Assembly and publication of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome in January 2020 enabled the immediate development of tests to detect the new virus. This began the largest global testing programme in history, in which hundreds of millions of individuals have been tested to date. The unprecedented scale of testing has driven innovation in the strategies, technologies and concepts that govern testing in public health. This Review describes the changing role of testing during the COVID-19 pandemic, including the use of genomic surveillance to track SARS-CoV-2 transmission around the world, the use of contact tracing to contain disease outbreaks and testing for the presence of the virus circulating in the environment. Despite these efforts, widespread community transmission has become entrenched in many countries and has required the testing of populations to identify and isolate infected individuals, many of whom are asymptomatic. The diagnostic and epidemiological principles that underpin such population-scale testing are also considered, as are the high-throughput and point-of-care technologies that make testing feasible on a massive scale.

2020 年 1 月，严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 基因组的组装和发布使得能够立即开发检测这种新病毒的测试。这开始了历史上最大规模的全球测试计划，迄今为止已有数亿人接受了测试。前所未有的检测规模推动了公共卫生检测管理策略、技术和概念的创新。本综述描述了新冠肺炎 (COVID-19) 大流行期间检测作用的变化，包括使用基因组监测来追踪 SARS-CoV-2 在世界各地的传播、使用接触者追踪来遏制疾病爆发以及检测病毒是否存在在环境中循环。尽管做出了这些努力，广泛的社区传播在许多国家仍然根深蒂固，需要对人群进行检测，以识别和隔离感染者，其中许多人没有症状。还考虑了支持此类人群规模测试的诊断和流行病学原理，以及使大规模测试可行的高通量和护理点技术。