The COVID-19 pandemic yielded important advances in testing for respiratory viruses, but it also exposed important unmet needs in screening to prevent the spread of infections in high-risk settings.

While PCR (polymerase chain reaction) tests are the gold standard for detecting viral infections, they remain a challenge for screening large numbers of people in places vulnerable to outbreak — such as health care centers and nursing homes — due to high costs and the fact that different tests are required for each virus.

A new Yale study, however, finds that an alternate strategy — using a nasal swab to screen for an antiviral protein produced by the body as a defense against infection — can be an effective method for ruling out respiratory infections, limiting PCR testing only to those most likely to be infected, at a fraction of the cost. 

The study was published online on June 20 in The Lancet eBiomedicine. 

In a Policy Forum, Jessica Espey and colleagues argue that waning support for accurate collection and curation of population data worldwide threatens to compromise crucial evidence-based government planning. “We live in an era of seemingly unlimited data, where our digital activities may generate nearly constant information streams, yet some of our most essential infrastructure – demographic information – is deteriorating, introducing known and unknown bias into decision-making,” write the authors. Accurate population data are fundamental to effective governance. Most countries rely on national censuses, which are traditionally conducted every 10 years, to supply this information. But according to Espey et al., fewer nations are completing censuses, and many are undercounting marginalized populations. For example, at the close of the 2020 census cycle, 204 countries or territories – encompassing 85% of the world’s population – had conducted at least one census between 2015 and 2024. Yet by July 2024, 24 of these, representing roughly one-quarter of the global population, had not published their findings. This reflects a significant decline from the 2010 round, when 214 countries conducted and released census data, encompassing 93% of the global population. Moreover, even when censuses are carried out, they increasingly suffer from declining response rates and growing coverage errors – particularly in the undercounting of vulnerable populations such as ethnic minorities and young children. In the United States, for instance, the 2020 census likely missed nearly 3 million Latino individuals and close to 1 million children under the age of five.

In this Policy Forum, the authors outline several reasons for this general decline: eroding trust in institutions, COVID-19 disruptions, budget cuts to statistical offices, and collapsing international support for data collection programs. In order to address this “quiet crisis,” Espey et al. suggest adopting register-based systems, harnessing geospatial technologies and AI, and producing small-area population estimates. However, technical innovations alone are not enough, note the authors; governments must also restore public trust by showing how data informs daily life, ensuring strong privacy protections, and promoting collaboration across sectors. “In an era of growing challenges, from climate change to economic inequality, accurate population data are not a luxury – they are essential infrastructure for healthy, resilient, functioning societies,” write the authors.