The next Covid Wave will be quickly tested

COVID-19 tests were in such low supply during the winter omikron increase that most infections – some estimates affecting three out of four Americans – could not be fully diagnosed. Now, with lots of rapid testing and another growing wave of cases, we may soon face a different problem: a huge number of infections will be missed in the coming months. Because This test is so comprehensive.

America’s covid-identification program has entered a new phase. Thanks to the federal government’s commitment to the entrance of new over-the-counter diagnostic manufacturers and the sending of up to eight tests to each home, at the moment, the chances of getting through a covid diagnostic lab are much higher than through self-swabbing. -Based PCR strategy. IHealth, one of more than a dozen companies, is producing 300 million faster antigen devices per month, while all the labs in the country combined have been able to conduct only 2.5 million tests a day. Because rapid results are rarely reported in public-health agencies, this means that our early-warning system may now be somewhat less sensitive than before. More importantly, the ubiquity of these tests combined with the subsequent wave of illness can lead to a wave of false-negative results – and thus a wave of missed opportunities for treatment.

The idea that rapid tests may not be completely reliable emerged during the omikron outbreak, when Americans were becoming accustomed to running only their own temporary private laboratories. In the wake of the sudden, unprecedented viral tsunami of winter, for the first time, millions of citizens have been unwittingly called upon to self-examine. Consumers have sought help from social media, where misinformation has spread. Many people experience confusion and remorse when their home devices miss the case, putting their friends and family at risk. The need to explain away these false negatives became almost non-existent. Written by experts Twitter thread Taking readers through evolving science. People thought that quick tests against the Omicron variant no longer worked. There was speculation that an additional throat sample was needed on top of the standard nasal swab, and the media outlets gave instructions on how to do it – openly Contempt FDA.

The dust has now settled, and the answer to why so many tests have been shortened is relatively simple: many people have received false-negative antigen results because this technology can always produce false-negative. Tests faster than the gold-standard PCR method are reported to miss about 30 to 40 percent of infections (which is not already perfect), even if patients feel sick; Self-swabbing is also less accurate than professionally obtained samples. In the meantime, multiple studies have confirmed that the current crop of rapid tests may actually pick up the Omicron variant, and experiments with throat swabbing suggest that the technique may help somewhat, but it is not a game changer. In other words, incorrect COVID test results have become more common during Omicron growth simply because COVID’s home testing itself has become more common. Now both will be more common.

Proponents of rapid-testing have long emphasized the public health potential of the technology: despite these affordable devices being missed in many cases overall, they still actively diagnose the majority of infected people (especially through repeated testing). Extensive screening of asymptomatic individuals has been encouraged to keep the public safe and help break the chain of transmission. Under this test model, it was not important to get an incorrect result, as the person was not likely to spread the coronavirus. But things are very different in 2022: the Biden administration is in the midst of launching a nationwide test-to-treatment program, where local pharmacies and health centers will provide on-site testing and instant prescriptions for anyone to be positive. Covid’s primary treatment options are antiviral pills such as Paxlovid and Malnupiravir, infusions such as remedicivir and monoclonal antibodies and can be expected. Other options Coming soon – Promise to blunt some of the remaining risks from the virus among immunized and high-risk vaccinated individuals. Since these treatments must be started within five to seven days of the onset of symptoms (depending on the therapy), timely receipt of a positive result is required for eligibility – and rapid tests will be essential. So what happens when an Omicron-era study finds that one in four patients whose symptoms started last week will be missing an antigen test?

Repeated self-examination after a negative result is officially recommended. Still, some users may feel confused after months of publicity for quick test suggestions About 100 percent caught In the case of “contagious”. The difference between “infected” and “contagious” – that is, those who are carrying the virus and those who are carrying the infection large enough to infect others – will be lost to many ordinary consumers, but the former is all a matter for treatment. Weak individuals who are experiencing symptoms such as Covid may be less concerned about whether they are contagious, or whether Paxlovid’s rules will reduce their risk of hospitalization or death by 88 percent. With so many bets, a single negative quick test won’t provide enough clarity.

Even if rapid testing is preferred, follow-up PCR samples should still be used to exclude treatment requirements. Repeating the antigen test for a few days will also help. Healthcare providers participating in the test-to-treat program may offer such guidance directly, but many people with a negative diagnosis at home are forced to feel falsely reassured without more explicit scientific coaching. The use of rapid testing can increase the speed of advanced learning when the case rate is moderate.

The growing availability of home testing is a blessing in disguise, as is the development of effective outpatient interventions for COVID. Yet the combination of these two advances could probably create a false-negative wave – in the coming weeks, from the BA.2 sub-variant, or later, from some other future viral offshoot. If the infection reaches the historic peak of Omicron again, millions of treatable cases could be missed with just one antigen test each time. The official White House line is that Americans now have “all the tools we need to protect each other and to treat COVID-19.” But to save every life we ​​can, the public must first know how to use these tools properly.

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