Christy Smith has never been tested for the coronavirus. As a blind person, she can’t drive to testing sites near her home in St. Louis, and they are too far away for her to walk. Alternative options — public transportation, ride share apps or having a friend drive her to a test site — would put others at risk for exposure.
The rapid tests that millions of other people are taking at home, which require precisely plunking liquid drops into tiny spaces and have no Braille guides, are also inaccessible to Smith.
Many people who are blind or have limited vision are not being tested as often as they would like — and some are staying isolated because testing is too difficult.
“Not all of us have access to somebody sighted to help with things on a regular basis,” Smith said. “It’s kind of a mix of frustration and just feeling a bit helpless,” she added.
When Smith’s husband, who is also blind, fell sick with a sore throat, stuffy nose and fever last fall, both of them isolated at home until his symptoms disappeared. They never found out what pathogen caused the infection.
Some blind people manage to take at-home tests with the help of video call apps, like Be My Eyes and Aira. These services pair blind individuals with a sighted person who can describe their surroundings and guide them through a test, step by step.
But these interactions are difficult, and not everyone who is blind owns a smartphone or is able to use a smartphone. What’s more, relying on others can erode a blind person’s privacy and independence.
“It’s your personal health information,” said Martin Wingfield, the head of brand at the Royal National Institute of Blind People in Britain. “You should be the first to know.”
Wingfield is part of a team that created a home pregnancy test that delivers results through raised bumps that can be felt by a blind person. The prototype uses a battery-operated motor that transforms chemical changes on a strip into raised bumps.
Known as a lateral flow assay, it is the same type of test used to detect the coronavirus at home. So in theory, the institute’s prototype could be modified to make at-home coronavirus tests more accessible, Wingfield said. The cost of so-called tactile tests would be roughly $20 to $30, he said, though manufacturers might be able to make them for less.
Another way to deliver test results could be through a change in smell or temperature, according to Hoby Wedler, a blind chemist and entrepreneur. Currently, most at-home tests use substances that change color after a chemical reaction. But “there are all sorts of things we can have these indicators do other than change color,” he said.
Although a change in scent might not be useful for COVID patients, who often lose their sense of smell, Wedler argued that other types of at-home tests could be made more accessible through concepts like this.
Coronavirus tests can be tricky to carry out. Many require the user to dispense liquid into small holes and not touch the testing strip.
“Blind people do most of what they do using touch in some way,” said Kim Charlson, the immediate past president of the American Council of the Blind. “Even guiding the swab into the tube without touching something or touching it can be very difficult, even for people who have been blind for a long time and are pretty confident.”
Charlson has worked with health agencies to create more walk-up test site options, and she is now asking manufacturers to make more accessible home tests.
One such company is Abbott, which makes the popular BinaxNOW test. When developing new tests, said Aly Morici, an Abbott spokesperson, the company will “continue to design with access and affordability in mind,” but she declined to give specifics about whether Abbott has plans for a redesign.
Some fixes could be as simple as changing the test instructions, according to Mark Riccobono, president of the National Federation of the Blind. When he and his wife, who are both blind, took at-home coronavirus tests in November, Riccobono had to ask his oldest child to read the instructions aloud.
Manufacturers could instead provide a phone number in Braille that people could call for instructions, Riccobono said. He also suggested that some sort of touchable template be placed over a test card or cartridge to orient blind people as to where they should drop liquid or put their nasal swab.
“It’s not really rocket science, there’s some easy things we can do,” he said.
In Britain, accessible instructions are already available, according to Michael Wordingham, a policy officer with the Royal National Institute of Blind People. These instructions, which can be found in Braille, large text or audio formats, explain how to navigate the process through touch.
“If you think about the swab, it would say, ‘Before you take it out of the packet, feel along for the thicker end and make sure you open it out of the other end so you don’t contaminate the swab,’” Wordingham explained.
Still, even the simplest solutions will take time to enact. Without good testing options now, some blind people, like Karen Johnson, 37, of Fort Wayne, Indiana, are largely staying home to be safe.
Johnson hasn’t seen some family members since the beginning of the pandemic because she said it is too hard for her to figure out how to be tested before and after a flight. When she does go into public spaces, Johnson is vigilant about wearing a mask and sanitizing her hands because she doesn’t know who else is wearing a mask or whether everyone is staying 6 feet away.
Ideally, she said she would love to have a free, public service where workers come to people’s homes to collect samples and run tests. Currently, some private companies like Scarlet and ParaDocs offer this service, but they cost more than regular at-home tests and are only available in certain areas, mostly in large cities such as New York, Miami and Los Angeles.
If these services were at least cheaper and more widespread, Johnson might finally be able to get tested.
“I would love to at least have that peace of mind to be able to say, ‘I didn’t catch it and I didn’t give it to you,’” Johnson said.
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