Push For Home-Based Tests Offers Benefits But Makes Tracking Cases Difficult

Health experts say more people may soon be testing for Covid-19 right from their homes as the Biden administration pushes at-home tests

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More people may soon be testing for Covid-19 right from their very own homes. The Biden administration announced ramped-up efforts Monday to make rapid at-home tests more widely available, while also lowering costs.

Covid-19 has been a part of life in the U.S. for more than a year and a half, but the co-founder of one testing company says right now demand for at-home Covid tests is up.

“At-home testing is at an all-time peak,” Jason Feldman, co-founder and CEO of Vault Health, said. “It's largely been because employers are bringing their employees back into the office, or they want to, and then we have schools and universities that are trying to keep kids in class.”

Vault Health produced the first FDA-authorized at-home PCR tests. Feldman says increased demand for home tests comes as businesses prepare to implement President Joe Biden’s vaccine or test mandate. It will require all companies with 100 or more employees to ensure their workforce is fully vaccinated, or require unvaccinated workers to provide a negative test at least once a week.

“Employers are going to be left with the responsibility of making sure that their employees are able to come back to work and stay safe. So with that, the number of tests required are going to be in the tens of thousands a day,” Feldman said.

To help meet the need, the Food and Drug Administration announced Monday it is streamlining its authorization process. The National Institutes of Health will spend $70 million on a new program to accelerate test-makers through regulations. That funding comes from the American Rescue Plan.

“Every tool we have in our kit to decrease risk for Covid is a is a is a step forward,” Sheldon Campbell, professor of laboratory medicine at Yale School of Medicine, said.

Campbell says though, the cost of at-home tests is still too high for widespread use. It is something the Biden administration has faced criticism for.

“At $15 or $20 a test, they're pretty expensive and pretty hard to deploy to large numbers of people. They are too expensive to have a whole lot of impact right now,” Campbell said.

Connecticut Public Health Commissioner Dr. Manisha Juthani says while at-home tests do provide quick results, they present a problem: there is no way to track positive cases.

“Home-based testing really serves a different function, it doesn't serve the same function that we as a public health department might do in terms of tracking rates,” Juthani said. “Certainly we can't track them at a larger level, because their home tests, that's exactly what they are, they will not feed into our rates.”

Feldman says Vault Health is taking measures to address that dilemma. Clinicians monitor the administration of PCR tests via Zoom.

“The challenge with rapid tests is we don't know who's taking them,” he said. “We make sure that when somebody is spitting in a tube or swabbing their nose, that it's occurring in front of us. We report those results directly to the state and to the employee or the patients, and they know where their status is, and so does the state. So it's a very validated, closed-loop process that ensures integrity in the testing.”

Most home-based tests, however, do not have that oversight. Juthani says positive at-home results will be counted in state data when people voluntarily report those cases to a health care provider go in for confirmatory tests.

Despite the push for more home-based tests, she says vaccination remains the pathway out of the pandemic.

“We know that that's going to be the way that we don't need to test as much anymore, don't need to quarantine as much anymore, don't need to isolate as much anymore, because your chances of getting Covid are so much less if you're vaccinated,” Juthani said.

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