The Challenges of Expanding Rapid Tests to Curb COVID-19

Type Journal Article Author Rita Rubin URL https://jamanetwork.com/journals/jama/fullarticle/2772299 Publication JAMA Network | Medical News & Perspectives Date 21/10/2020 DOI 10.1001/jama.2020.21106 Abstract The test would cost around a dollar, and it would provide results in about the time it takes to brew and down the day’s first cup of coffee. A negative result would mean it was safe to go to work or to school, as long as other basic mitigation measures—mask wearing, social distancing, and handwashing—were practiced. A positive result, seconded by a different test, would necessitate self-isolation. Given that an estimated 40% of people with SARS-CoV-2 infection have no symptoms but can still transmit the virus to others, widespread, do-it-yourself (DIY) rapid testing for presymptomatic or asymptomatic people could end the exponential spread of coronavirus disease 2019 (COVID-19), said Mina. An epidemiologist, pathologist, and member of the Center for Communicable Disease Dynamics at the Harvard T. H. Chan School of Public Health, he also directs a recently launched volunteer organization called Rapid Tests. By contrast, the gold standard polymerase chain reaction (PCR) test used to diagnose COVID-19 requires laboratory processing that sometimes takes days, not minutes, to obtain results, due to backlogs and supply shortages. So an individual could be negative when tested but positive by the time the result is returned. As Amesh Adalja, MD, senior scholar at the Johns Hopkins University Center for Health Security, said in an interview, “a PCR test that [gives] results back in 8 days is a worthless test.” Frequent rapid testing “could potentially be game-changing before the vaccines,” said Rochelle Walensky, MD, MPH, an infectious disease physician at Massachusetts General Hospital and an advisor to Rapid Tests. “The opening up of society could happen much sooner.”