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Can we test our way out of COVID-19?

Last week the Centers for Disease Control and Prevention (CDC) came under attack again for its new guidelines suggesting that brief exposure to a person with COVID-19 didn’t automatically mean that an asymptomatic person needed to be tested. 

But Dr. Robert Redfield, CDC director, explained to me in an interview on SiriusXM’s “Doctor Radio” that he was all for testing asymptomatic contacts provided that “testing should be actionable from a public health point of view.” In other words, the medical personnel necessary to perform the contact tracing are essential to the process.

Last week a patient came to my office and told me that his building superintendent had been working in his apartment for several hours and later tested positive for COVID-19. My patient was asymptomatic, but I sent him for a test as a precaution. It was negative. Dr. Redfield told me that he agreed with having this patient tested, isolated, and all his contacts traced, if positive. 

But even with close to 80 million COVID-19 diagnostic tests performed in the U.S. since the start of the pandemic, there still is frequently a several-day delay between testing and results, which makes contact tracing very difficult. The gold standard is still the polymerase chain reaction test developed in the 1990s, which looks for the specific genetic material (nucleotide) unique for this coronavirus. 

Yet, now, several faster, cheaper antigen (protein specific to the virus) tests are in the works; an accurate saliva test was recently released and approved by the Food and Drug Administration (FDA), and a breathalyzer-type test also is in the works.

Binax Now, made by Abbott Labs, received an emergency use authorization by the FDA. “I think it’s a game-changer,” Dr. Redfield told me on “Doctor Radio.” I think he’s right.

For one thing, the FDA is reporting a 96 percent to 97 percent accuracy rate based on clinical trials. For another, its cost is only $5 per test and results are available in as little as 15 minutes — a true point-of-care test. Thirdly, the test utilizes a so-called lateral flow technique, which doesn’t rely on elaborate, large lab equipment to analyze the results. So it may be portable and usable in doctor’s offices, ambulances, schools, universities, sports events and, yes, even at protests or riots.

The Trump administration announced last week that it would purchase 150 million of these rapid coronavirus antigen tests for $750 million. Abbott has indicated that it is preparing to ramp up production to 50 million tests per month, beginning in October. So this new test will not be a game-changer just in terms of speed, price and accuracy but also because it should be widely available. 

Abbott or a similar product — perhaps combined with a breathalyzer or saliva test — may bring us all to the point of self-testing soon, by which you can determine your results and beam it out to those you want or need to see it via your smartphone. But, in the meantime, it already is a significant breakthrough in screening for coronavirus. Our nurses or technicians will be able to test large populations who are at some risk of having COVID-19, determining not just who has the virus but also an accurate view of the virus’s prevalence throughout a community. 

The next hurdle will be to use the test results wisely to guide behavior and decrease the spread of the virus, to promote public health solutions across the board rather than as a provocation for more fear and hysteria or as a justification for more excessive shutdowns, leading to a mental illness pandemic of unprecedented proportions.

Can we test our way out of COVID-19? No, we can’t — but, combined with consistent public health messaging and calm compliance, and a likely vaccine, we can be on the right road to getting there.

Marc Siegel, M.D., is a clinical professor of medicine and medical director of “Doctor Radio” on SiriusXM at NYU Langone Health, and a Fox News medical analyst. He is the author of six books, including “COVID; the Politics of Fear and the Power of Science,” which will be published in September.

Tags Coronavirus disease Health Infectious diseases Occupational safety and health Robert Redfield Zoonoses

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