{"id":9738,"date":"2020-07-26T16:14:10","date_gmt":"2020-07-26T20:14:10","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9738"},"modified":"2020-08-20T14:04:30","modified_gmt":"2020-08-20T18:04:30","slug":"time-to-amplify-our-voices-calling-for-inexpensive-rapid-home-testing-for-covid-19","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/time-to-amplify-our-voices-calling-for-inexpensive-rapid-home-testing-for-covid-19\/2020\/07\/26\/","title":{"rendered":"Time to Amplify Our Voices Calling for Inexpensive Rapid Home Testing for COVID-19"},"content":{"rendered":"

Earlier this month, I highlighted how inexpensive rapid home testing for COVID-19 could get us out of this mess faster than a vaccine.<\/a><\/p>\n

To spare you re-reading the whole thing, here are the main points.<\/p>\n

Imagine a simple test done on a saliva sample placed on a paper strip. Results back in 15 minutes. Available without a doctor’s order. A couple of dollars per test. Would be as easy to perform as a home pregnancy test.<\/p>\n

And, most importantly, the results will highly correlate with what we care about the most when testing a person without symptoms — are they infectious to others?<\/em><\/p>\n

With testing applied broadly, and a negative test in hand, think of the implications!<\/p>\n

Outpatient visits and procedures. Hospital visitors. Schools and universities. Air travel. Public transportation. Fitness clubs and gyms. Educational, business, and research conferences. Hair salons and barbershops. Bars and restaurants. Houses of worship. Nursing homes. Meat-packing plants, agricultural jobs, transit, and other high-risk work. Choral practices. Cruises. Homeless shelters. Dormitories and military barracks. Spectator sports. Prisons and jails.<\/p>\n

Endless, really.<\/p>\n

Prototypes for these tests, or slightly more complex versions, already exist.<\/a> So what’s the hold-up?<\/p>\n

Even though numerous companies and academic groups are working on such tests, there’s no guarantee the FDA will approve them — especially since they’re going to be less sensitive than the gold standard PCR tests we use for symptomatic people.<\/p>\n

But this lack of sensitivity shouldn’t block availability, since the tests likely will<\/em> be positive during the few days that people have the highest titers of virus in their respiratory tract, and hence are most contagious. The quantity of virus in this early period (as measured by cycle thresholds) often is millions-fold (or more) higher than just a week later. Rapid tests done regularly should be able to capture this period of exponential viral growth.<\/p>\n

And a reasonably accurate test with results back quickly is far better than no test at all — or, as is sometimes happening, a test done with frustrating and potentially dangerous delays in results due to testing backlogs.<\/a><\/p>\n

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Hey @michaelmina_lab<\/a>, this one's for you! h\/t @boulware_dr<\/a> @StarTribune<\/a> SteveSack. pic.twitter.com\/waA3PpKtAO<\/a><\/p>\n

— Paul Sax (@PaulSaxMD) July 25, 2020<\/a><\/p><\/blockquote>\n