FDA Covid-19 Serology Tests Lessons Learned

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CDRH director Jeffrey Shuren and Office of In Vitro Diagnostics and Radiological Health director Timothy Stenzel say that knowing what they know now, they would not have permitted SARS-CoV-2 serology tests to be marketed without FDA review and authorization. Writing in a New England Journal of Medicine Perspective, Shuren and Stenzel list five lessons learned from the agency’s experience with Covid-19 serology tests that flooded the market after some government officials touted their use in reopening the economy and insurance coverage was provided for some uses not supported by science: 

  •          it is important to authorize medical products independently, based on sound science, and not permit market entry of tests without authorization;
  •          the federal government should coordinate the preparation of a public/private research plan to address epidemiologic questions about disease spread and immunity at the beginning of an outbreak as part of its preparedness plan;
  •          capacity should be established within or on behalf of the federal government to evaluate test performance before outbreaks occur so that independent evaluation can be performed quickly during an outbreak;
  •          the scientific and medical communities should understand the purpose and clinical use of serology tests and how to appropriately use test results in general to inform patient care; and
  •          all parties involved in public health emergency response need better information more quickly.

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