Our View: Make rapid home COVID tests easily available
Instances when Americans might need to know whether they have COVID-19 and need to know now are legion, especially with a winter season of the delta variant and flu approaching. Examples?
Your child’s elementary school reports another student with COVID-19. Your employer wants proof of vaccination or twice weekly testing. There’s an upcoming indoor wedding with elderly attendees. Or a vaccinated member of your household has a sore throat and worries about a break-through infection.
A rapid test at home would provide an answer in 15 minutes.
But the pharmacy down the street is sold out. And at $14 to $24 for a two-test pack, costs can become prohibitive for those on a fixed or low income, or families with two or more children who might need frequent testing during school months.
Making matters worse is test sensitivity. The most inexpensive at-home product is an antigen test that detects proteins found on the surface of the coronavirus. They have an 80% average reliability for people with symptoms, but fare worse when there are no symptoms (a period when the infected are most contagious).
Even so, reliability of antigen tests can jump dramatically if someone repeats the process over a period of a few days. But that means acquiring a stockpile of tests. (Consumers also need to be sure to follow directions to the letter to ensure greater accuracy.)
If you were in Britain, where the government has contracted with a few key manufacturers, you could go online and order free tests. In Germany, where dozens of manufacturers compete to sell them with minimal regulation, the market-based approached has cut the cost of COVID-19 tests to about a dollar each.
Battered by the delta variant, and with nearly 706,000 COVID deaths, America needs to find its own solution.
A Harvard assistant professor of epidemiology, Michael Mina, has gained traction pushing for something closer to the German approach. He urges that the antigen tests be reclassified as “public health tools” rather than medical devices, thereby taking them out of the more intense review of the Food and Drug Administration.
This could mean relying largely on manufacturers’ internal reliability testing to gauge whether their products are accurate enough for public use.
The problem is that the FDA has been here before when it tried last year to expedite emergency approval of molecular rapid tests, which are more costly than antigen tests. It significantly reduced the review process requirements, only to later find that for twothirds of scores of submitted products, internal quality control measures were flawed.
If a test for a viral infection is unreliable, it’s worse than useless. It’s dangerous, because of the false negatives produced.
To his credit, President Joe Biden is tacking closer to the British example. His administration is working with Amazon, Kroger and Walmart to sell COVID-19 tests discounted by a third. And the federal government is spending $3 billion for several hundred million tests, many distributed to such places as long-term care facilities, prisons and homeless shelters.
But with an American population of 330 million, that investment still falls far short. Serious consideration must be given to making rapid tests free and easily accessible so that any and all can monitor themselves.
Americans have learned a lot since the first confirmed COVID case in the United States on Jan. 20, 2020. They know that even as cases are once again on the decline, they could surge back. They know the vaccine works. But they also know that a break-through infection could make them contagious to the unvaccinated (like young children) or those highly at risk. They just need to know whether that coughing is a cold or COVID.
Rapid tests can be the answer. The government needs to rapidly make them available.