages 1880-1887, September.
    3. Ely, Jeffrey & Galeotti, Andrea & Jann, Ole & Steiner, Jakub, 2021. "Optimal test allocation," Journal of Economic Theory, Elsevier, vol. 193(C).
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