An inexpensive, 30-second strip test taken twice a week in the privacy of one’s home can get the country back to normal in a matter of weeks, says a Nobel laureate and Harvard microbiologist.
Michael Mina, M.D. and Ph.D., a professor of epidemiology and immunology at Harvard University, and Paul Romer, Ph.D., co-recipient of the 2018 Nobel Prize in economics, were blunt in their assessment at a December 10 virtual event hosted by The Heritage Foundation.
“Every day we are not doing this, we are losing ground,” said Mina.
“Imagine if we can test everyone in the U.S. and quarantine all those infected for just a week,” said Romer. “We could stop this virus in its tracks basically within a week.”
Mina and Romer have been advocating this response since March, but the public focus has been on lockdowns, social distancing, masks, and vaccine development.
“Policymakers have locked themselves into a losing strategy,” said Doug Badger, a visiting fellow at The Heritage Institute, at the panel discussion.
Worse, says Badger, is public health leaders’ suggestion that the public isn’t trying hard enough to be safe and it is time to move forward.
“We are at a juncture now, that we need to change strategies,” Badger said.
Mina showed an example of the strip test, a plastic two-inch case containing a piece of paper.
“You can build these in the millions, every single day,” said Mina during his presentation. “We can put these in peoples’ homes so that when people brush their teeth, they take a COVID test.”
If the test is positive, the consumer could stay home for a few days until another test shows a negative result, usually within a week.
“This is a tool that provides immediate feedback so they can do what they do normally do, safely,” said Mina.
Currently, Americans are using the PCR test, a nasal swab test that takes seven to eight days to process.
“We have people standing in line for hours for a test that is ultimately useless,” said Mina during the discussion.
Mina says he understands why the PCR, which must be administered and interpreted by a health professional, has become the test of choice for health agencies. One concern is that a rapid test will encourage individuals to let down their guard, “to go out and party,” says Mina.
“Not everyone ‘parties’ all the time,” said Mina. “This is not going to be a license to party. The same thing was said about HIV—if you give people their HIV status, everyone would go out and have sex. The same thing was said about seatbelts, that they would cause everyone to drive recklessly.”
Set Target, Launch
To control public infection rates, the nation would have to determine how quickly it wants to eliminate the virus and scale up the tests. Two things would factor into the equation: the costs of lockdowns and the “R” factor, a disease’s reproduction rate—how many people get sick based on the spread of one infected person.
“The strategy has been, let’s restrict the activities of everyone because we don’t know who is infected,” said Romer during the presentation. “If you knew who was infected, you could put restrictions on only those who are infected. Then you don’t have to suffer the enormous costs that we are bearing.”
Mina and Romer both say mathematical projections for controlling COVID with rapid testing have already been determined.
“If you start with a raging epidemic, like where we are right now, and you just get 50 percent of people to use this, within a month, we would see enormous gains,” said Mina.
“It is a social choice, how quickly we want to stop the virus,” said Romer during the panel discussion.
The prospect of testing every American simultaneously and keeping those who are positive at home for a week may not be realistic, but getting somewhat closer to that would help, says Romer.
“Once you know who is infected, is not that hard to solve this problem,” said Romer.
What Will it Take?
Another way of getting the pandemic under control is with a vaccine, which is now underway, as two vaccines received emergency use authorizations from the federal government in December. The panel, however, says it will take months for a vaccine to have a significant effect.
The Trump administration has purchased about 150 million rapid tests for pilot studies, at $5 a test, which is a positive step, says Mina, but for the strategy to have a quick and significant impact the country would have to make available 10 million to 30 million tests per day.
Mina says the nation would also have to overcome pushback from the scientific community and get support from the U.S. Food and Drug Administration (FDA).
“There is a view in science that if it is not perfect, it is not worth doing,” said Mina during the discussion.
The FDA has approved rapid tests, but with restrictions. One test requires a doctor’s prescription, and physicians are required to report results to public health agencies (see related article, page 5). Restrictions also make providers leery of liability.
As of mid-December, Congress was considering a new COVID relief bill that did not include rapid testing. Mina says the tests can be produced for under $1.50 and they can be distributed cheaply.
“Congress is in Santa Claus mode, where it thinks its job is to collect taxes and send checks to people, costing hundreds of billions of dollars,” Romer said during the discussion. “Why are we doing that instead of spending $20 billion or $30 billion on something that would just end this pandemic?”
AnneMarie Schieber (firstname.lastname@example.org) is managing editor of Health Care News.
“Virtual Event: Rapid COVID Tests: A Cure for Lockdowns, A Complement to Vaccines,” The Heritage Foundation, December 11, 2020: https://www.heritage.org/public-health/event/virtual-event-rapid-covid-tests-cure-lockdowns-complement-vaccines