Enhanced testing can substantially improve defence against several types of respiratory virus pandemic

Mass testing to identify and isolate infected individuals is a promising approach for reducing harm from the next acute respiratory virus pandemic. It offers the prospect of averting hospitalizations and deaths whilst avoiding the need for indiscriminate social distancing measures. To understand scenarios where mass testing might or might not be a viable intervention, here we modelled how effectiveness depends both on characteristics of the pathogen ( R , time to peak viral load) and on the testing strategy (limit of detection, testing frequency, test turnaround time, adherence). We base time-dependent test sensitivity and time-dependent infectiousness on an underlying viral load trajectory model. We show that given moderately high public adherence, achievable frequent testing can prevent as many transmissions as more costly interventions such as school or business closures. With very high adherence and fast, frequent, and sensitive testing, we show that most respiratory virus pandemics could be controlled with mass testing alone. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement JP's work is supported by Open Philanthropy and the Wellcome Trust (Collaboration Award 206298/Z/17/Z, ARTIC-Network). JAH is supported by a Wellcome Trust Early Career Award (grant 225001/Z/22/Z). CW is supported by Sir Henry Wellcome Postdoctoral Fellowship (reference 224190/Z/21/Z). JPG's work is supported by the UK Health Security Agency and the UK Department of Health and Social Care. These funders had no role in the study design, data analysis, data interpretation, or writing of the report. The views expressed in this article are those of the authors and not necessarily those of the UK Health Security Agency or the UK Department of Health and Social Care. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All code developed for this study is available online at