Testing Won’t Save Us From COVID-19
The theory of fast testing fails to account for real life's messiness
We've known it since the early days of the pandemic: To stop the spread of COVID-19, we need more and better testing. But with the crisis marching toward what could be a very dark winter, this old and sensible idea has lately been recast as a fantasy solution. If our COVID tests were only cheap enough to make, and prompt enough in delivering results, according to Harvard epidemiologist Michael Mina, then we could “quickly contain and end this terrible plague.” Let’s call it the Theory of the Magic Testing Cure: Give the masses inexpensive, instant, at-home diagnostics, and everyone who is infectious will know to put themselves in quarantine. “The tests actually become the intervention,” said Mina.
His theory has been gaining both attention and adherents since July. “To get out of this pandemic, we need fast, easy coronavirus testing that’s accessible to everyone,” The New Yorker’s Atul Gawande wrote earlier this month. Now even governments are signing on: The UK has lately worked up a $130 billion “moonshot” scheme to implement rapid testing on a massive scale; in the US, a similar plan appears to be on the table in Maryland. But all this enthusiasm may be premature, at best. The Magic Testing Cure is based on several key assumptions that may not pan out, and a dangerously narrow understanding of the pandemic.
Let’s start with the basics: The cheap test for which Mina and others have been advocating is called a rapid antigen test, and it looks for proteins on the surface of the virus that causes COVID. Like an over-the-counter pregnancy kit, it’s cheap, quick and easy to use in the privacy of your own home. The downside is that antigen tests are far less accurate than PCR tests, which have so far been the standard means of diagnosing the disease.
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