At this stage of the pandemic, rapid antigen and molecular testing should be ubiquitous and cheap.

Almost from the beginning, federal officials, including former President Donald Trump, touted the advantages of rapid testing, such as those made by the medical giant Abbott’s laboratories.

Dr. Michael Mina, an epidemiologist, immunologist, and former professor at Harvard University's Chen Zengxi School of Public Health, has believed for months that rapid antigen testing is a way to get rid of the pandemic in the country.

But at community testing sites in Colorado, the testing contractor COVIDCheck Colorado and the state's Department of Public Health and Environment have phased out rapid CUE molecular testing.

Instead, the testing site has reverted to only free PCR testing.

With the phasing out of rapid testing at community sites, public health officials have lost a key tool because of the surge in COVID-19 cases in the state.

Liane Jollon, executive director of San Juan Basin Public, said: “Although we are entering Colorado where there seems to be a major winter surge, we are still in a situation where we are unable to conduct extensive rapid testing.” Health.

"We think (rapid testing) will increase our methods of disease control," she said.

In May 2020, the U.S. Food and Drug Administration announced that it had authorized the first antigen test, which could help public health officials track the spread of the coronavirus.

"Antigen tests are also important in the overall response to COVID-19 because their production costs are usually lower than PCR tests, and once multiple manufacturers enter the market, they may expand to test millions of Americans every day. . A simpler design helps our country to determine infection rates closer to real-time,” former FDA Commissioner Dr. Stephen Hahn and FDA Center for Equipment and Radiological Health Director Dr. Jeffrey Shulen said at a press conference.

Since May 2020, the FDA has authorized 40 antigen tests to detect proteins in viruses instead of genetic material, and about a quarter of them are non-prescription home tests.

Family diagnosis has always been a special focus of federal and state testing. The logic is that cheap and accessible testing will help Americans to screen themselves frequently and limit transmission.

The Biden administration has made free and rapid home testing a pillar of the President’s COVID-19 action plan. The state announced in September that CDPHE will launch a free, rapid home testing program in which Colorado people can request testing, and the state government will ship the test results to their homes.

However, even though the FDA has approved some rapid home tests and the government has locked down public health tools, they are still in short supply and are hard to find nationwide.

A recent study by the Kaiser Family Foundation found that the FDA's regulatory framework, lack of initial investment by the federal government, changing information and guidance, the cost of rapid testing for non-prescription homes, and the unpredictability of the supply chain and demand all limit rapid Test availability and access.

Some believe that economy and profit play a huge role in quickly detecting shortages.

The New York Times reported in August that Abbott Laboratories asked a production plant to destroy tests after sluggish demand and reduced case rates.

In mid-September, the San Juan Basin Public Health Department announced that community checkpoints operated by COVIDCheck Colorado and CDPHE will phase out the use of CUE rapid tests before mid-October.

The press release said: "COVIDCheck Colorado has decided to coordinate with CDPHE to stop providing CUE COVID-19 testing in order to alleviate the major logistical and operational challenges faced by staff."

A few days later, Governor Jared Polis announced that the state would provide residents with free quick tests at home.

A CDPHE spokeswoman said in an email that the state purchased 2 million Abbott BinaxNOW rapid antigen tests in September, and 500,000 were purchased earlier this month, with no supply issues for its home test program.

The spokeswoman said that the state receives 97,768 tests every week, and as of Monday, it has shipped 907,470 over-the-counter test products.

Jollon said it is best for people to conduct multiple tests a week to monitor transmission more closely.

"This is a strategy we have seen in some other countries, and (that) has been discussed in the United States, but we have not yet," she said. "We basically rely on more expensive diagnostic tests to guide our disease control strategies.

"If we can conduct rapid testing more widely, we can develop disease control strategies so that everyone in the school or workplace will be tested frequently," she said. "This will require a lot of cheap, widely available quick tests."

According to these standards, although CDPHE's test plan is successful, there are still shortcomings.

A total of 907,470 BinaxNOW tests were shipped, including two per box, and even one test was not allowed for all Colorados.

At community testing sites in Colorado, PCR testing is still the only tool, making local public health officials doubt whether rapid testing will be provided soon.

"The faster the results come out, the better for us," Qiao Lun said. "We hope to see more quick tests available."

Traditional PCR tests are diagnostic tools that can confirm diseases and allow doctors to treat patients.

Dr. May Chu, a clinical professor at the Colorado School of Public Health, said: "We are sure that you have received this test."

"The PCR test is indeed a critical diagnostic test," she said. "We determine a patient and whether that patient needs treatment."

But PCR testing requires laboratories and professional and expensive equipment to process samples, which usually takes 24 to 72 hours.

She said the test itself is expensive, costing $100 or more.

In contrast, Abbott’s BinaxNOW COVID-19 test costs $23.99, can be done at home, and produces results almost immediately.

For epidemiologists and public health experts, rapid antigen and molecular testing serves a basic function: surveillance.

"Public health testing is different from diagnostic testing," Zhu said. "...You are considering reducing the risk.

"When you conduct surveillance, it is important to know the infection rate in the community," she said.

Although the accuracy of rapid antigen detection is about 15% to 25% or more lower than that of PCR detection, it is less costly, faster in turnaround, and easier to produce, so more extensive and more frequent screening can be performed.

Public health experts can then use this data to understand transmission and make important decisions about quarantine and other life-saving preventive measures.

"(The monitoring test) allows you to understand the burden or burden of disease in the community," Zhu said. "From a public health perspective, reducing the burden as much as possible is success."

"Ideally, we want to have both (PCR testing and) a fast-acting screening tool that we can deploy to people widely, whether they have symptoms or not," Qiao Lun said. "If you are going to school or you are going to work in a key service department, you can take multiple tests a week. (Conducting) multiple screening tests will correct the lower accuracy.

"If you have cheap, widely available rapid tests, even if they are not 100% accurate, it provides you with another way to quickly identify positive individuals and pull them out of the environment where they might spread the infection," Qiao Lun Say.

Sign up for our daily email newsletter or receive breaking news sent to your inbox:

Choose from multiple print and digital subscription packages

© 1996–2020 Durango Herald | Ballantine Communications, Inc. All rights reserved. | Terms of Use | Privacy Policy