Rapid Tests Aren’t Useful if You Can’t Access Them
Experts argue that limiting access defeats the purpose of rapid testing
On Monday, the U.S. Food and Drug Administration (FDA) authorized Quidel’s Quickvue at-home rapid test for emergency use, bringing up the number of rapid tests authorized by the FDA to four.
Some experts have been calling on the U.S. government to scale up at-home rapid testing for months, arguing that they’re a critical tool for stopping the spread of Covid-19. Rapid tests allow a person to know — in real time — whether they are contagious and have to quarantine. Experts argue that making these tests freely available to people to regularly use at home would encourage them to test themselves more frequently, which, in turn, would greatly reduce the number of contagious people out in public and reduce the spread.
The FDA’s authorization of such tests is a step in the right direction, but critics have pointed out that the tests still won’t be widely available, and thus, the FDA has missed the point. The Quidel test is only authorized for prescription use, which means that a person must still go through their health care provider to access it.
“Yet another decision to take a good rapid test and decrease accessibility and increase cost by requiring a (useless) physicians prescription,” tweeted Michael Mina, PhD, an assistant professor of epidemiology at Harvard T.H. Chan School of Public Health who has been among the most vocal proponents of rapid testing, on Monday. “No person should need a medical prescription for a #Covid19 test.” He argues that requiring a physician’s signature will not only make people less likely to use such tests but also make access to testing more inequitable than it already is.
So far, only one of the four FDA-authorized rapid tests do not require a prescription to use: the Ellume antigen test, which was authorized in mid-December. The Lucira Covid-19 All-In-One Test Kit, which became the first to be authorized in November, and Abbott’s BinaxNOW Covid-19 Ag Card Home Test, also authorized in December, both require prescriptions. These tests don’t come cheap, either: according to AARP, Ellume’s test costs about $30; BinaxNOW costs about $25, plus overnight shipping; and Lucira’s costs about $50. It’s not clear yet how much Quidel’s test will cost. As Rep. Kim Schrier of Washington pointed out in a February statement, “at $30/test, [Ellume’s test] is impractical for at-home screening on a regular basis.”
A recent national survey, led in part by Harvard’s Center for Communicable Disease Dynamics, found that 86% of Americans say they would use at-home rapid antigen tests to stop the spread of Covid-19. The problem is that a minority of people are aware such testing exists. Together, these data points suggest a “strong consumer demand and support for a federal national testing program, if the public is informed,” according to the report.
The pressure is on the Biden administration to ramp up its support for rapid testing. In February, it said it would buy 8.5 million of Ellume’s tests and invest in six additional companies to produce 61 million rapid tests by the end of the summer, as NPR reported. Many experts have argued that 61 million tests would not be enough, especially as more transmissible variants, which increase the risk of infection, continue to circulate. Rapid testing must scale up, and doing so in a massive way is possible: As Mina has pointed out, there are many highly scalable tests that “work as well” as Abbott’s BinaxNOW test that are with the FDA but have yet to be approved.