Why We Can’t Let COVID-19 Vaccinations Distract from Rapid Testing

The acceleration in COVID-19 vaccinations the U.S. has experienced thus far in 2021 is without question reason for future optimism, but we can’t lose sight of another breakthrough that is critical to the world’s ability to manage the virus: the development of rapid, at-home testing for infectious diseases.

As vaccination numbers have increased, many local governments and individuals across the nation have begun to let their guard down, easing restrictions on public gatherings and mask-wearing, perhaps believing a return to the normalcy of pre-COVID times is just around the corner. Deeper analysis reveals that this is largely wishful thinking.

Even an advanced country such as the U.S., which has thus far been among the world’s leaders in vaccinating its citizens, likely has a long way to go to reach vaccination rates of 70% to 85% that are necessary to achieve herd immunity. A report from Bloomberg estimated it would take until 2022 for the U.S. to achieve herd immunity, and that, too, may be wishful thinking given widespread vaccine hesitancy among certain groups. For example, one-third of U.S. troops have opted out of vaccination and 49% of Republican men in a recent poll said they don’t plan on getting vaccinated.

Regardless, one definitive conclusion we can make is that the rest of the world is significantly trailing developed countries such as the U.S. and United Kingdom in vaccination administration. Bloomberg estimated it would take the rest of the world another seven years to achieve herd immunity at the current pace of vaccination. Along those lines, 85 less-developed countries, primarily in the Southern Hemisphere, are not expected to have widespread access to the vaccine before 2023, according to The Economist.

In short, COVID-19 is here to stay – at least for several years, and possibly forever, just like influenza or the common cold. The reality is that we aren’t going to “beat” the virus in the sense that it will become a thing of the past, but we most certainly can do a better job of managing and containing it.

That brings us to testing. Until the world achieves herd immunity, citizens of both developed and emerging economies will need access to rapid, self-administered COVID-19 tests to slow the advance of the virus. These types of tests are needed to distinguish among a variety of acute respiratory infections that display common symptoms, such as influenza, respiratory syncytial virus and even pneumonia. The not-so-good news is that we aren’t close to where we need to be, even in the U.S.

A recent analysis from researchers at Brown and Harvard universities revealed that the U.S. needs to perform about six million tests per day to stop outbreaks from growing and protect vulnerable citizens. However, as of late March, the nation’s daily testing count stood at less than two million and has never exceeded three million since the pandemic’s beginning. You can bet the daily testing situation across the globe is considerably more dismal.

Why do we need testing when we’ve got vaccines?
In the U.S., COVID-19 cases, deaths and hospitalizations have declined from their earlier highs as vaccination rollout has progressed. While that is clearly a positive development, the negative side of the coin is that this progress has prompted us to collectively disregard testing, which serves as a critical component of slowing the spread of COVID-19 from a public health standpoint.

For example, “a regimen of regular testing works as a sort of COVID-19 filter, by identifying, isolating, and thus filtering out currently infected persons, including those who are asymptomatic,” according to a New England Journal of Medicine editorial by researchers from Harvard University and the University of Colorado.

Testing delivers significant public health value in two ways. First, it informs individuals when they are infected and need to self-isolate. Second, it enables officials to monitor and track the progression of the disease. Further, considering the recent expansion of COVID-19 variants as well as uncertainty about whether vaccinated individuals can continue to spread the virus, the need for rapid testing is and will remain significant.

What’s needed for successful COVID-19 testing
Although there are a number of what are touted as rapid “at-home tests” for COVID-19 on the market, many of these are misleading. “At-home sampling” is a more accurate description for most of these tests, which typically require users to send their samples to a lab for analysis, a process that usually takes several days.

There are two types of COVID-19 diagnostic tests: molecular, such as polymerase chain reaction (PCR) tests, and antigen tests. Each require a nasal or throat swab but differ in what they attempt to detect. Molecular tests seek out genetic material that comes only from the virus, while antigen tests identify protein fragments that are indicative of, but not unique to, the virus. For most people, a molecular test is generally the better option, because these types of tests are associated with fewer false negative results, according to Harvard Health.

Here are the four essential market needs that must be addressed in any COVID-19 testing approach:

• Low cost per test: To ensure widespread adoption and availability, at-home COVID-19 tests should cost no more than a latte.
• Accessible, easy-to-use and readily available: Users should be able to take their own samples, then process those samples at home via a portable analysis device that connects to a smartphone app.
• Quick access to results: After a sample is obtained and placed into the device, results should be available to users within approximately 30 minutes.
• High performance: Tests should be proven to achieve at least 95% accuracy, enabling greater confidence in the results and less-frequent testing.

While it’s important to acknowledge the scientific breakthroughs associated with the development of the COVID-19 vaccine and its speedy rollout in the U.S., we can’t lose sight of the need to improve management and containment of the virus across the globe. For that to happen, the world needs access to rapid, convenient, reliable infectious disease testing. A return to “normalcy” – however that may be defined in the era of COVID-19 – depends on it.

Ron Chiarello is founder, CEO and chairman of Alveo Technologies, developer of a diagnostic platform for detecting and managing infectious diseases.