Back in August I wrote that cheap $5, 15 minute Covid-19 tests could really open up travel and other activities.
- If testing was cheap enough and available enough, everyone could test themselves everyday
- Testing could be done on the spot before travel. Everyone would know that everyone else on board had been tested.
These are highly specific and sensitive tests, but not perfect. Still they’re likely better than a PCR test taken days in the past, taken only by a handful of travelers.
The good news is that the Abbott Labs BinaxNOW test I wrote about four months ago has finally received an Emergency Use Authorization. The bad news is that this $5 test is now a $30 test because in order to approve it the government required people taking the test to be monitored. And it requires a prescription.
Here’s Harvard epidemiology and immunology professor Michael Mina:
The test IS the type of rapid test I have been calling for.
BUT: requires a prescription – and instead of $5 it will cost an additional $25 for a digital MD service to have someone watch you use it
Example of taking a simple cheap test and making it difficult/inaccessible
2/
— Michael Mina (@michaelmina_lab) December 16, 2020
What if someone self-administers a test wrong? (This happens even with professionally-administered tests, and contributes to error rates.) What if someone tests positive and results aren’t reported directly to health authorities? (In much of the country there’s very little contact tracing being done, either because of lack of investment or because the virus is so widespread it’s simply not possible.)
BinaxNOW, by the way, effectively uses the same methodology as an over-the-counter pregnancy test. And self-sampling from the anterior nose is considered reliable.
The FDA’s stance has been to prohibit testing that they cannot fully controlled, preferring less testing over frequent self-testing that isn’t monitored, with direct access to results. Remember the FDA forbid use of any test other than the CDC test that didn’t work at the start of the pandemic.
The Ellume test, available at home without a prescription starting in January, is expected to cost $30 as well with results reported via an app (“That app automatically sends data by Zip code to the cloud — ensuring that regional health officials can learn about positive results”).
We know it’s possible to have $5 at home tests, because we now have one. It’s likely possible to drive the cost down further. Then, at least until spread and vaccination brings the virus under control, many people could test themselves every day and know to self-isolate when a result comes back positive. Companies could require it of workers. Businesses could require it of consumers. That doesn’t eliminate the risk of spread, but it substantially reduces it, and lets normal life resume. It’s possible, if only the government would allow it.
Current tests at the $75 – $150 price point aren’t working, just look at daily case counts in the U.S. Maybe sub-$5 paper strip tests are worth a try.
Hi Gary. It is a great idea, in principle. But these tests have major flaws. Mina has been pushing this message for months, even as the entire scientific community is calling BS on his claims. Mina shames and rages against anyone who opposes his unsupported view and ignores all requests for evidence that these tests are viable for use in the way he’s proposing. There are serious issues with what he’s proposed and supports, please take this in to account as you publish this article and look in to the storm he’s caused. Scientists across the country would love for something as easy as he’s proposed but it’s based on bad science by someone who has wrongly been given a soapbox.
One huge problem with testing is that they will get sick with Covid-19 the same way as Trump did. With Trump, the White House did massive testing. Everyone tested everyday, sometimes twice a day. Gazillion test. Test, test, test. All negative. Then one person got Covid-19 while still negative (later became positive) and WHAM! Trump is infected.
Testing is great but is backward looking not a picture of the present.
This is offensive clickbait. The author has zero qualifications. That nearly every western country has struggled with finding a balance between an expectation for free movement/privacy and control of community spread of disease is not a function of what test is used, FDA policy or cost. So everyone gets a $5 test they are not trained to administer or interpret and some not insignificant portion show up in emergency rooms with false positives. Great solution. This is just devise so you can capture an extra 23 cents in ad revenue. Pathetic.
Yeah, it’s delusion to think rapid testing opens up travel.
So let’s say I’m taking a trip. I test negative day of departure. Great!
But wait i was exposed 3 days ago and I dont know it.
So three days after arriving at my destination i test positive. Now I have to isolate for at least 10 days, away from home, in a hotel room, at my own expense. And hope I don’t actually get really sick.. It only gets more difficult if that trip was abroad.
Thats not a workable system.
Travel only comes back once people are protected from disease through vaccination.
99.8% survival rate.
@Derek,
Not saying testing in infallible, but testing is not just backward looking. Trump is a terrible example since they may have tested most/all of the people around him daily, but doubtful Trump and associates tested as often as they claimed. The administration wouldn’t say when he last tested negative prior to his positive test and also Trump himself refuted how often he was tested. Finally, testing without following any other guidelines of mask wearing and distancing like Trump was doing is ridiculous and resulted in exactly what anyone would expect–Trump infected.
I assume from this article you believe bad data is better than no data.
The reality is if you’re sick, you shouldn’t be travelling. If you feel fine, you should. Latest research shows that asymptomatic people rarely spread the virus, even to members of their own household. The risk of asymptomatic travelers giving you Covid on a plane is, apparently, near zero. HEPA-filtered airplane air is not conducive to Covid spread. Not that many understand this, of course. But it’s the reason why people who are “out and about” don’t have more Covid than people who stay home (where the spread actually happens).
@JimC – Exactly right! They were not testing daily or they would have said so. It is highly likely he was infected the night of the debate when his whole family refused to wear masks, except his wife. Even trying to do things right, people end up infected but the White House has not been any kind of a good example.
Defeating the virus is the only way to get travel — and freedom — back: https://www.bloomberg.com/news/articles/2020-12-15/air-travel-demand-is-higher-than-ever-in-australia-jetstar-says
I agree with your view. Don’t let the perfect be the enemy of the good. We need, desperately, widely available, quick, cheap, “good enough” testing in this country to go along with the more accurate, expensive, slow lab testing that (after almost an entire year) we still can’t seem to make readily available.. It doesn’t need to be 100% accurate. Even temperature scans would catch a fair number of cases and we won’t even do that. In the past year I’ve only been to two businesses that scanned my temperature before entry (both Asian) and it took all of 10 seconds and required no expensive equipment. If we’d adopt a lot more of the low-tech, low cost measures (aside from the obvious ones like mandatory masking) as part of the overall strategy it would make a big difference and yes it would help us be able to travel again sooner. It is unbelievable that we are (hopefully) now within 6-9 months of real progress worldwide in the pandemic using vaccines and the travel industry and most countries still haven’t figured out or agreed upon a path going forward for systematic and relatively safe travel. I mean how do they expect people to be buying plane tickets for even the summer or the fall if people still have no idea what the requirements for travel will be most places?
@Bob,
many airlines now have a covid19 insurance incl in the airfare free of charge. If you’re tested positive they cover all the cost for the quarantine, lodging, food, free rebooking,…
How much does a Rapid Antigen test cost in the U.S.?
Over here you get a box of 25 tests for around 200€, i.e. Roche rapid antigen test.
That’s already considerably cheap.
Cheap enough to test ourselves every time we have to absolutely see someone else
So I’m not sure if anyone posting here is a healthcare provider, but I’ll provide my two cents.
First of all, sensitivity and specificity are based on the test itself (from the sample). PCR is a highly reliable method for testing. But that ASSUMES you get an adequate sample, which raises a HUGE question.
Being literally at the FRONT LINES for this past year (hooray), patients who present with COVID do not come always with a cough, runny nose, or sore throat. I’ve had patients just come with diarrhea for 5 days, with a fever. But here’s the kicker-despite covid being a virus, if your infection is in your gut for example, you may not get an adequate sample from the nose. Infection from COVID doesn’t mean you fluoresce with COVID particles all over your body or your nose such that “if it’s caught in the nose, its definitely in your body”. Therefore, nasal swabs have SIGNIFICANT limitations on illness.
Lets not forget the fact that not everyone has a massive viral load if you swab their nose. We’ve had patients who went to the ICU, who had 3 negative COVID swabs and the last one was positive. How did we know it was covid? low oxygenation, fever, classical chest x-ray/CT scan findings that were indicative of COVID and nothing else. So even the sickest of sick people may not be able to provide an adequate specimen for testing.
So, let’s take any of us at home. Some will swab better than others, some may not want to swab at all. Some might even just run their swab through the sink and say it was their swab. With a test where getting an adequate sample is so hard, this cannot be done at the national level. I think the general public latches on to these words like specificity and sensitivity as “a perfect test”, but that is assuming laboratory conditions. PCR itself, is sensitive and specific. But that is a laboratory test, not a clinical test.