Dr. Michael Mina thinks there’s a simple way to beat back COVID-19: fast, cheap tests, taken at home every day or two.

Right now, tests are designed for medical purposes. They identify whether someone with symptoms has COVID-19 or not. But they miss – according to Mina’s estimate – 97% of people when they are most infectious.

COVID-19, we now know, is most contagious in the first few days – just before a person shows symptoms and in the few days after symptoms start, if they ever do. Waiting until someone has symptoms before scheduling them for a test, means they won’t know they were contagious until they aren’t.

In recent weeks, Mina, an infectious disease epidemiologist at the Harvard T.H. Chan School of Public Health, has been lobbying heavily for fast, cheap, at-home tests, hoping to get the federal government to fund their development and remove barriers to their approval. He’s spoken with senators, foreign leaders, and company executives, who share this idea, but is increasingly frustrated by the administration’s inaction.

Dr. Michael Mina

On Friday, he laid out his vision to reporters on a group Zoom call. What follows is an edited version of what he said.

What’s the difference between current COVID-19 tests and what you’re envisioning?

The tests that are being deployed now are like deluxe espresso machines. These are tests that require instrumentation. There’ll be a big, big startup cost to get it going and each individual test will be expensive. They will have a difficult time getting the scale to where it needs to be to make an impact on a population level. What I really want is the instant coffee version. I want a $1 thing versus a $20 thing.

How can tests be used to stop transmission of COVID-19?

The way to do that is to use cheap tests that are highly accurate to detect somebody at the moment they’re transmitting. People can act on it, because they’re getting immediate results. I want them to take them every single day or every other day.

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How could they act on it?

If we can get a test that everyone wakes up – just like they put in their contact lenses –they take a test. And if it turns positive, they stay home. And they take a test the next day and they stay home until the test turns negative, or for a set number of days, maybe 7 days.

That alone, if everyone’s doing it, or even just a majority of people are doing it, it will stop the vast majority of transmission and it will cause these outbreaks to disappear in a matter of weeks. We don’t have to wait for a vaccine.

You think it would make that much of a difference?

We could reduce maybe by 90-95% transmission in this country in the next few weeks if everyone could have one of these tests tomorrow. Of course, that’s not at the moment possible, but it could be if the federal government were treating this with the same urgency that they’re treating a vaccine, which may or may not even work.

What do you think the government should be doing?

(The government should) put $1 billion into really pushing the technology for $1 paper strip tests that can be printed in the millions, which they can be, and get a package of 50 in every American’s hands over the next month – or not even every American – it could just be Texas, Arizona and Florida right now, because those are the states that are seeding infections to other states.

Why don’t these tests exist already?

We’re allowing red tape and this archaic view – we have so defunded and under-appreciated public health in this country for so many years that we literally don’t have a recognition of the fact that there could be a test whose main goal is public health and not clinical medicine. Everything is wrapped up in insurance reimbursements and FDA regulations as diagnostics. It takes a whole rethinking of what a test that somebody might use looks like and how it’s defined.

So, this is a regulatory problem?

I’m usually not against regulation, but it’s just gotten so extreme here, and it’s truly been hindering every step of the way our ability to test our way out of this virus since February. The current landscape is bottlenecking these companies that could have a cheap test today into producing a more expensive espresso machine, because they can’t actually legally use the instant coffee.

Until the regulatory landscape changes, these companies have no reason to try to bring (a fast, cheap, at-home test) to market. So, a lot of them are just kind of sitting on it. Or they’re trying to spend more time and more money to better and better optimize tests, which might take months. My fear is that what will come out of it at the end of those months is a test that does meet FDA approval, but that’s too expensive and too complicated to scale and use for everyone.

How do you answer people who criticize cheap tests as being less precise or reliable than the current tests?

A lot of people are wasting time trying to figure out how to get instant coffee to be as good as espresso. They’re different things.

Do you have any financial stake in any of the companies making these tests?

I have no financial ties or any other connection to any of these companies. I’m truly just basing this on science.

And you really think this is the best hope for getting a handle on the pandemic?

We don’t have a vaccine tomorrow. We don’t have anything but shutting down the economy and keeping schools closed. This can work. This is a tool that tomorrow could start to go into production and within a few weeks’ time could start to change the whole course of outbreaks in major cities in America and in so doing, make all of the United States safer.

Contact Karen Weintraub at kweintraub@usatoday.com

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: COVID tests: Cheap, at-home tests will stop pandemic, Harvard doc says



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