As At-Home Coronavirus Tests Hit Pharmacies, What Role Can They Play In The Pandemic?

By Mano Sundaresan NPR

As of this week, you can buy relatively low-priced COVID-19 rapid tests to take at home. The tests are available through pharmacies and do not require a prescription to buy one.

This bit of good news comes the same week that all people ages 16 and up in the U.S. are eligible to get a vaccine. The Food and Drug Administration authorized Abbott’s BinaxNOW and Quidel’s QuickVue at-home tests in late March. Both are antigen tests. The BinaxNOW test is currently available and Quidel says it expects to start shipping the QuickVue tests next week.

Antigen tests are less sensitive than genetic PCR tests, which are often considered the “gold standard” of testing, but the antigen tests do provide rapid results and can detect both symptomatic and asymptomatic cases in the window when someone is infectious. The BinaxNOW tests that are authorized for over-the-counter use are sold in packs of two, so users can test themselves twice, 36 hours apart. The sequential testing is designed to catch an infection that may just be ramping up.

“They are very reliable, if the question that you’re asking and the reason that you’re taking the test is, am I infectious right now and a risk of transmitting the virus to other people?” says Dr. Michael Mina, a Harvard epidemiologist who has advocated for at-home testing. “These tests work exceptionally well for that question.”

The BinaxNOW test retails for $24 for two tests. Mina says he hopes the price will decrease to roughly $1-3 per test as time goes on.

“Right now in the United States, there’s no market competition, so I hope that more tests will be authorized to either drive down the prices or that the government could subsidize the price of these tests,” says Mina. “Using a test like this is a public health good.”

This interview has been edited for length and clarity.


Interview Highlights

On the necessity of at-home COVID-19 tests

I think the landscape has shifted dramatically, in a good way. What we do need today is to have enough tests so that people can know — if they have a reason to think that they might be infectious and want convenient access to a test without having to go and wait for days to get a result back from a PCR laboratory. There is still a role for that. … We’re going to see kids get their normal illnesses and these tests are going to be crucial to enable parents and others to be able to know in real-time whether their child has the virus or if they just have a regular childhood cold.

On how these tests can serve as a backup plan

Come fall and winter, should anything go wrong with the vaccines, we need backup plans, and thus far into the pandemic, we have had essentially no backup plans and we’ve had over half a million deaths as a result. If new variants come around that get around people’s immune systems, especially in elderly, whose immune systems a year after they get vaccinated might be waning in terms of their level of protection, we want to be able to limit spread as much as possible. And these tests are our eyes to be able to see where the virus is and whether we’re at a risk of spreading it to people who could become sick.

On frustrations regarding the slow rollout of these tests

Had these tests been rolled out in the middle of last year in large numbers, we could have potentially seen hundreds of thousands of fewer deaths by preventing the surges. Instead, we had a lot of testing where nearly all of it was effectively useless to help slow spread [because getting results took so long.] But we can’t roll back time, and so I hope that in the future we develop the regulatory framework that would enable tests to be considered in the context of public health versus medicine, and that the speed of getting them authorized would be commensurate with the danger and risks posed by the pandemic upon us.

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