LAUSR

Since the discovery and recognition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the official declaration of the coronavirus disease-2019 (COVID-19) pandemic at the beginning of 2020, various different test methodologies have been developed at record speeds and made available for the diagnosis, screening, surveillance, and management of SARS-CoV2 infection and COVID-19 illness. The rapid scientific developments in the quest to learn and define the mechanisms of SARS-CoV-2 transmission, illness, and recovery, in combination with the public health challenges of a rapidly spreading virus, have forced the healthcare community to adapt continuously to the unfolding pandemic. Official testing guidelines and proposed algorithms continue to evolve, as we learn more about the variety of symptoms early in infection, changing public health needs, and the need to return to pre-pandemic activities that include in-person school attendance, travel, sports, and other economic and social activities. Initial testing guidelines focused on detection of the SARS-CoV-2 virus using molecular techniques, but as the pandemic has progressed other technologies such as SARS-CoV-2 antigen tests have emerged and are attaining wider acceptability and availability. Coincident with the evolution of different testing methodologies, changes in sampling techniques from naspharyngeal swabs, to nasal swabs, and potentially to patient self-collected swabs further complicate the development of testing strategies and guidelines. While high complexity molecular methods for viral RNA are the gold standard for diagnosis, a bottleneck in testing capacity and speed has become apparent. This bottleneck has led to a recognition that rapid point-ofcare or laboratory SARS-CoV-2 antigen testing may play an important role in screening and surveillance for COVID-19 illness. To help answer some of the questions about how testing is being used and how the in vitro diagnostic industry can help meet diagnostic testing needs, a panel of experts was convened with the objective of gaining critical insights regarding different testing strategies for SARS-CoV-2 in a variety of healthcare, community, congregate, and public health settings We have invited back a select group of experts who participated in the Scientific Advisory Board to share their perspectives and to provide an update on the current state of testing strategies for SARS-CoV-2 from their respective points of view.