As of July 2020, 16 states recommended testing asymptomatic members of the general public. The rate of COVID-19 tests reported in each state correlates with more inclusive testing recommendations and with higher epidemic intensity. Higher per capita testing was associated with more complete reporting of COVID-19 deaths, which is a fundamental requirement for analyzing the pandemic.
Testing recommendations for COVID-19 in the United States varied by state and over time in the spring and summer of 2020.
We compiled data about COVID-19 testing, cases, and deaths, and excess pneumonia + influenza + COVID-19 deaths to assess relationships between testing recommendations, per capita tests performed, epidemic intensity, and excess mortality during the early phase of the COVID-19 pandemic in the United States.
Reported deaths due to COVID-19 likely represent an undercount of the true burden of the pandemic. Coordinated, consistent guidelines for COVID-19 testing should be a high priority for state and national health systems.