By Dr. Navin Vembar
Good news has been difficult to find amid the Coronavirus pandemic, so when new information about rapid, cheap COVID-19 testing emerged over the weekend, I was genuinely excited.
Rapid tests aren’t a brand new concept: 30-minute testing was deployed on the West Coast throughout the summer by event businesses who are determined to do business despite recommendations to adhere to social distancing guidelines, and some doctors have even conducted rapid testing as a private consulting service. But two companies, SalivaDirect and Rapid Tests, present the kind of scalable testing we need to improve our testing capacity and infrastructure as we work to get students back in their classrooms and move towards restoring our societal and business activities.
Both of the companies I read about leveraged rapid, cheap tests that would allow testing to be scaled dramatically. That’s important because, even if they’re less accurate than their existing counterparts, which have proven painful and difficult to coordinate and access en masse, increased testing frequency and availability can help us more quickly return to a more normal version of the country.
SalivaDirect’s Testing Protocol
SalivaDirect is a new lab-based testing solution that can be pooled, costs less than $4 per test, and can scale up PCR-based testing. By design, it’s a protocol not a product, meaning that labs can be approved to follow the protocol, but there isn’t a central owner of the process, and it appears that their approach took into account the cost and availability of materials in design. All of that means that more prevalent testing is going to be available. And, in further good news, the FDA gave the protocol an emergency approval this weekend, which means implementation is going to happen soon.
Even with less accurate testing, if we can test daily, in the home, we can more quickly work at an individual level to contain the outbreak.
This isn’t generally true about all diseases, but COVID-19 surveillance is greatly improved by this approach given its ability to spread quickly and “hide” in non-symptomatic people. The governmental approvals are predicated on a clinical level of accuracy, however, so some work will have to be done to make it clear how these tests are to be used and for what purpose. Even without a clear articulation of the scaling of rapid testing infrastructure and resources or the guidelines that will emerge alongside their use, one can easily imagine a lot of these $1 tests will become available to everyone and policies will be put in place that require people to test negative two or three days in a row (to offset the accuracy) before going to work, classes, or public events.
“With more widespread transmission, we need to serially screen an even larger fraction of the population to find and stop spread.”—The Washington Post
These are hopeful steps in our ability to contain COVID-19 through low-cost, highly-available disease surveillance. A truly effective strategy would require additional inputs and efforts, including:
- Reasonable policies—both governmental and institutional
- A general understanding by the public of what these tests provide (and a quick ability to know when you should isolate) and what they don’t (perfectly accurate understanding of whether you have COVID-19 or not)
- Hot spot forecasting and identification of geo-specific risk areas based on accurate and aligned mobility data, with the ability to reallocate testing resources quickly and efficiently
These are not approaches that magically remove risk, but dramatically improve our ability to curtail spread.
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