---
id: "coronavirus-smarter-crowdsourcing:recommendations/pooled-testing"
type: "GovLab policy recommendation"
title: "Pooled Testing"
url: "https://coronavirus.smartercrowdsourcing.org/recommendations/pooled-testing"
summary: "Governments and researchers should implement pooled testing strategies, innovating with pool design through ranking schemes or geographic schemes."
source: "The GovLab (coronavirus.smartercrowdsourcing.org)"
licence: "Creative Commons Attribution-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-sa/4.0/)"
---

# Pooled Testing

Governments and researchers should implement pooled testing strategies, innovating with pool design through ranking schemes or geographic schemes.

- Part of: [Smarter Crowdsourcing in the Age of Coronavirus](https://coronavirus.smartercrowdsourcing.org/), [all recommendations](https://coronavirus.smartercrowdsourcing.org/recommendations)

## Strategy 1

Partner with academic institutions,researchers and private sector laboratories. Governments should engage the academy,research firms,and private sector laboratories to develop algorithms,testing strategies,and innovative ways to design pooled testing schemes.

- Timeframe: 1-3 Months (immediate)
- Audience: Private Sector, Academia, Government Workers
- Type: Research, Data, Partnerships
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/partner-with-academic-institutions,researchers-and

### Actions governments should take (strategy 1)

1. Convene an [advisory panel](https://sites.google.com/tamu.edu/nets-covid/home?authuser=0) of experts with relevant skills and experience from research firms, [universities](https://isci.cl/en/covidcat/initiatives-and-reports/), and private sector laboratories
2. Commission an advisory panel to develop pooled testing strategy
3. Identify specific partners to support implementation of pooled testing strategy

### Examples from around the world (strategy 1)

1. Rwanda has enrolled scholars from multiple disciplines to [develop its pooling algorithm](https://theconversation.com/rwandas-covid-19-pool-testing-a-savvy-option-where-theres-low-viral-prevalence-141704), based on [matrix, or array testing](https://pubmed.ncbi.nlm.nih.gov/7855467/) to maximize its national pooled testing strategy and to better understand the spatial spread of COVID-19 at the national level and identify new infection hotspots. By making use of local experts, Rwanda has developed a protocol to further maximize the efficiency of pooling.

## Strategy 2

Waive regulatory barriers. Governments should consider ways to adjust regulations that restrict innovation pertaining to pooled testing schemes.

- Timeframe: 3-6 Months (medium)
- Audience: Government Workers
- Type: Policy/Legislative/Regulatory, Technology/Innovation
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/waive-regulatory-barriers.-governments-should-cons

### Actions governments should take (strategy 2)

1. Identify key legal and regulatory bottlenecks restricting pooled testing
2. [Review legislation and regulatory statutes that may restrict innovation pertaining to implementing pooled testing schemes](https://www.washingtonpost.com/health/what-is-pool-testing-and-how-does-it-work/2020/06/26/33eee7ea-b7e4-11ea-a510-55bf26485c93_story.html)
3. Consider policy actions, such as waivers or emergency use authorizations that will allow for temporary approvals to implement pooled testing schemes

### Examples from around the world (strategy 2)

1. The United States has issued an emergency use authorization for [Quest Diagnostics to conduct pooled testin](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-first-emergency-authorization-sample-pooling-diagnostic)g in diagnostic testing, which will allow for pooled samples containing up to four individual swab specimens, thus bypassing normally slow regulatory procedures. [Stanford University](https://med.stanford.edu/news/all-news/2020/04/testing-pooled-samples-to-track-early-spread-of-virus.html) and the [State of Nebraska](https://www.npr.org/sections/health-shots/2020/07/06/886886255/pooling-coronavirus-tests-can-spare-scarce-supplies-but-theres-a-catch) have been conducting pooled testing since before July 2020.

## Strategy 3

Rapidly pilot pooled testing schemes. Governments should act quickly (<1 month) to pilot various pooled testing schemes such as Dorfman,Splitting,Sterret,and Matrix testing to gauge scalability and utility amongst [different contexts and populations](https://www.eurekalert.org/pub_releases/2020-04/su-vst042820.php).

- Timeframe: 1-3 Months (immediate)
- Audience: Government Workers
- Type: Policy/Legislative/Regulatory, Technology/Innovation
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/rapidly-pilot-pooled-testing-schemes.-governments-

### Actions governments should take (strategy 3)

1. Convene an advisory panel of experts with relevant skills and experience from research firms and universities
2. Identify ideal populations to work with on pilot testing scheme such as nursing homes, congregate living residences, or groups of healthcare workers
3. Secure partnerships with laboratories to manage the throughput of pooled tests

### Examples from around the world (strategy 3)

1. India established a [pooled testing protocol](https://www.mohfw.gov.in/pdf/GuidelineforrtPCRbasedpooledsamplingFinal.pdf) for quarantined migrant workers and international travelers which combines 25 samples at a time. The country also uses pooled testing to monitor green zones where prevalence is low. Rather than monitoring specifically vulnerable populations, India is using pooling to test groups where prevalence is perceived as being low, thus maximizing the efficiency gains from pooled testing.

## Strategy 4

Iterate learning and share best practices. Governments should contract with or perform their own evaluation of pooled testing schemes,improve on existing processes,and share best practices across jurisdictions and sectors.

- Timeframe: 6-12 Months (long)
- Audience: Government Workers
- Type: Research, Data, Technology/Innovation, Capacity Building
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/iterate-learning-and-share-best-practices.-governm

### Actions governments should take (strategy 4)

1. Document findings and lessons learned from pooled testing pilots
2. Share findings publicly and with relevant national and international stakeholders
3. Publish research and advocate for replication of successes within the country and in other comparator countries

### Examples from around the world (strategy 4)

1. The government of Wuhan implemented a [citywide testing drive](https://www.nytimes.com/2020/05/26/world/asia/coronavirus-wuhan-tests.html), leveraging massive resources and intensive campaigning, to test over six million people in 10 days. The aggressively high throughput in testing was only possible due to [pooling samples](https://www.livescience.com/pooled-sampling-covid19-in-wuhan-and-us-cities.html). This allowed the government to catch asymptomatic cases and prevent outbreaks, at a moment of [low prevalence](https://news.cgtn.com/news/2020-06-02/Wuhan-completes-9-89-million-COVID-19-tests-citywide--QZLbBpbAEE/index.html). Wuhan’s example shows pooled testing potential to facilitate periodic population-wide testing for a particular community.