Written by: Catherine Kawaja ‘24
Edited by: Max Ulibarri ‘23
The technological advances of the last thirty years have increased the demand for and opened up the possibility of shortcuts in all areas of life. Now that tasks like grocery shopping and ordering transportation have been replaced by a click of a button, people have little patience for long wait times or unnecessary errands. The many problems of the COVID-19 pandemic are no different. People want to see accessible treatments, efficient dissemination of a vaccine, effective contact tracing, and arguably most importantly, quick and simple testing.
Without widespread, frequent testing for both asymptomatic and symptomatic people, treatment plans and contact tracing will be in a constant state of catch up. Identifying positive individuals quickly allows them to self-isolate and obtain medical care, reducing risk for themselves and those around them. Furthermore, quarantining earlier in the course of infection reduces community spread of the disease. In short, testing helps save lives. From a broader public health lens, testing also increases understanding about how specific outbreaks are related to policy efforts such as making masks mandatory, the disease’s infection rate, and specific age groups or communities that are being affected disproportionately.
However, in contrast to the many inventions that have generated our fast-paced society, many forms of testing have slow results and are not easily accessible. The incentive for people to get tested decreases vastly if testing means driving far from home to reach a testing facility, waiting several days for results, or missing work. Furthermore, sometimes it can be complicated for doctors to connect with the patients after the test was given. It is not feasible nor productive for all testing to occur in person without immediate results. This is not only because of the problems stated above, but also because the world doesn’t operate solely on an in-person basis anymore. If one can get most information and necessities from their phone, shouldn’t one be able to use their phone or another easily operated device to get COVID-19 tests and results as well? Companies like Everlywell, Quidel, and FastDetect, Inc. say yes.
These companies are adapting testing to the modern world in different ways. Everlywell, like many others, sends at-home tests to patients who then set up a profile and register their kit ID on the website. After using a nasal swab to collect a sample, users mail their tests out and receive results online within 72 hours of the lab receiving the package. The process of testing oneself is much less time consuming and more comfortable as it is in the home. However, Everlywell tests cost $109, and despite insurance reimbursements, the up front cost makes them unavailable and impractical for many people.
Source: Everlywell, Find Out Whether You Are Infected with COVID-19 [Internet] [December 22, 2020]. Available at: https://www.everlywell.com/products/covid-19-test/
Devices from Quidel and FastDetect are not currently used in the home, but they give almost immediate test results. These companies present the possibility for rapid testing at airports, schools, and maybe even concerts and sporting events that could potentially allow for larger groups of people to congregate in a safe way. In medical facilities, the short wait time of these devices could help solve the problem of doctors connecting with patients about results, treatment plans, and quarantining. Quidel’s device costs over $1,000 and FastDetect’s is $2,000, but once purchased, each test will only cost $5 and $15 respectively. The high volumes of tests made possible by these devices would eventually make up for the upfront cost.
Quidel’s Sofia 2 is an antigen test, which is different from Everlywell and FastDetect’s use of polymerase chain reaction (PCR) to detect the virus. An antigen test of a nasal swab detects parts of proteins that are found on or within the virus. This can be done much more quickly than PCR, which detects the specific DNA or RNA sequence of the virus. After the sample is inserted into Sofia 2, it only takes 15 minutes for the test results to be displayed. Unfortunately, the Quidel test has a 4.8% false negative rate, which is relatively high. Because of this, there is a greater likelihood that people would unknowingly spread the virus.
Source: Quidel, Sofia SARS Antigen FIA [Internet] [December 22, 2020]. Available from: https://www.quidel.com/immunoassays/rapid-sars-tests/sofia-sars-antigen-fia
CalTech scientist Axel Scherer’s FastDetect test is a breakthrough approach that could solve the problems of the current testing options once it is in circulation. Scherer increased the speed of thermocycling to make PCR faster (the process usually takes about an hour). Additionally, to improve detection, Scherer’s device reflects light inside a cavity through the PCR product. PCR is much more accurate than antigen testing, and Scherer’s test will produce results in less than 20 minutes.
Source: FastDetect, FastDetect Point-of Care Everywhere [Internet] [December 22, 2020]. Available from: https://fastdetect.com
The increased availability of at-home and rapid tests will transform the response to and experience of this pandemic. Momentum is in the direction of these companies because they are working to make frequent COVID-19 testing fit into the modern lifestyle of the public.
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