Consider this alternative to your morning routine: Your alarm goes off, you turn on the coffee machine, you brush your teeth, and you take an at-home COVID-19 antigen test. By the time you are pouring that cup of coffee, you’ll know whether you are contagious and can make a smart decision about whether to go to work or school or stay home.
Inexpensive, widespread, frequent, rapid testing — either at home, school, or the workplace — is a critical public-health tool, and our fastest way out of this pandemic. Yes, highly safe and effective vaccines are rolling out across the country right now, and they are truly a scientific marvel. But most Americans are still months away from being vaccinated, and we’re on track to lose another 250,000 Americans before April. We can’t afford to wait.
Our current testing system could be summed up as “too little, too late.” People are most contagious from a couple of days before they show symptoms into the early days of illness, but we don’t test people until they have symptoms. An estimated 20% of us never get symptoms but can still spread this disease to others unknowingly. Also, it can take several days to get PCR test results back, so by the time one finds out they’ve tested positive, they may no longer be contagious and likely cannot remember who they were with last week. And their contacts have already begun spreading the virus.
Rapid antigen tests offer different possibilities. Think of a home pregnancy test. They can be done anywhere, don’t require a lab and give quick results. They may be less sensitive, but the idea is to identify people when they have the highest viral load and are most likely to spread the disease. Time is a critical factor, and these could be done two or three times per week. If viral levels are too low to be detected on Monday, they’ll be caught Wednesday, and that child will stay home from school when he is most likely to infect others. Meanwhile, in today’s world, that child would not even be tested. Or, if he was, he’d still be waiting for the results. Right now we are flying blind. Antigen testing at scale would be a game changer.
Teachers, staff and families are afraid to bring large numbers of children together indoors, especially older children. Until there is widespread vaccination, most parents I speak with would feel much safer sending their children back to school if they knew all the students and staff were being screened on a regular basis. This doesn’t preclude masks and distancing. It adds another big layer of safety.
This is how rapid antigen testing, appropriately priced and scaled, could help reopen our schools safely. Think about what this would mean for restaurants, fruit packing plants and other settings.
Rapid tests are another tool in the toolbox but likely one of the most powerful ones.
We are so close to this being a reality. Last week, Congress passed a $900 billion stimulus package that includes $25.4 billion in funding for testing. If just a fraction of this funding went to the manufacture, purchase and widespread distribution of these simple antigen tests, we could get this virus under control within weeks, get back to school and work safely, reboot our economy, and save thousands of lives.
The FDA earlier this month gave emergency use authorization for two home antigen tests. They are still too expensive to make them practical for this model of frequent home testing. But more are in the pipeline. We can expect production to ramp up and prices to drop. So, continue to mask and distance. Don’t gather indoors. Get your coronavirus vaccine as soon as you are able. And I’ll continue my work to get these tests to our schools, businesses and homes as soon as possible.