Dr. Tom Price: Coronavirus tests – make prescription-free, at-home testing widely available

We must make widescale, rapid testing available

Across the vast majority of the United States cases, hospitalizations and deaths from COVID-19 are at some of their highest levels yet. These numbers are expected to continue to rise in the following increased travel numbers and family gatherings associated with the holiday season.

Despite the very positive news of vaccines becoming available, the reality is that they will not be available for all Americans until the second half of 2021. The lack of widespread vaccine availability has many implications, including the significant economic impact the virus is having on the American worker and economy.

While we cannot fully return to normalcy or get the economy operating at its full potential until there is either a vaccine or herd immunity, which will not occur any time soon, there are ways in which we can mitigate the impact of the virus.

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Of course, precautions like mask-wearing and social distancing will help. But we also need to re-evaluate how we approach testing, understanding that information is key to controlling the spread of infection, so we should equip Americans with as much information as possible.

While the barriers to testing are nothing like they were in the early days of the pandemic, there are still more challenges than necessary. We must make widescale, rapid testing available.

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Until population-wide immunity is achieved, which won’t be reached until the vast majority of the population is vaccinated, the best way to stop the spread of the virus is frequent, regular, reliable testing of millions of Americans. This testing should offer clear and rapid results and be self-administered in private settings.

While the FDA recently approved the first over-the-counter COVID-19 test, the main barriers to widescale rapid testing remain both regulatory and political. Daily testing with easy-to-use, rapid paper-strip tests is the most effective bridge to when we can achieve population-wide immunity.

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Most of the nearly 300 COVID-19 tests FDA-approved COVID tests, including paper-strip tests, must be processed in a lab. Except for the recently approved Ellume Health’s COVID-19 Home Test, the FDA also limits most tests to persons who have a doctor’s prescription.

However, the at-home, paper-strip test is the simplest and least expensive test. It can be just as reliable as other kinds of tests, if used frequently. All this test requires is a saliva sample rather than a nasal swab and gives a simple yes/no result in the matter of an hour.

Although less accurate than the FDA’s preferred polymerase chain reaction (PCR) test, these tests are quite accurate for detecting contagiousness, which is what matters most during this pandemic. Additionally, it is arguably more useful than PCR because it’s quicker and less likely to detect the virus after the person is no longer contagious. Any false positive – or a suspicious negative for that matter – result can always be caught by double-checking with a PCR test or a second rapid-test that targets a different antigen. This useful, quick test will save more lives than the current, highly accurate but, very slow test.  

The faster we make these prescription-free, at-home paper-strip tests available, the faster we can get control of the pandemic.

The faster we make these prescription-free, at-home paper-strip tests available, the faster we can get control of the pandemic.

The FDA needs to immediately drop the prescription requirement – this will significantly increase the likelihood that all people, including those who are asymptomatic but have traveled or visited family, will take a test. The government needs to encourage both the mass production of these tests while also considering subsidizing the cost to ensure all those who need tests are able to obtain them.

This should all be paired with a broader public health initiative to provide people information on how to be tested and the steps to take once the results are known. 

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Through easy to obtain, at-home paper-strip tests and a public health initiative to spread awareness, we will increase confidence in our COVID-related activity and aid in garnering trust for our system. This increase of knowledge and information will also enable Americans to actively take personal responsibility actions, in a way not possible currently, empowering them to do so much more to help.

Of course, we need a vaccine to get the virus completely under control. However, we could put these measures in place immediately, which would greatly increase information and the ability of all of us to act more responsibly as we continue to battle the pandemic.

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