Can the cheap tests save the Spring semester?
August 19, 2020 Leave a comment
So, regardless of what happens at NC State, Fall semester at a bunch of places is on-line only. It’s really not the same. It seems to me one place in particular where Michael Mina’s ubiquitous, cheap, daily testing plan could totally be implemented to great effect is college campuses. Its frustrating that this still is not approved, but there’s damn sure no reason (other than that its amazing how bad this country is doing at everything except science innovation) we shouldn’t be able to scale this by Spring. Anyway, I’ve written about this before, but I think David Plotz has the best summary of this testing regime I’ve seen:
COVID testing, like almost every aspect of the American response to the pandemic, has been a disaster. Tests are expensive and exceedingly slow. You don’t get your results back for days — or even weeks — meaning you’re very likely to spend your most contagious hours spreading the virus as you wait for a result. Plus they’re hard to get, so only a tiny fraction of the people who should be tested actually are tested.
But finally, finally, there’s a great, attainable, new idea for revolutionizing testing — a new testing protocol could stop the pandemic cold, and bring us the benefits of a vaccine without a vaccine. The basic notion is that we should mass produce very cheap, very fast, and somewhat inaccurate at-home COVID tests, and millions of us should take them daily. The architect of this plan is Harvard epidemiologist Michael Mina, who’s outlined his case in the New York Times, the Atlantic, and in a podcast interview with me, among other places.
The technology exists. A few small companies have developed COVID saliva tests that you can do in 15 minutes at home. (The tests — essentially a strip of treated paper — works a bit like home pregnancy tests.) In Mina’s scenario, we would mass produce these tests, which would cost $1 to $5 each, and tens of millions of us would take them every day — any kid before going to school, any worker before heading to the office. If you tested positive, you’d get the result immediately and you stay home. This would break chain after chain of transmission, and crush the pandemic as effectively as a vaccine.
So why aren’t we doing this? The FDA won’t approve the cheapo tests because they’re not as accurate as the gold-standard PCR tests. They use a different, less precise method, and only catch people with a higher level of circulating virus. But Mina points out that this is actually the strength of these cheap tests — which are more “contagiousness” tests than “diagnostic” tests.
The gold-standard PCR tests catch tons of people way past their contagious period, when they have tiny amounts of coronavirus RNA but aren’t actually infectious. The cheap tests catch virtually everyone who’s actually contagious. More importantly, it catches them immediately, and while they’re at home, so they know they’re sick in 15 minutes, not days later when they’ve been out spreading the disease. Most importantly, it doesn’t require massive infrastructure and a lab, just some of your own spit and a strip of paper
Mina told me he’s getting calls from top officials around the world — “crown princes” — about trying this out, and he knows the idea has made its way to Jared Kushner’s office. The US is practically the only country that has enough community spread where this kind of mass home testing makes sense. Other countries accomplish the same crackdown with vigorous contact tracing.
The US should crash course the cheap-test program immediately by funding the small companies to scale up production, and should pilot it in a city that’s experiencing an outbreak. How quickly could they bring rates down if they had half the population of Miami taking a daily test? If that works, do it nationwide. It would cost billions a week, but the pandemic costs way, way more. Until we get a vaccine, this is the best idea we have for getting back towards normal.
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