In July, I wrote a short update blog on the COVID-19 diagnostic situation. At the time, governments around the world seemed to be operating relatively stable testing systems, capable of turning around reliable results in a timely manner. However, as schools and workplaces have begun to reopen, the demand for testing has started to increase, placing many systems under considerable pressure. In the UK, for example, we are now seeing sporadic reports of shortages of tests, individuals being turned away from drive-in facilities and a slowing of the result turnaround time. This situation is now being seen, to a lesser or greater extent, in many countries around the world.1
As we have discussed previously, having access to reliable and rapid testing technology is an absolutely critical component of tackling any pandemic. Molecular testing currently dominates our response to COVID-19 because it is highly accurate. However, this type of lab-based testing is a complicated process which can quickly stall at times of elevated demand; the samples generally need to be 1) collected via a throat swab by a trained technician at an appropriate location, 2) sent away to a specialist facility for analysis and 3) returned the individual in a timely manner. Each of these three components can represent a ‘pinch-point’ in times of high demand, and this seems to be what many governments are beginning to experience at the time of writing. This has really put the current system under the microscope, and has seen the search for alternative testing methods intensify.
In July, I introduced the concept of rapid antigen testing. At that time, the US Food and Drug Administration (FDA) had granted Emergency Use Authorisation (EUA) to just two rapid antigen tests from major US diagnostic firms. While these tests undoubtedly offer a quicker alternative to molecular testing, they both still require a lab facility and specialist instrumentation to perform. Since July, two further antigen tests have been approved, one of which being a visually-read technology from healthcare company Abbott.