At-home testing could transform the fight against the novel coronavirus. USA TODAY
Dr. Michael Mina thinks theres a simple way to beat back COVID-19: fast, cheap tests, taken at home every day or two.
Right now, tests are designed for medical purposes. They identify whether someone with symptoms has COVID-19 or not. But they miss according toMinas estimate 97% of people when they are most infectious.
COVID-19, we now know, is most contagious in the first few days just before a person shows symptoms and in the few days after symptoms start, if they ever do. Waiting until someone has symptoms before scheduling them for a test, means they wont know they were contagious until they arent.
In recent weeks, Mina, an infectious disease epidemiologist at the Harvard T.H. Chan School of Public Health, has been lobbying heavily for fast, cheap, at-home tests, hoping to get the federal government to fund their development and remove barriers to their approval. Hes spoken with senators, foreign leaders, and company executives, who share this idea, but is increasingly frustrated by the administrations inaction.
Dr. Michael Mina(Photo: Harvard T.H. Chan School of Public Health)
On Friday, he laid out his vision to reporters on a group Zoom call. What follows is an edited version of what he said.
The tests that are being deployed now are like deluxe espresso machines. These are tests that require instrumentation. Therell be a big, big startup cost to get it going and each individual test will be expensive. They will have a difficult time getting the scale to where it needs to be to make an impact on a population level. What I really want is the instant coffee version. I want a $1 thing versus a $20 thing.
The way to do that is to use cheap tests that are highly accurate to detect somebody at the moment theyre transmitting. People can act on it, because theyre getting immediate results. I want them to take them every single day or every other day.
More: 'Totally unacceptable': Testing delays force labs to prioritize COVID tests for some, not others
If we can get a test that everyone wakes up just like they put in their contact lenses they take a test. And if it turns positive, they stay home. And they take a test the next day and they stay home until the test turns negative, or for a set number of days, maybe 7 days.
That alone, if everyones doing it, or even just a majority of people are doing it, it will stop the vast majority of transmission and it will cause these outbreaks to disappear in a matter of weeks. We dont have to wait for a vaccine.
We could reduce maybe by 90-95% transmission in this country in the next few weeks if everyone could have one of these tests tomorrow. Of course, thats not at the moment possible, but it could be if the federal government were treating this with the same urgency that theyre treating a vaccine, which may or may not even work.
(The government should)put $1 billion into really pushing the technology for $1 paper strip tests that can be printed in the millions, which they can be, and get a package of 50 in every Americans hands over the next month or not even every American it could just be Texas, Arizona and Florida right now, because those are the states that are seeding infections to other states.
Were allowing red tape and this archaic view we have so defunded and under-appreciated public health in this country for so many years that we literally dont have a recognition of the fact that there could be a test whose main goal is public health and not clinical medicine. Everything is wrapped up in insurance reimbursements and FDA regulations as diagnostics. It takes a whole rethinking of what a test that somebody might use looks like and how its defined.
Im usually not against regulation, but its just gotten so extreme here, and its truly been hindering every step of the way our ability to test our way out of this virus since February. The current landscape is bottlenecking these companies that could have a cheap test today into producing a more expensive espresso machine, because they cant actually legally use the instant coffee.
Until the regulatory landscape changes, these companies have no reason to try to bring (a fast, cheap, at-home test)to market. So, a lot of them are just kind of sitting on it. Or theyre trying to spend more time and more money to better and better optimize tests, which might take months. My fear is that what will come out of it at the end of those months is a test that does meet FDA approval, but thats too expensive and too complicated to scale and use for everyone.
A lot of people are wasting time trying to figure out how to get instant coffee to be as good as espresso. Theyre different things.
I have no financial ties or any other connection to any of these companies. Im truly just basing this on science.
We dont have a vaccine tomorrow. We dont have anything but shutting down the economy and keeping schools closed. This can work. This is a tool that tomorrow could start to go into production and within a few weeks time could start to change the whole course of outbreaks in major cities in America and in so doing, make all of the United States safer.
Contact Karen Weintraub at kweintraub@usatoday.com
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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How to stop the COVID-19 pandemic? Harvard doc says cheap tests are the answer. - USA TODAY
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