President Donald Trump and Gov. Kim Reynolds are pinning their coronavirus response plans on new shipments of rapid COVID-19 tests. Reynolds at a news conference last week said the new tests would significantly increase testing access, providing nearly a million additional tests.
Any new testing capacity is good news, but this may be too little, too late. These are not the super convenient and accessible COVID-19 tests we have been waiting for.
The feds are sending states more than 100 million rapid tests from Abbott Laboratories. The new tests deliver results in about 15 minutes without expensive lab equipment, but still require a health professional to administer them. Reynolds is reserving Iowa’s share, some 900,000 tests, for medical offices.
This is a far cry from the testing regime many people envisioned at the onset of the pandemic in the United States eight months ago — cheap tests people could take at home every morning before they went out into the world. We have the technology to offer truly rapid COVID-19 testing, but we don’t have the political leadership or regulatory will to make it happen.
There are different types of virus tests, each with advantages and disadvantages. Iowa and the United States need an all-of-the-above strategy to regularly test a large share of the population.
Highly sensitive tests can detect smaller virus loads, but they are expensive and also time-intensive, which means patients often are no longer infectious by the time they get a positive result.
Cheap, rapid tests are less accurate but still would be hugely beneficial if the government would allow them on a mass scale, according to a recent article in a top U.S. medical journal.
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Low-sensitivity tests are good enough to identify the most infectious cases, and could be distributed on a much larger scale, according to experts from Harvard University and the University of Colorado writing in the New England Journal of Medicine last week. So far, however, government approval of COVID-19 tests has hinged on high sensitivity for the virus.
High-sensitivity tests would be great if everyone could get them. Since we can’t, the prevailing testing strategy likely is only capturing a small portion of cases. Authors of the new paper call on federal officials to offer a regulatory pathway for non-clinical, at-home use.
“Measuring the sensitivity of a testing regimen or filter requires us to consider a test in context: how often it’s used, to whom it’s applied, when in the course of an infection it works, and whether its results are returned in time to prevent spread,” they wrote.
Not only has Trump’s federal government failed to effectively build up adequate testing capacity, it has actively impeded other entities’ efforts to innovate.
Since the beginning of the pandemic, the federal government’s broad and rigid medical regulations have repeatedly stood in the way of promising new testing capabilities. An early decision to block private labs from developing their own tests may have contributed to a deadly delay in surveilling the virus.
After the better part of a year, we still have not learned the basic lessons from the early days of the pandemic. In Iowa and elsewhere, coronavirus continues to spread largely undetected.
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