Very High Throughput Many-Persons-To-1-Test-Kit Infectious Disease Screening
Abstract The 2020 COVID-19 pandemic presses huge demand for testing capacity. We posted a new idea--multiplier grid (MG)--online in mid-March 2020 and circulated a writeup by email shortly after to address this issue. It enables use of a moderate number of test kits to screen a large number of individuals to look for a small number of infected individuals. Now, we describe a protocol to implement the MG based on existing diagnostic technologies and existing automated lab equipment. Using industry standard 96-well plate (reserving first 2 wells for positive/negative controls), screening 94*94 = 8,836 individuals needs only 2*96 = 192 sets of test kits, with multiplier being 46. If a test costs $250/kit, with MG per person cost goes down to about $5. The very low cost makes periodic blanket screening (e.g. twice weekly) post-lockdown feasible, without putting pressure on reagent supply and equipment time. Going further, pooling samples from individuals that share the same basic unit of the population beforehand boosts the multiplier further to 46*4 = 184 for average household size of 4, and the number of individuals screened to 94*94*4 = 34,344, using only 2*96 + 4 = 196 sets of test kits. the MG can also be used in livestock farming to detect infection early to avoid mass culling.